In-Vitro Fertilization (IVF)
What is IVF Treatment ?
In Vitro Fertilization is an Assisted Reproductive Technology (ART) where a woman’s eggs and man’s sperm are combined in an advanced high-tech laboratory to create an embryo. In fact, the actual meaning of the word “In Vitro” is “Outside the body of living organism” therefore the entire fertilization process in an IVF procedure takes place outside the human body.
When the egg combines with a sperm it starts to fertilize and develops into an embryo. Usually, on Day 5 of fertilization, the embryologists identify the best embryo which is then transferred into the female uterus. Of course, optimum laboratory environment and high-tech equipment are required to ensure healthy embryos develop and the desired pregnancy can be achieved. Assisted reproductive technology comprises several techniques used to help infertile couples in achieving parenthood. In Vitro Fertilization, IVF is also an advanced assisted reproductive technology (ART) that aids infertile couples in conception.
Historical Milestones
The experiments of fertilization outside the human body began in the 1960s thus by 1978, the first test tube baby, Louise Brown was born in the United Kingdom. The birth of this baby transformed the field of medicine and infertility. With the passage of time, assisted reproduction techniques kept on advancing. Consequently, IVF and later on, ICSI were introduced. These techniques not only aimed at achieving parenthood but also helped with the prevention of genetic problems and other fertility issues. Initially, the techniques were subjected to a lot of criticism. However, today assisted reproductive techniques are widely accepted as they merge hope with science standing as a beacon for countless couples striving for parenthood.
Infertility Prevalence
Infertility has become a significant concern globally. It has been roughly estimated that around 10-15% of couples struggle to conceive naturally. It can be due to female or male factors i.e., sperm abnormalities, ovulatory dysfunctions, and blocked tubes can lead to infertility in men and women. Several other factors including, environment, increased age and lifestyle choices, also contribute to the prevalence of infertility. In such cases, IVF offers hope to couples struggling to conceive naturally. It has aided in transforming countless infertility tales into stories of successful parenthood.
Fertility Specialists
A fertility specialist is trained to diagnose and treat infertility and reproductive issues. They help, couples who struggle to conceive naturally, in realizing their dream of parenthood with the help of various medical techniques. Fertility specialists play a vital and invaluable role in IVF treatments. They are the backbone of IVF procedures. They provide expert diagnosis, advanced treatment plans, and counselling which educate couples on reproductive health and various infertility treatment options available depending on their case. The role of a fertility specialist goes beyond diagnosis and treatment because the IVF journey impacts emotional health. Therefore, the fertility specialists at Australian Concept counsel patients to help them with any psychological or emotional challenges they might be going through during their IVF journey.
IVF Process and Stages
The process begins with ovarian stimulation, where fertility medications are administered to encourage the ovaries to produce multiple eggs. Subsequently, eggs are retrieved through a minor surgical procedure. In the laboratory, these eggs are then fertilized with sperm, and the resulting embryos are closely monitored for their development. A few days later, the healthiest embryos are selected for transfer into the woman’s uterus. Following the transfer, a waiting period ensues, during which hopeful parents eagerly await the outcome. Pregnancy tests and ultrasounds are conducted to confirm the success of the IVF procedure, bringing the dream of parenthood closer to reality.
The resulting embryo is implanted into the uterus to achieve conception. IVF is the most effective type of ART however, it is imperative to consult a fertility specialist to understand the procedure, and potential risks, and to determine whether it is the right option for you.
Ovarian Stimulation
To ensure successful in vitro fertilization more than one egg is required. Therefore, ovaries are stimulated with follicle-stimulating hormone and/or luteinizing hormone (LH) to produce more than one egg per cycle. The production of multiple eggs increases the chances of fertilization because sometimes eggs may fail to fertilize. It is vital to monitor hormones during the procedure so the right amount of hormones are administered alleviating the chances of over or under-stimulation and indicating impending ovulation. Furthermore, monitoring helps to determine that the trigger shot is given at the right time so, the eggs are timely retrieved. Generally, about two to three weeks of ovarian stimulation is required before eggs can be retrieved.
Egg Retrieval
Egg retrieval is a minor surgical procedure which takes place at the clinic after about 36 hours of administering a trigger shot. To keep the patient from pain, anesthesia is administered. To retrieve eggs from the ovaries, the doctor finds follicles, firstly, with the help of a thin needle to which an ultrasound guide is attached. The eggs are retrieved from follicles using a needle attached to a suction device. It takes about 30 minutes to remove eggs from follicles. The patient may feel cramps, pressure or a feeling of fullness after the procedure which eventually fades away.
