IVF – All about the miracle Test Tube baby procedure.
What is IVF (In-vitro fertilization)?
IVF is the process of manual fertilization of a female egg by a male sperm outside the body in a lab dish, followed by transfer of the fertilized (the embryo) into the uterus. In vitro fertilization is a fertility procedure that produces what is known as “test-tube babies”. In vitro fertilization means fertilization that occurs outside the body, in contrast to in vivo fertilization that refers to the natural fertilization inside female genital tract.
How did in-vitro fertilization start?. Who was the first test tube baby?
On 25 July 1978, the English Louis Brown was the first “test-tube baby” to be born using the IVF technique. The successful conception was pioneered by the obstetrician Patrick Steptoe (on the right) and the physiologist Robert Edwards (on the left), who was awarded Noble prize in medicine for development of IVF.
By 2012, it was estimated that about 5 million children had been born via in vitro fertilization and other similar techniques. The physician and researcher from Kolkata, Subhash Mukhopadhyay, pioneered the second successful test-tube baby birth in India, just 67 days after the previous one.
What are cases in which IVF can help?. Can IVF help me?
Many patients with infertility are advised by their healthcare providers to try in vitro fertilization as a highly recommended and effective solution for their problem. Here are the most common cases for which doctors recommends in vitro fertilization :-
Endometriosis is presence of normal benign endometrial tissues (inner layer of the uterus) in an abnormal site like myometrium (muscles of the uterus), ovaries or fallopian tubes.
The abnormally located endometrial tissue respond to hormonal control; which means it menstruates and bleeds monthly with the period. The exact cause of endometriosis is unknown; theories suggest it to be caused by retrograde menstruation upwards towards the ovaries and fallopian tubes with subdequent implantation of endometrial tissues in these areas.
Endometriosis causes dysmenorrhea (painful menstruation), dyspareunia (painful intercourse) and infertility.
Anatomic distortion caused by endometriosis results in blocking and damage to fallopian tubes and formation of abnormal structures (cysts) in the ovaries, which eventually make it impossible for sperms to reach female eggs leading to infertility. In vitro fertilization provides an alternative pathway for fertilization instead of the distorted one.
Oligospermia or Oligozoospermia is defined as abnormally low male sperm count less than 15 million sperms per one milliliter of semen. Low sperm count can result from an associated varicocele, duct obstruction urinary tract infection, smoking, poor diet, lack of exercise or drug abuse.
You probably know that only one sperm eventually fertilizes the female egg, and also you might be thinking that 15 million sperms per milliliter of semen has to be enough, but actually what happens is that most of sperms that enter the ♀reproductive system either get lost and cannot find their way to the unfertilized egg (two fallopian tubes, but only one leads to the egg), or they get destroyed by female inhibitory enzymes secreted to ensure only the fittest sperm will make it to the ova. When conventional treatments for oligospermia cannot fix the problem, in vitro fertilization becomes one of the most suitable solution for fertility.
Low Egg Output (Decreased ovarian reserve):
Just as in oligospermia, ovulation disorders or premature ovarian failure (early loss of normal functions of ovaries before 40) will significantly decrease the chances for in vivo fertilization to occur and in vitro fertilization will be considered as an option.
Blocked Fallopian tubes (B/L tubal block):
After male ejaculation, sperms take the following course to reach the unfertilized ova :
Penis → Vaginal canal → Cervix → Uterus → Fallopian tubes → Ovaries → Ova.
Of the above pathway, Fallopian tubes are the narrowest passages. Salpingitis (Fallopian tube inflammation) leads to stricture and narrowing which blocks the way for sperms to reach the unfertilized egg. Other causes of Fallopian tube damage includes compression by tumors or enlarged lymph node from outside or presence of cysts or tumors inside. In such cases, IVF can be the only option for you to have a baby.
Fertility preservation using IVF and creating embryos is done for those patients whose fertility is expected to be lost or negatively affected. Examples included patients who are about to start chemotherapy or other medications that can harm their fertility, also some females may decide to preserve their eggs to maintain their chances of having a baby in the future. The preserved eggs or sperms can later on be combined to form an embryo. . Also IVF can be used in combination with gestational surrogacy (some countries ban it though).
Avoiding a possible Genetic Disorder:
If you’ve a bad gene that runs through the family, doing in vitro fertilization will enable your doctor to screen for that gene after fertilization takes place, so as to make sure that your baby won’t have that gene.
Other Indications for IVF:
- Uterine fibroids : benign tumors in the wall of the uterus making it unsuitable for hosting the in vivo fertilized egg.
- Idiopathic infertility : infertility that presents with unknown cause.
- Female antibodies against male sperms.
- Sperms unable to penetrate and fertilize the ova.
- Azoospermia (No sperm in the ejaculate)
What are the steps in IVF?
Before in vitro fertilization is applied to you, your physician will make sure that you’re prepared, so as to increase the chances for success of the procedure. Here are the 5 steps of IVF:-
Step 1: Prescription of fertility medications
Before the procedure starts, your doctor will ensure that eggs production by your ovaries is adequate. Fertility medication will be prescribed for stimulation of ovulation, as multiple eggs, not only one, are needed for IVF because of the likelihood that some will not fertilize. Fertility medications may cause headaches, hot flushes, abdominal pain or mood swings, these are normal side effects so don’t be alarmed if you experience any.
Step 2: Retrieval of Eggs
Your physician will periodically exam your blood samples for hormonal levels and your ovaries for eggs via ultrasound so he can decide when you are ready for eggs retrieval. Eggs are retrieved by a hollow needle inserted through the pelvic cavity under the guidance of ultrasound. Don’t worry, this’s a minor procedure, and you’ll be given some medications for the discomfort.
Step 3: Semen Collection and Sperm Processing
Sperm sample will be retrieved from the male partner and prepared for IVF using standardized sperm preparation protocols, sperm preparation is done so that, only the motile sperm fraction is isolated for the IVF procedure
Step 4: Combination of sperms and eggs [Insemination]
Now everything is ready for fertilization to start, the eggs and sperms are mixed in a laboratory dish to make a zygote. The egg then will be monitored for normal fertilization and division.
Step 5: Transfer of a fertilized egg
After a healthy fertilized egg that is capable of division is produced, it’s transferred to the female uterus with the help of a soft catheter through a minor nearly painless procedure, for implantation to take place.
Some minor adverse effects of the procedure may present including cramping, constipation and bloating or breast tenderness. However, if you experience pelvic pain, heavy vaginal bleeding, red urine or a high fever, you should call your healthcare provide at once.
What are the adverse effects of IVF?. Can In-vitro fertilization go wrong?
In addition to the side effects of fertility medications and the procedure itself, even a successful IVF can still carry some adverse effects.
Multiple pregnancies – In vitro fertilization increases your chances to give birth to more than one baby as a side effect of the prescribed fertility drugs. Multiple pregnancies can lead to premature delivery or low birth weight.
Miscarriage – There are slightly higher chances of miscarriage after conception done by IVF.
Cost – IVF is an expensive procedure that’s usually not covered by insurance. Failure of the procedure can be a huge cause of hopelessness for some patients, especially those who cannot afford a second shot. The success rate of IVF seldom exceeds 35%
OHSS – Ovarian hyperstimulation syndrome, is a serious adverse effect of IVF that can occur if proper tailored doses of fertility medications is not given
We hope you found this article interesting!.
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