IVF– or in vitro fertilisation, stands for fertilisation taking place outside a woman’s body under controlled laboratory conditions. A woman’s eggs are collected and fertilised by sperm. The fertilised egg/s are then implanted into the woman’s uterus.
IVF treatment is an option when natural conception isn’t possible.
Infertility is a more common issue than we give credit for. On average, a healthy 30 year old woman has around a 20% chance of conceiving each month. By the time she reaches 40 years of age, her chances have dropped to around 5%. Fertility for women decreases as they get older, because of changes in the menstrual cycles and the number and quality of her eggs. Older men do not produce sperm are which are as healthy or mobile as younger men do.
Most of us assume we’ll be able to conceive naturally and have children when we plan a pregnancy. But it’s not always as straightforward as this. Around 1/3 of fertility issues are due to women, 1/3 due to men and the remainder due to a combination or unknown causes.
The general recommendation is that if a heterosexual couple, having regular sex have been trying to conceive for one year (or six months if you are over 35), and are having no success, then it’s time to be checked. A consultation with a general practitioner and then referral to an obstetrician and gynaecologist specialising in fertility problems is the usual management.
There are a range of reasons why IVF can become necessary. Generally it’s used when natural conception isn’t possible or, there is a high risk of genetic abnormalities being passed on to the baby.
IVFinvolves a number of steps. Although individual fertility clinics may vary in their techniques, the general principles and proc esses are the same.
After taking a careful history, having a counselling session and basic screening tests from the couple these are the usual IVF steps:
This is when your partner needs to do his bit and provide the scientists with a fresh sample of semen. With every ejaculation there are around 250 million sperm released, though this number varies. Age, hormones, frequency of ejaculation, diet and general health all play a role.
With standardIVFtreatment, the eggs and sperm are mixed together in a Petri dish. If the egg is fertilised, the embryo is cultured in the laboratory for around five days and monitored carefully before being transferred into the woman’s uterus.
If the quality or quantity of the sperm is not sound, then a single sperm may be injected into an egg and then transferred directly into the woman’s uterus.
An alternative is when sperm are sorted and the healthiest are selected to for transfer directly into the woman’s uterus. This can happen when the risk of genetically inherited disease from the father is high.
Pregnancy tests are usually done around ten days after the embryo transfer. Medication used in IVF treatment can affect a urine pregnancy test, which is why a blood test is more accurate.
Clinics in Australia aren’t required to publish their success rates of IVF. And the way they do treatments and interpret their successes varies. As a general rule, the younger the woman the higher the chances of success.
The cost of IVF can be considerable, not just in money terms but emotionally as well. Some couples need several rounds or cycles of IVF before they have a successful pregnancy. Before you start IVF, speak with Medicare and your private health insurer so you understand the costs.
The cost of IVF varies between individual clinics and treatments. Only some of the cost of IVF is covered by Medicare and private health insurers, and there are generally out of pocket expenses.
The chances of success with IVF are dependent on many factors however, there’s generally a 1 in 5 chance of becoming pregnant and having a baby after successful IVF. The younger the woman, the greater the chances of her having IVF success.
There have been some changes in fertility clinic practice around the numbers. Currently many clinics will only transfer one or two back, so that the chances of having a multiple pregnancy are reduced.
There are some bulk billing IVF clinics, though these are outnumbered by the number of private companies.
Written for Huggies by Jane Barry Midwife and Child Health Nurse on 4/05/20.