What is IVF?

Author

Assoc. Prof. Muhammet Emin Çam

Rector Advisor, Vice Dean, and Faculty Member - Istanbul Kent University, Faculty of Pharmacy, Departmant of Pharmocology
Visiting Researcher&Lecturer - University College London, Mechanical Engineering and Faculty of Medicine, UK
Visiting Lecturer - University of Aveiro, Faculty of Biomedical Engineering, Portugal

"IVF is a miracle of modern medicine that revives hope and offers a healthy future."

Tüp bebek / İn vitro fertilizasyon (IVF) nedir?

What is In Vitro Fertilization (IVF)?

In Vitro Fertilization (IVF) is a process where eggs and sperm are combined in a laboratory to create an embryo. This procedure is a solution for couples who are unable to conceive naturally. First, hormonal treatment is administered to the woman to stimulate the ovaries and develop multiple eggs. These eggs are then retrieved through a procedure guided by ultrasound and are combined with sperm cells in the lab. Once fertilization occurs, the embryos are monitored for development, and the highest quality embryo(s) is transferred into the woman’s uterus. After the transfer, the embryo implants in the uterus, initiating pregnancy. IVF is particularly effective for women with blocked fallopian tubes, men with low sperm count, or couples facing unexplained infertility. Advances in technology have increased the success rates of IVF, allowing more couples the chance to conceive through this method.

Who is IVF suitable for?

IVF is a suitable treatment option for couples who face difficulties in achieving pregnancy naturally due to various reasons. For women with blocked fallopian tubes, IVF may be the only way to conceive. It is also a preferred option when men have a low sperm count or poor sperm quality, making natural fertilization unlikely. Additionally, women of advanced maternal age, whose egg reserves have diminished, may have a better chance of achieving pregnancy through IVF. IVF is also recommended for conditions like endometriosis or polycystic ovary syndrome (PCOS), which can cause infertility in women. Furthermore, in cases of unexplained infertility, where no specific medical cause has been identified but pregnancy has not occurred, IVF can offer a solution. Beyond these scenarios, couples who have previously undergone unsuccessful IVF attempts may be advised to try IVF again using advanced diagnostic and treatment techniques.

How does the IVF process work?

The IVF process involves several key steps and typically takes 4-6 weeks to complete. Initially, the woman’s ovaries are stimulated with hormone therapy to develop multiple eggs, a process that usually takes 10-14 days. During this period, the response of the ovaries is closely monitored through ultrasound and blood tests. Once the eggs are mature, they are retrieved in a procedure that usually takes 15-20 minutes under light anesthesia. The retrieved eggs are then fertilized in the laboratory with sperm cells, initiating the development of embryos. The fertilization and embryo development stage typically lasts 3-5 days. Finally, the highest quality embryo is selected and transferred to the woman’s uterus. The embryo transfer procedure is usually painless and quick. After the transfer, the woman waits about two weeks before taking a pregnancy test to determine if the embryo has successfully implanted. During this waiting period, specific medications and hormones prescribed by the doctor are used to support the pregnancy.

How long does the IVF process take?

The IVF process typically takes about 4-6 weeks from start to finish. However, this duration may vary depending on the inpidual’s treatment plan, body response, and egg development. The initial phase involves ovarian stimulation with hormone therapy, which usually lasts 10-14 days. During this time, the ovaries’ response is closely monitored through ultrasound and blood tests. Once the eggs are mature, they are retrieved in a procedure that generally takes 15-20 minutes. After the eggs are collected, the fertilization process begins in the laboratory, where the eggs are combined with sperm cells to create embryos. This stage typically lasts 3-5 days as the embryos develop. Finally, the highest quality embryo is selected and transferred to the woman’s uterus. After the embryo transfer, a waiting period of about 10-14 days is required before a pregnancy test is conducted to confirm whether the embryo has implanted successfully. Each step can be adjusted based on the inpidual’s specific circumstances, affecting the overall duration of the process.

What is the success rate of IVF?

The success rate of IVF depends on various factors and is generally influenced by the woman’s age, egg quality, sperm quality, and previous pregnancy history. For women under 35, the success rate of IVF typically ranges from 40-50%, but this rate decreases with age. For instance, in women over 40, the success rate may drop to around 10-20%. This decline is mainly due to the decrease in both the quantity and quality of eggs as women age. Additionally, sperm quality plays a crucial role in the success rate. In some cases, the condition of the uterus during embryo transfer, the quality of the embryos, and genetic factors can also impact success. With advancements in technology and the application of new treatment protocols, IVF success rates have increased in recent years. Moreover, techniques like Preimplantation Genetic Testing (PGT) allow for genetic screening of embryos, ensuring the selection of the healthiest embryos, which can further improve success rates.

