4 December 2019

IVF: Everything you need to know

Medical Director
Cesar Diaz-Garcia
MD PhD Assoc Prof
IVI London

 

Infertility is not as uncommon as you think

Infertility is more common than people realise: it affects around 20% of couples. The causes of infertility can be down to a number of things, but generally speaking, 30% of infertility issues are due to the woman and 30% of the time it is due to the man, with 20% resulting from a combination of both, leaving 20% unknown. But it is not just people with fertility issues that seek reproductive assistance, there are also many other reasons people may need our help, for example, same-sex couples, single women or those carrying a genetic disease and wanting to avoid passing those diseases onto their child.

IVF takes time

In-vitro fertilisation (IVF) is when the woman’s eggs are removed from her ovaries, fertilised outside the body in the lab and then placed back into the womb.

This process takes time, although at IVI.  we tend to use what’s known as ‘short protocol’ for most of our patients: the stimulation of the ovaries can still take up to 5-6 days minimum, to ensure as many eggs mature as possible before collection. The treatment will also involve taking medication normally by means of injection, as well as going to the clinic for scans/blood tests before the egg collection takes place. After the egg collection, patients will then come back for an embryo transfer followed by a pregnancy blood test a few weeks later. In total, you can expect one cycle of treatment to take around 4-5 weeks.

 

What type of IVF is right for you?

Conventional IVF is not the only treatment available and sometimes not the most appropriate for you depending on your situation. There is a less intense form available known as ‘Natural IVF’ which involves no drug use and the procedure is simply making sure the sperm is introduced to the egg at the right time. There is also a treatment known as ICSI. Deciding on whether you need ICSI or classic IVF normally depends on the quality of the sperm you are using. Classic IVF allows the sperm to naturally penetrate the egg in a dish, ICSI involves selecting the best individual spermatozoon and manually injecting it into the egg. Depending on the quality of both the egg or sperm there are also IVF treatments available using an egg or sperm donor.

 

Age isn’t just a number

When it comes to fertility, the most contributing factor to your success is the woman’s age, and more specifically the age of the woman’s eggs. The decline in fertility begins around the age of 35 with it dramatically reducing when you hit your 40s. This means that by the early 40s it is much more difficult to conceive and by 45 it is likely that your doctor will advise the use of an egg donor. Although men’s fertility is less affected it still declines over time, this is due to a decline in testosterone levels meaning that less sperm is produced.

 

You may need more than one cycle of treatment

The national average success rates for IVF are around 35%, therefore in many cases, patients will have to undergo multiple cycles to fall pregnant. IVI are introducing new techniques and innovation resulting in our success rates constantly improving. However, it is important to mentally prepare yourself that there is a chance that it may take multiple attempts. You should ask your doctor to give you a personal prediction of your chances in your first consultation after your doctor has done a full diagnosis.

 

Multiple pregnancies and IVF

The chances of having twins seem to dramatically increase when going through IVF. This is because some clinics transfer more than one embryo at a time to increase the chances of becoming pregnant. Multiple pregnancies come with risks to both the mother and baby so clinics are required to try and avoid them. This is why IVI adopt a SET (single embryo transfer) policy whenever possible. Currently, IVI London has a twin pregnancy rate of 0.9%, which is well below the HFEA cut off at 10%.

 

There are lots of additional techniques available

There are many other treatments in addition to IVF that can help improve your chances of a successful pregnancy. For example, EmbryoScope: this is where your embryos will be incubated for 5 days. In that time the embryologists will use a live camera feed to monitor their progress without disturbing them. Genetic screening is also an additional treatment the doctor may recommend. This involves an embryo biopsy to test for up to 600 different chromosomal abnormalities. By doing this the embryologist can identify the healthiest embryos and transfer them first for the best chance of success.

 

IVF treatment can be a stressful time. It is important that you have all the information you need before going ahead with the treatment. IVI holds a bi-weekly open evening allowing you to meet the team and answer any questions you may have. Alternatively, you can book in for a first consultation for a personal diagnosis and advised next steps.

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