Fertilization and Embryo Development
The retrieved eggs are placed in a liquid to aid development. During this stage, eggs are monitored so that healthy eggs can be chosen to be put together with sperm for fertilization. The healthy eggs and sperm are combined in laboratory petri dishes under optimal conditions for fertilization where the sperm fertilizes the egg on its own. At this stage, not all eggs are successfully fertilized hence, a greater number of eggs means higher chances of successful fertilization.
Embryo Transfer
After successful fertilization, the eggs are kept under observation so the embryologist can select the healthiest embryos for embryo transfer. The embryo transfer procedure takes place at the clinic. This procedure is painless however, mild anesthesia may be administered to help the patient relax. One or more embryos are filled in a syringe containing some amount of fluid. This syringe is attached to a catheter which is placed into the uterus. With the syringe, the embryo/embryos are implanted into the uterus where the embryo attaches itself to the lining of the uterus to achieve pregnancy.
Luteal Phase Support
A successful natural conception depends upon adequate endometrium development. Estrogen and progesterone, produced by developing follicles before ovulation and by corpus luteum after ovulation, help in successful endometrium development. However, this physiology is disrupted in IVF conducted with gonadotropin-releasing hormone agonists or antagonists. Hence, in IVF stimulating cycles, supplementation of the luteal phase with progesterone is essential for higher pregnancy rates and to achieve optimal results.
Human chorionic gonadotropin (hCG) can also be administered for this purpose but an increased risk of ovarian hyper-stimulation syndrome (OHSS) is associated with it therefore, progesterone is preferred. It supports the endometrium lining hence, giving a nurturing environment for embryo development and healthy pregnancy.
Medications and Protocols
For a healthy and successful pregnancy, a well-functioning reproductive system is essential. IVF treatment requires various hormones to regulate the cycle, prevent premature ovulation and stimulate ovaries. We will delve into various types of essential hormones that are required in an IVF program.
Follicle Stimulating Hormone (FSH):
Primarily, FSH is used to produce more than one egg in a single menstrual cycle. the reaction of each patient to this hormone may vary. In some, it can result in ovarian hyper-stimulation syndrome, while in others it may not have enough eggs. Therefore, an individual’s response to FSH is monitored through blood tests and ultrasounds. It can also be used with LH or hCG for ovulation or maturation of eggs. The FSH administered for ovarian stimulation can also play a role in the preparation of the endometrium lining.Luteinizing Hormone (LH):
In IVF, LH hormone is administered for the final maturation and release of eggs from the ovaries. While in a natural cycle, LH triggers ovulation but in IVF, a natural surge of LH is suppressed from doing so to prevent premature ovulation. Hence, an artificial surge of LH hormone is administered when eggs are ready for retrieval.Anti-Mullerian Hormone (AMH):
This hormone plays a vital role in the planning stages of IVF treatment as it gives insights into the woman’s ovarian reserve. Moreover, AMH levels help in predicting how the patient’s body will respond to fertility drugs. Thus, each patient’s IVF protocol is made keeping his needs in view.Progesterone and Estrogen Hormones:
Estrogen and Progesterone hormones are administered in IVF, as the former aids in follicular development and in preparation of endometrium lining while the latter supports in preparation of endometrium lining and maintaining early pregnancy. The administration of these hormones is closely monitored to increase the chances of a successful pregnancy. Furthermore, they aid in the prevention of premature ovulation while progesterone also plays a vital role in luteal phase support.Human Chorionic Gonadotropin:
Human Chorionic Gonadotropin play several roles in IVF treatment. It aids in the final maturation of eggs, the luteal phase, and the potential risk of ovarian hyper-stimulation syndrome (OHSS). It mimics luteinizing hormone for the maturation of eggs and ovulation. hCG can cause OHSS therefore, patients who are at a higher risk of developing it are given other alternatives instead of hCG.
Who Benefits from IVF?
Couples who are unable to conceive naturally or fail to carry pregnancy successfully can benefit from IVF. It can also assist over-aged couples in achieving parenthood.
