Let's Talk About IVF: Procedure and Risks
Sun, April 18, 2021

Let's Talk About IVF: Procedure and Risks

 

IVF (in vitro fertilization) refers to the joining of a female’s egg and a male's sperm in a laboratory dish, said Medline Plus, a trusted health information website. Natural or unassisted conception is when the egg and sperm are fertilized inside a woman’s body and the baby is born nine months later. This happens if the fertilized egg attaches to the womb’s lining and continues to grow.   

IVF, on the other hand, is a form of assisted reproductive technology (ART), meaning that special medical techniques are utilized to help a woman to become pregnant. IVF is often tried when less pricey fertility treatments have failed.  

How Public Reporting of IVF Outcomes Influences Medical Decision-Making and Physician Training

Only 323 of 1,019 reproductive endocrinology and infertility clinicians who were members of the Society of Reproductive Endocrinology and Infertility or the Society of Reproductive Surgery responded to all applicable questions, said Stephanie Gunderson and colleagues of BMC, an open-access journal portal.

The respondents’ practice settings were private practice (57.1%), academic/public (17.6%), academic/private (23/1%), and other (2.2%). 96.8% believed that public reporting affected other providers’ practices while 93.9% believed that other providers denied IVF to poor-prognosis patients to improve reported success rates. Only 42.9% said that their own medical management was influenced by public reporting of IVF outcomes.

When asked how public reporting influenced their practices, 16.7% said they decreased the number of embryos transferred and 22.8% stated that they increased the number of embryos transferred. Moreover, 27.8% said public reporting influenced their own willingness to offer non-donor, fresh single-embryo transfer. 17.6% of respondents believed that reporting benefits education and training of fellows. Most believed that couples seeking infertility treatment (59.1%) would benefit from public reporting of IVF outcomes, along with the adoption of eSET (69%), ART twinning rate (66.8%), and improved quality initiatives in infertility care (46.6%).

A smaller proportion of respondents said that public outcomes reporting promotes scientific advancements in the field (44.1%) and quality improvements (46.6%). Public reporting also benefits patient satisfaction (22.2%) and information sharing among groups (26.9%). 58.8% of respondents said they advertise their success rates on clinical websites, but most of them compared their success rates with other clinic websites (72.7%). 76.2% said clinical advertising was misleading to patients.

90.4% of those who train clinical fellows believed that fellows did not reduce a center’s pregnancy rates by performing oocyte retrieval. However, 61.7% believed that fellows reduce a center’s pregnancy rates by performing embryo transfers. The findings provided an important starting point for evaluating providers’ perceptions of public reporting. The authors believed that it is essential to understand how public reporting influences the decisions of ART providers, particularly with regard to utilizing single embryo transfers and fellow involvement in procedures.

 

 

Why Is IVF Done?

It is done to treat for infertility or genetic problems, stated Mayo Clinic, an American non-profit academic medical center. If it’s to treat the former, you and your partner might consider trying less-invasive treatment options (ex: fertility drugs to increase egg production) before opting for IVF. IVF can also be offered as a primary treatment for infertility among women age 40 and above. This procedure can be conducted if you or your partner has fallopian tube damage or blockage, ovulation disorders, endometriosis, impaired sperm production, and more.

How Is IVF Done?

The first step is simulation or super ovulation. Fertility drugs are prescribed to the woman to boost egg production. She will have regular transvaginal ultrasounds to see the ovaries and blood checks, as well as to monitor hormone levels.

The second step is egg retrieval. Follicular aspiration— which is a minor surgery— is conducted to remove the eggs from the woman’s body. This surgery is done for the other ovary and the woman may experience some cramping after the procedure. But the cramping sensation will subside within 24 hours. In rare cases, a pelvic laparoscopy may be done to remove the eggs. Donated eggs may be used if a woman does not or cannot produce eggs.

The man’s sperm is then placed together with quality eggs, which is the third step of IVF. The sperm and eggs will be mixed, which is called insemination. They are stored in an environmentally-controlled chamber. The fertilized becomes an embryo once it divides. Couples who are more at risk of passing a genetic disorder to their child may opt for pre-implantation genetic diagnosis (PGD). It is done approximately three to four days after fertilization. PGD is performed when laboratory scientists remove a single cell from each embryo and screen it for genetic disorders.

Finally, the embryos are placed into the woman’s womb three to five days after the egg is retrieved and fertilized. This is done in the clinic while the woman is awake. The medical professional inserts a catheter containing the embryos into the vagina, then through the cervix, and into the womb. If an embryo implants in the womb’s lining and grows, the woman becomes pregnant. Unused embryos may be frozen and implanted or donated.   

 

 

What Are the Risks of IVF?

The risk of undergoing this procedure is having multiple births, albeit if more than one embryo is transferred to the uterus. A woman carrying multiple fetuses will have a higher risk of early labor and low birth weight than a pregnancy with a single fetus. Miscarriage can also happen to women who conceive via IVF with fresh embryos. The rate (15% to 25%) is similar to those who conceive naturally; however, it increases with maternal age.

Using injectable fertility drugs like human chorionic gonadotropin (HCG) to induce ovulation can lead to ovarian hyperstimulation syndrome, causing the ovaries to become swollen and painful. Symptoms include mild abdominal pain, nausea, vomiting, and diarrhea— which can last for a week. If the woman becomes pregnant, symptoms might last for several weeks.

It is possible for the woman to develop a more severe form of ovarian hyperstimulation syndrome. Although it is rare, it can lead to rapid weight gain and shortness of breath. Stress can also be a risk factor for those who resorted to IVF. The financial, emotional, and physical stress of undergoing this procedure can be draining. Hence, it is important to get support from counselors, loved ones, and friends to help the couple cope with post-IVF stress.

 

IVF is used to treat infertility among couples. Risks such as miscarriage can also happen when an individual undergoes this procedure. Fertility treatment can be a stressful experience, so it is important for couples to have a support system to help them cope with post-IVF treatment.