In vitro fertilisation (IVF) is a process of fertilisation where an egg is combined with sperm outside the body, in vitro (“in glass”). The process involves monitoring and stimulating a woman’s ovulatory process, removing an ovum or ova (egg or eggs) from the woman’s ovaries and letting sperm fertilise them in a liquid in a laboratory. The fertilised egg (zygote) undergoes embryo culture for 2–6 days, and is then transferred to the same or another woman’s uterus, with the intention of establishing a successful pregnancy.
IVF is a type of assisted reproductive technology used for infertility treatment and gestational surrogacy, in which a fertilised egg is implanted into a surrogate’s uterus, and the resulting child is genetically unrelated to the surrogate. Some countries banned or otherwise regulate the availability of IVF treatment, giving rise to fertility tourism. Restrictions on availability of IVF include costs and age to carry a healthy pregnancy to term. IVF is mostly attempted if less invasive or expensive options have failed or are unlikely to work.
Common questions related to In Vitro Fertilization (IVF) and Pregnancy
Will the IVF technique damage my ovaries?
There is no evidence to suggest that either normal laparoscopy or ultrasound egg retrieval damages the ovaries. In fact, some reports in the medical literature suggest that following ovarian biopsy, pregnancies occur in couples with a long-term history of infertility.
Will scar tissue around my ovaries make it impossible to retrieve the eggs?
Not ordinarily. The surgeon must be able to see the follicles in order to guide the needle to the proper spot for retrieval of the eggs whether by sonographic (ultrasound) or surgical methods.
How many embryos do you transfer?
That depends on each patient and embryo quality. Ultimately, it is up to each couple.
What if I ovulate before oocyte (also called egg or ovum) retrieval?
Once ovulation has occurred it is impossible to retrieve the eggs. The entire team of physicians, nurse and embryologist will monitor your cycle very carefully to avoid premature ovulation.
If an egg is not retrieved or if the technique does not produce a pregnancy on the first attempt, how soon can the procedure be repeated?
This depends on the individual. The primary reason for delay is to allow the patient’s normal menstrual cycle to resume, which may take 2 to 3 cycles.How many times will IVF be repeated per couple?There is no specific number. This is determined by the couple together with the physician.
Can we have intercourse during the two-week period before an IVF procedure is performed?
Yes. We recommend that the husband refrain from ejaculation for at least 48 hours, but for no more than 5 to 6 days preceding egg retrieval. This precaution assures that the semen sample obtained for IVF will contain a maximum number of healthy, motile sperm. For those couples who have male factor issues, please speak with your IVF coordinator for more information.
After the IVF procedure, how long must we wait to have intercourse?
Although a definite time of abstinence to avoid damage to the embryo has not been determined, most experts recommend abstinence for two to three weeks after egg retrieval. Theoretically, the uterine contractions associated with orgasm could interfere with the early stages of implantation.
What about other activities? How soon can I resume my normal routine?
It is recommend that the patient be sedentary for a full 72 hours following the transfer process. Strenuous exercises such as jogging, horseback riding, swimming, etc. should be avoided until pregnancy is confirmed. Otherwise, the patient is free to return to her regular activities.
How soon will I know if I’m pregnant?
Pregnancy can be confirmed using blood tests about 14 days after egg aspiration. Pregnancy can be confirmed by ultrasound 30 to 40 days after aspiration.
Will I have an egg in every follicle?
It varies from patient to patient . As many as half of the follicles may not contain an egg in some patients.
Is there a possibility of multiple births with IVF?
Yes, when multiple embryos are transferred 25% of pregnancies with IVF are twins. (In normal population, the rate is one set of twins per 80 births.) Triplets are seen in approximately 2-3% of pregnancies.
Is there an increased chance of birth defects if I become pregnant through IVF?
There are no known ill effects. Abnormal embryos, even those produced through normal fertilization, do not seem to mature. However, any long-term effects of IVF remain to be determined.
How much time does the entire IVF procedure require?
Approximately three to six weeks (all as an outpatient). Fertility drugs are administered to stimulate the ovaries. Then during the four to ten days prior to ovulation, the patient is monitored by ultrasound as well as by hormone levels.
What happens to any extra embryos?
Patients will have several options regarding the disposition of the remaining embryos. One option is to freeze embryos for your later use. Other options are to donate or simply dispose of them. Excess embryos, if any, belong to you, and you will determine what is to be done.
Will I need a high risk OB because I conceived with an IVF procedure?
A high risk OB is only needed when there are complications that put the mother or baby at increased risk, or in the case of multiple births. Other than a higher incidence of multiple births, IVF does not increase the risk to the baby.
Is there a higher miscarriage rate for IVF patients?
The miscarriage rate is about the same for IVF as the general population. Many times older females undergo IVF and their miscarriage rates are naturally higher. Since pregnancy testing is done two weeks after embryo transfer, we often know about spontaneous miscarriages in the very early stages of pregnancy. These miscarriages would probably go unnoticed in the general population.
How much does IVF cost?
The cost varies depending if you qualify for our shared risk plan and on how much medication you will need for stimulation.
What can be done to improve sperm quality?
Sperm quality on the day of egg retrieval is often related to what happened in the male’s body 3 months ago. This is because sperm development takes 3 months. Listed below are guidelines to help ensure the semen specimen is of the best possible quality. A fever of 101 degrees Fahrenheit or higher within 3 months prior to IVF treatment may adversely affect sperm quality. Sperm count and motility may appear normal, but fertilization may not occur. If you become sick during the IVF cycle, please notify the nurse, and take Tylenol to keep your temperature below 101 degrees Fahrenheit.
Keep the use of alcohol and cigarettes to a minimum before and during IVF treatment. Do not use any “recreational” drugs.If any prescription medication has been taken during the last 3 months, notify the IVF nurse. Do not sit in hot tubs, spas, Jacuzzis, or saunas during or 3 months prior to the IVF cycle. Do not begin any new form of endurance exercise during or 3 months prior to the IVF cycle. Physical activity at a moderate level is acceptable and encouraged.Avoid all testosterone, DHEA, and Androstenedione/Androstanediol hormone containing supplements.
Tell your infertility physician if you have ever had genital herpes, or suspect you may have been exposed to genital herpes in the past. Also tell your physician if you have pre lesion symptoms, develop a lesion, or have healing lesions before or during the IVF cycle.Refrain from ejaculation for 2-3 days, but not more than 5 prior to collecting the semen sample for the IVF cycle. The IVF nurse will have your specific instructions from the embryologist.
Please contact your physician or visit an expert with questions or concerns about your health condition.