Male
- Poor sperm morphology/motility
- Low sperm count i.e., azoospermia
- Ejaculation disorders
- Varicocele
- Obesity
- Stress
- Exposure to toxins
Female
- Blocked fallopian tubes
- Endometriosis
- Low ovarian reserve
- Hormonal Imbalance
- Uterine fibroids
- Age
- Premature ovarian failure
Age and IVF
Age plays a vital role in the success of In Vitro Fertilization (IVF). While male age also impacts IVF to some extent, female age is an imperative factor in its success. This is because fertility in women decreases with the increase in age. The quality and quantity of eggs in women over the age of 35 starts to decrease hence, the success rate of IVF is higher in women under 35 years of age as compared to women over 35 years of age.
IVF Success Factors
Age plays an essential role in the success of IVF. Increased maternal age has adverse effects on IVF treatment results. Data suggests that there is a 40% chance of successful IVF treatment in women under the age of 35 years, approximately 30% chance of success in women aged 35-37 years while the chances decrease to 16% in women above 37 years of age. It happens because with age the woman’s ovarian reserve diminishes.
Previous Treatments
Previous fertility treatments also have an impact on the success of In Vitro Fertilization (IVF). For instance, if a couple has previously undergone IUI, Clomid, etc., to treat infertility but failed then it means they might need to undergo IVF which will potentially increase the chance of success. If either partner has undergone treatment for a specific underlying cause of infertility.
Lifestyle and Health
Couples desiring to undergo IVF must be aware of how their lifestyle choices can influence IVF outcomes. A healthy lifestyle and diet can help in achieving successful results while exposure to environmental toxins, high-stress levels, consumption of drugs, alcohol, smoking, and poor eating habits can adversely impact your IVF journey. Consuming a balanced diet and regular exercise can impact your IVF journey positively.
Risks and Complications
In Vitro Fertilization (IVF) is a safe procedure however, potential risks and complications are always there. It is suggested to discuss all the potential risks and complications with your healthcare specialist so you can have realistic expectations from the treatment. Following are some of the risks and complications associated with IVF;
- Ectopic Pregnancy can happen if the embryo implants itself outside the uterus. The risk of ectopic pregnancy can be alleviated by regular monitoring and early detection.
- There is a risk of birth defects in babies born through IVF but it is rare.
- Multiple pregnancies can happen in IVF which can have serious impacts upon the health of mother and child. To reduce the risk of multiple pregnancies, specialists usually go for single embryo transfer.
- Other potential risks and complications of IVF include Ovarian Hyper-stimulation Syndrome (OHSS), mood swings, hot flashes, bleeding, infections, cramps, bloating, nausea, etc. They take place as a reaction to medical procedures or medicines given during IVF.
Ethical Considerations
Since its introduction, IVF has faced severe criticism for several reasons. It has been ethically and religiously criticized for embryo selection, status and multiple pregnancies. Some religious beliefs and individuals give an embryo the status of a newborn baby. They are concerned regarding multiple pregnancies when more than one embryo is transferred to the uterus. Multiple pregnancies can risk the health and life of both, the baby and mother. Therefore, it is advised to minimize such risks as much as possible. Embryo selection is also a concern for some individuals as it may cause gender imbalance and give way to bias in selecting one embryo over the other, ultimately leading to the misuse of technology. Australian Concept works to maintain the integrity of the assisted reproduction technique. We have established ethical guidelines to prevent the misuse of technology and unethical practices.
Financial Considerations
Owing to its complexity, intricacy and technologically advanced nature, IVF is an expensive procedure. The cost of one IVF cycle comprises of consultations, diagnosis, medicines, and the cost of the procedure itself. Moreover, if one cycle fails the couple has to pay additionally for subsequent cycles which can be financially draining. If the couple plans on undergoing PGD or PGS the cost of IVF can increase significantly. Hence, couples must be monetarily prepared for it and should look for financial assistance options before proceeding with IVF. Australian Concept provides a detailed breakdown of IVF costs to its patients during consultation. We believe that no couple should remain childless due to financial restraints therefore, we offer financial assistance and flexible payment methods to help infertile couples achieve their dream of parenthood.
Alternative Options
Keeping the expensive nature of IVF in view, couples can go for other options of assisted reproduction. Also, not every couple struggling to conceive has to undergo IVF to achieve parenthood. Sometimes, their issue can be treated with less expensive and less advanced procedures such as IUI. Some couples may have to undergo a more advanced technique to achieve parenthood such as ICSI. Both procedures can be used as an alternative to conventional IVF. ICSI is a technique that is performed as a part of IVF. However, it can increase the cost of IVF. Whereas, IUI is a less expensive procedure that can help couples become parents if the underlying condition of infertility is such that it can be treated appropriately.
