IVF Explained: IVF Treatment and How Does It Work?

IVF is a medical process that combines an egg and a sperm in a controlled environment rather than inside your body. Your doctor collects your eggs from your ovaries, then mixes them with your partner’s sperm in a lab. Once the egg and sperm combine (fertilize), the embryo develops. Healthy embryos are then placed back into your uterus to create a pregnancy. Because this method goes around the usual barriers to getting pregnant, IVF is good for people who face a variety of problems.

What Is In Vitro Fertilization (IVF)?

In vitro fertilization (IVF) is when your doctor allows fertilization to occur in a lab, as opposed to occurring inside your body. First, doctors will remove one or more eggs from your ovaries using a special needle. The eggs are then combined with sperm in a lab setting. After they have been mixed, the resulting embryos develop for a short time and are monitored by the doctors. If the developing embryo appears to be healthy, your doctor will then place the embryo into your uterus so you can become pregnant. Since the IVF method bypasses many of the normal barriers to conceiving, it has proven to be successful for individuals experiencing a wide range of infertility challenges.

Who Needs IVF Treatment?

People in many kinds of situations go to their Doctors for IVF. Examples of common reasons for IVF include:

• Blockage of the fallopian tube(s)
• Low number of sperm in your semen
• Difficulty getting an egg to release
• Unknown causes of not being able to get pregnant

Some women are advised to do IVF at an older age because they lose quality in their eggs over time. Others might want to do IVF to prevent certain genetic problems from going into the next generation.

Why IVF Treatment Is Done

Doors open to doctors advising IVF when there is little hope that less invasive options will succeed. With IVF, doctors can control the whole process of getting your egg and your partner's sperm together and increase the likelihood of having a baby. Another major advantage is that doctors are now able to look at each embryo for possible genetic defects prior to transferring the embryo. Sometimes, people use IVF to save their ability to reproduce while undergoing cancer treatment (chemotherapy).

Step-by-Step IVF Treatment Process

The process of IVF is made up of a group of sequential steps. 

1. The first is taking hormones to make your ovaries produce enough eggs. More eggs are better because they give you more opportunities for fertilization. 
2. The second is performing a minor surgical procedure called egg aspiration. Egg aspiration uses ultrasound guidance and removes eggs. 
3. At the same time that the eggs are retrieved, a sample of sperm is obtained.
4. The eggs are mixed with the sperm and left alone to develop into embryos.
5. Embryos grow for a few days, and then a healthy one is picked and put into your womb. 
6. If there are too many embryos, they can be frozen for later use.

How to Prepare for IVF Treatment

Preparing yourself for IVF requires both physical and mental preparation. Physicians may tell you what kind of lifestyle choices will enhance the possibility of conceiving via IVF. These choices could be as simple as eating well, exercising regularly, and stopping drinking or smoking. Many times, physicians will order medical tests to determine if there are any underlying reproductive health issues or irregularities. They may ask you to take prescription supplements, like prenatal vitamins, as well.

Just as important as preparing physically is mentally preparing oneself for the stress associated with IVF. IVF can be a source of great emotional stress; therefore, it is helpful to have the support of family members and/or professionals (counselor/psychologist/support groups).

What to Expect During IVF Treatment

When you begin an IVF cycle, you will typically visit your physician every week or so during the stimulation phase of your cycle. Blood tests and ultrasounds will be performed to monitor your Hormone levels and Egg development. As previously mentioned, these hormonal medications may lead to discomfort such as bloating/mood swings/mild pelvic cramping. The Egg retrieval process is usually done under sedation and is relatively short. Post-transfer testing and adherence to specific post-transfer instructions are typical recommendations. One of the most difficult aspects of waiting for pregnancy test results is managing those feelings with professional assistance.

Risks and Side Effects of IVF

While IVF has proven itself to be a relatively safe treatment option, there are potential risks and side effects related to the medication (hormones) and procedures involved in IVF. Possible side effects include: bloating/mood swings/pelvic discomfort. Ovarian hyper-stimulation syndrome (OHSS): OHSS is characterized by swelling of the ovaries due to excessive response to fertility drugs, which can be extremely painful and sometimes requires medical intervention. Risk of multiples: when transferring more than one embryo, there is an increased risk of having twins/triplets/etc. Carrying multiples increases the risk of complications during pregnancy for both mom and baby.

Recovery After IVF

Depending on whether or not you were having an Egg retrieval or an embryo transfer, recovery varies. For most patients, Egg retrieval is completed in approximately 30 minutes. Mild discomfort is experienced in 90% of patients, which resolves within 2-5 days post-procedure. Most patients resume all daily activities following embryo transfer. However, some caution regarding heavy lifting/exercise may be necessary during this period. Some patients may be prescribed progesterone suppositories/pills to help establish implantation and support early pregnancy. Emotional recovery is equally important. Supportive relationships, follow-up appointments with your physician, and self-care strategies can assist regardless of whether you achieve pregnancy or not.

References

Edwards, R. G., Steptoe, P. C., & Purdy, J. M. (1980). Establishing full-term human pregnancies using cleaving embryos grown in vitro. British Journal of Obstetrics and Gynaecology, 87(9), 737–756. 

Kaser, D. J., & Racowsky, C. (2014). Clinical outcomes following selection of human preimplantation embryos with time-lapse monitoring: A systematic review. Human Reproduction Update, 20(5), 617–631. 

Maheshwari, A., Hamilton, M., & Bhattacharya, S. (2008). Effect of female age on the diagnostic categories of infertility. Human Reproduction, 23(3), 538–542. 

Steptoe, P. C., & Edwards, R. G. (1978). Birth after the reimplantation of a human embryo. The Lancet, 312(8085), 366. 

Zegers-Hochschild, F., Adamson, G. D., de Mouzon, J., Ishihara, O., Mansour, R., Nygren, K., Sullivan, E., & Vanderpoel, S. (2009). International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary of ART terminology, 2009. Fertility and Sterility, 92(5), 1520–1524.