IVF is the most refined treatment but not the first of treatment.
It has to be done as per the indication only. Sometimes delay in taking decisions may end up in opting for third-party measures so what one needs is the correct and guided approach.
As patients, we have many queries as to why IVF only so here are the reasons as to when your clinician will advise you for same:
1) Fallopian tube damage or pathology:
Tubal block on X-RAY(HSG) doesn’t always mean opt for IVF directly. In that case, the decision is taken as per level and grade of the block, the age of female and married years besides cofactors
- If tubal surgery is not possible then, IVF is the method of choice.
- In case of problem in tubal function even after tubal surgery, IVF is the method of choice after an infertility duration of 2 years or longer.
Depending on the female age IVF can be done after a shorter duration of infertility.
Actually, Tubal factor was the first indication when IVF was started in the world to help childless couples
2) Unexplained infertility (idiopathic):
When an exact obvious cause cannot be diagnosed after all basic workup of the couple. This is considered as the most frustrating condition for both the doctor and the couples and adds to stress.It contributes to 10-15% of all infertility cases
IVF has indicated if the duration of infertility is 3 years or longer. But If the woman is older than 36 years, IVF may be considered earlier.
3) Male factor:
Here couple has two options: Either go for donor sperm or Go for IVF/ICSI as per the Sperm count.
Another option is SSR (Surgical sperm retrieval) Provided doctor has the expertise to do the same
What we focus on the semen is TMC-Total Motile Sperm count-This is the basis to take a decision like mentioned below-
Total motile sperm count < 1 million: first treatment of choice isICSI•
TMC > 1 and < 10 million: IVF can be performed if infertility duration is 2 years or longer•
TMC > 10 million: treat as unexplained infertility
In case of mild or moderate endometriosis treat as unexplained infertility. In case of severe endometriosis, policy treat as tubal pathology
5) Cervical factor / immunological infertility:
After an infertility duration of 2 years, IVF is indicated. This may be considered sooner if the woman is over 36 years of age.
6. Hormonal disturbances:
Like in PCOS if after multiple ovulation induction cycles patient fails to get pregnant then one has to plan IVF. No of cycles of Ovulation induction vary as per female age partner but shouldn’t exceed 4 cycles as after that there is no benefit of doing so