Choosing the Right IVF Center
Accreditation and Certifications:
Choosing the right IVF center is crucial for successful IVF treatment. A vast number of IVF centers are available all over the country promising to provide successful results. The availability of numerous options has made it difficult for patients to select the right IVF center. While choosing an IVF center, among several other factors, the couple should look for accreditations and certifications. Accreditations and Certifications provide valuable assurance that a patient needs while selecting an IVF center. Additionally, they remove any doubts concerning the veracity of promises made by the clinic. Australian Concept is the most successful IVF center in Pakistan. It has experience of 20+ years in the field of fertility with the largest branch network all over the country. Over the years, we have helped 1000s of couples in achieving their dream of parenthood.
Experienced IVF Team
Another factor, that must be kept in view while choosing an IVF center, is the experience and expertise of the medical team available. The medical team is the backbone of any medical facility. As we know, IVF is a complex and intricate procedure which needs an experienced professional who has a deep understanding of embryology, reproductive medicine and endocrinology. The success of an IVF treatment depends upon these specialists. They provide tailored treatment plans, navigate unforeseen challenges and optimize the chances of successful results. The expertise of a medical team at a facility is of utmost importance as it instils confidence in patients, reducing stress thereby. Australian Concept has a team of fertility specialists from all over the country who are highly trained and well-known for their satisfactory results.
Success Rates
Success rates must be considered when choosing an IVF center. Couples should do their research as sometimes, IVF centers show fake success rates to gain customers, the couples should be vigilant while selecting one. Through success rates, couples can evaluate the proficiency and track record of an IVF center in achieving a successful pregnancy. high success rates indicate that the clinic is experienced in handling complex cases however, it is to be kept in mind that several factors impact success rates such as age, diagnosis, and treatment options. It is to be noted that success rate alone should not be the determining factor. It should be considered alongside other factors such as the expertise of fertility specialists, patient reviews and ethical practices.
Facility and Equipment
While choosing an IVF center, the couples should also carefully assess the facility and equipment available there. Advanced technology at a facility indicates precision, and accuracy, and enhances the chances of successful results. Australian Concept has the most advanced and state-of-the-art technology available at its Lahore center. It has highly advanced laboratories, incubators, and micro-manipulators to achieve precision during procedures. We are the only IVF center in Lahore using a Multi Chamber MIRI-Time Lapse incubator. Furthermore, we offer PGD, and PGS among other tests to detect any genetic disorders in the embryos so that our patients can achieve their desired results.
FAQ's
What is IVF treatment?
In vitro fertilization (IVF) is a fertility treatment where fertilization occurs outside the body, in a laboratory dish. Eggs are retrieved from the woman, sperm is collected from the man, and fertilization is achieved. The resulting embryo(s) are then transferred to the woman's uterus for potential pregnancy.
What is IVF treatment for pregnancy?
IVF is used to help couples struggling with infertility achieve pregnancy. It can address various infertility issues in men and women.
How many days are required for IVF treatment?
The entire IVF process typically takes 4-6 weeks. However, the exact duration can vary depending on individual factors.
How many injections for IVF treatment?
IVF often involves fertility medications like injections to stimulate egg production. The exact number of injections will depend on your specific situation.
Is IVF treatment painful?
Some aspects of IVF can cause mild discomfort, such as egg retrieval. However, medication can help manage any pain.
What happens during IVF treatment?
IVF involves several steps: medication to stimulate egg production, egg retrieval, sperm collection, fertilization, embryo culture, and embryo transfer. Your doctor will guide you through the specific process.
What is the cost of IVF treatment in Pakistan?
IVF treatment costs in Pakistan can vary significantly depending on the clinic, location, and specific needs. It's best to contact clinics directly for cost estimates.
Is IVF treatment allowed in Islam?
Islamic views on IVF can vary. Consulting with a religious scholar you trust is recommended to understand the perspectives relevant to your situation.
What precautions to be taken during IVF treatment?
Your doctor will provide specific instructions regarding medications, lifestyle adjustments, and monitoring during IVF treatment.
Can gender be desired in IVF treatment?
While some techniques may influence the likelihood of conceiving a specific sex, they are not foolproof and ethical considerations exist. Discuss this with your doctor if interested.
Do periods become irregular if you conceive through IVF treatment?
Pregnancy, regardless of conception method, typically stops menstruation. After childbirth, your menstrual cycle may take some time to return to regularity.
Success Stories
Learn more from 15000s+ of our patient’s exciting success stories who received treatment at Australian Concept Lahore and realized the dream of becoming a parent with the blessings of Allah.
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