How many embryos are transferred during IVF?

The number of embryos transferred during IVF depends on factors such as the woman’s age, embryo quality, and previous treatment history. Generally, in younger women with high-quality embryos, a single embryo transfer is recommended. This approach is favored to minimize the risk of multiple pregnancies, which are associated with a higher risk of complications such as miscarriage, preterm birth, and other pregnancy-related issues. However, in women over the age of 35 or those who have had previous unsuccessful IVF attempts, transferring two embryos may be considered. In rare cases, more than two embryos may be transferred, but this requires careful evaluation and consideration of the associated risks. The single embryo transfer (SET) approach has become more common in recent years as it maintains the likelihood of a successful pregnancy while ensuring the safest outcomes for both the mother and baby. By opting for SET, the risk of multiple pregnancies is significantly reduced, contributing to a healthier pregnancy.

Are there any side effects or risks associated with IVF?

Although IVF treatment is generally considered safe, some side effects and risks are associated with the process. The most common side effects include mild abdominal pain, bloating, and mood changes due to hormone therapy. A more serious side effect, Ovarian Hyperstimulation Syndrome (OHSS), can occur when the ovaries are overstimulated, leading to symptoms such as abdominal pain, bloating, nausea, and, in rare cases, more severe complications. OHSS is more likely to occur in women receiving high-dose hormone therapy, but careful monitoring can manage and reduce this risk. Additionally, there is a risk of multiple pregnancies, especially when more than one embryo is transferred, which can lead to complications like miscarriage, preterm birth, and low birth weight. Therefore, single embryo transfer is often preferred. In rare cases, there is a risk of infection during the embryo transfer procedure. However, these risks are typically minimized with careful monitoring and appropriate medical care, ensuring that IVF remains a safe and effective treatment option for couples experiencing infertility.

Are babies born through IVF healthy?

Most babies born through IVF are as healthy as those conceived naturally. The IVF process itself does not cause significant health issues in babies. However, multiple pregnancies carry a higher risk of complications, such as premature birth, low birth weight, and birth complications. These risks can be reduced by opting for a single embryo transfer (SET) rather than transferring multiple embryos. SET aims to maintain a high birth rate per pregnancy while minimizing the risk of multiple pregnancies. Long-term studies on IVF-conceived babies show that their overall health, development, and intelligence levels are similar to those of naturally conceived children. While some studies suggest a slight increase in minor genetic or structural anomalies in IVF-conceived babies, this is generally attributed to factors like parental age and health rather than the IVF technique itself. In summary, most babies born through IVF are healthy and lead normal lives, with the majority experiencing no significant differences from those born through natural conception.

Can genetic testing be done during IVF?

Yes, genetic testing can be performed during IVF, offering significant advantages, especially for couples at risk of genetic diseases. Preimplantation Genetic Testing (PGT) allows for the genetic screening of embryos before they are transferred into the uterus. PGT can identify chromosomal abnormalities, single-gene disorders, or sex-linked diseases in embryos. This testing is particularly recommended for couples with a history of recurrent miscarriages, advanced maternal age, a family history of genetic disorders, or those who have previously had a child with a genetic anomaly. By selecting healthy embryos through PGT, the risk of passing genetic diseases to offspring is significantly reduced, and the chances of a successful pregnancy are increased. Moreover, PGT helps in selecting the healthiest embryos from multiple embryos, which can enhance the likelihood of a live birth. Although PGT adds an extra step to the IVF process, it provides considerable assurance for couples at genetic risk and increases the chances of achieving a healthy pregnancy.

How is the pregnancy monitored after IVF?

The pregnancy monitoring process after IVF is generally similar to that of a natural pregnancy but may require some additional attention. About 10-14 days after embryo transfer, a pregnancy test is conducted to confirm the pregnancy. In the early weeks following IVF, doctors often recommend closer monitoring. During this time, an ultrasound is typically performed around the 6th week of pregnancy to check if the embryo has properly implanted in the uterus and to monitor the development, including the detection of the fetal heartbeat. Regular check-ups are crucial to detect any complications early and to manage them effectively. The risk of miscarriage is highest during the first trimester (the first 12 weeks) in both IVF and natural pregnancies, so careful medical supervision during this period is essential. For the rest of the pregnancy, monitoring generally follows the same protocol as a natural pregnancy, but closer attention may be required if there are multiple pregnancies or other complications. In conclusion, the pregnancy after IVF should be carefully monitored, and it’s important to follow the doctor’s recommendations to ensure the best possible outcome for both the mother and baby.