Exploring Assisted Reproductive Technologies: What to Expect

In vitro fertilization, also known as in vitro fertilization, is a complex series of steps that lead to pregnancy. This is an infertility treatment that leaves most couples unable to conceive for at least a year. IVF can also be used to prevent the transmission of genetic problems to children.

In in vitro fertilization, mature eggs are collected from the ovaries and fertilized by sperm in the laboratory. Next, one or more fertilized eggs, called embryos, are placed in the uterus and the steps that cause the baby to grow are performed. One cycle of IVF takes approximately 2 to 3 weeks. In some cases, these steps are split into multiple parts and the process can take some time. 

In vitro fertilization is the most effective infertility treatment that uses eggs or embryos and sperm. Together, this group of treatments is called assisted reproductive technology. 

In vitro fertilization can be performed using a couple’s own eggs and sperm. Alternatively, it may include eggs, sperm, or embryos from known or unknown donors. In some cases, a gestational carrier (someone who has had the embryo implanted in her uterus) may be used. 

The chances of having a healthy baby with IVF depend on many factors, including age and the cause of infertility. Additionally, IVF is a time-consuming, expensive, and invasive procedure. If more than one embryo remains in the uterus, it is possible to have more than one baby. This is called a multiple pregnancy. Your medical team can help you understand how IVF works, what the risks are, and whether it’s right for you. 

Why it’s done: 

IVF is a treatment for infertility or genetic problems. Before undergoing IVF to treat infertility, you and your partner may be able to try other treatment options that involve fewer or no internal procedures. For example, ovulation-inducing drugs can help the ovaries produce more eggs. Additionally, in a procedure called intrauterine insemination, sperm is injected directly into the uterus near the time when the ovaries release an egg, called ovulation.

IVF may be offered as a primary treatment for infertility in people over 40 years of age. If you have certain health conditions, IVF is also possible. For example, IVF may be an option if you or your partner have any of the following conditions: 

Fallopian tube damage or blockage. Eggs travel from the ovaries through the fallopian tubes to the uterus. If both fallopian tubes are damaged or blocked, it becomes difficult for the egg to be fertilized and the embryo to move into the uterus. 

Ovulation disorder. If ovulation does not occur or occurs infrequently, there are fewer eggs for sperm to fertilize. 

Endometriosis. This condition occurs when tissue like the endometrium grows outside the uterus. Endometriosis often affects the ovaries, uterus, and fallopian tubes. 

Uterine fibroids. Uterine fibroids are tumors that develop in the uterus. In most cases, they are not cancerous. It is most commonly seen in people in their 30s and 40s. Uterine fibroids make it difficult for a fertilized egg to attach to the lining of the uterus.

Previous surgery to prevent pregnancy. 

A surgery called tubal ligation cuts or blocks the fallopian tubes to permanently prevent pregnancy. If you want to get pregnant after tubal ligation, in vitro fertilization may be helpful. If you don’t want or can’t have reverse tubal ligation surgery, it may be an option for you. 

Sperm problems. A low sperm count or abnormal changes in sperm movement, size, or shape can make it difficult for the sperm to fertilize the egg. If a medical test reveals a problem with your sperm, you may need to visit a fertility specialist to see if you have a treatable problem or other health issue. 

Unexplained infertility. This is when the cause of infertility cannot be found even after testing. 

Genetic disease. If you or your partner are at risk of passing on a genetic disorder to your child, your medical team may recommend undergoing a procedure involving in vitro fertilization. This is called preimplantation genetic testing. After the eggs are collected and fertilized, they are tested for certain genetic problems. Still, not all of these obstacles were found. Embryos that do not appear to contain genetic problems can be implanted in the uterus. 

Desire to preserve fertility due to cancer or other health conditions. 

Cancer treatments such as radiation and chemotherapy can adversely affect fertility. If you are about to start treatment for cancer, IVF may be considered as a way to have a baby in the future. Eggs can be collected from the ovaries and frozen for later use. Alternatively, eggs can be fertilized and frozen as embryos for future use. 

People whose uterus is not functioning or for whom pregnancy poses a serious health risk may choose IVF, which uses another person to continue the pregnancy. This person is called a gestational carrier. In this case, the egg is fertilized by the sperm and the resulting embryo is placed in the uterus of the pregnant carrier. 

Risks: 

Certain health problems are more likely to occur with IVF. From short-term to long-term, these risks include: 

Stress. IVF can be physically, emotionally, and financially taxing. Support from counselors, family, and friends can help you and your partner navigate the ups and downs of infertility treatment. 

Complexities associated with the egg retrieval procedure. 

After taking drugs that stimulate the growth of the sacs in the ovaries that contain the eggs, a procedure is performed to collect the eggs. This is called egg retrieval. Using ultrasound images, a long, thin needle is guided through the vagina and into the sac, also called the follicle, to collect the eggs. Needles can cause bleeding, infection, and damage to the intestines, bladder, and blood vessels. Risks are also related to drugs called anesthesia, which can help you sleep and prevent pain during surgery. 

Ovarian hyperstimulation syndrome. 

It is a disease in which the ovaries become swollen and painful. It can be caused by injections of ovulation-inducing drugs, such as human chorionic gonadotropin (HCG), which induces ovulation. 

Symptoms often last up to a week. These include mild abdominal pain, bloating, upset stomach, vomiting, and diarrhea. If you become pregnant, symptoms may last several weeks. In rare cases, some people develop a more severe form of ovarian hyperstimulation syndrome, which causes rapid weight gain and shortness of breath. 

Miscarriage. The miscarriage rate for pregnancies resulting from IVF using fresh embryos is about the same as for natural pregnancies, with approximately 15 miscarriages among pregnant women in their 20s and more than 50% miscarriages among pregnant women in their 40s. The proportion increases as the pregnant woman’s age increases. 

Ectopic pregnancy. This is a condition in which a fertilized egg attaches to tissue outside the uterus, often the fallopian tubes. The fetus cannot survive outside the womb and there is no way to continue the pregnancy. A small number of people who use IVF experience an ectopic pregnancy.

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