IVF Treatment FAQs

Following are the common questions about IVF Treatment:

1. What is IVF treatment?
2. Who needs IVF treatment?
3. Is IVF painful?
4. How is IVF done?
5. How many injections are required for IVF treatment?
6. What is a good AMH level for IVF?
7. Is IVF a safe treatment?
8. Are IVF babies healthy?
9. Who is not a good candidate for IVF?
10. What to do after embryo implantation in IVF?
11. Can I travel after IVF?
12. Can IVF lead to ectopic pregnancy?
13. Are there any side effects of IVF treatment?
14. Can age affect the outcome of IVF treatment?
15. What is the difference between IVF and test-tube babies?
16. Is IVF and surrogacy the same?

Q. What is IVF treatment?

A. IVF or in-vitro fertilization is a common artificial reproductive procedure that helps a woman conceive where they cannot get pregnant naturally. IVF is known as इन विट्रो फ़र्टिलाइज़ेशन in Hindi. In this treatment, the egg of the female is fertilized by the male sperm in a scientific glass tube or a Petri (vitro) dish under a medically controlled environment, hence the in-vitro fertilization. Over 8 million IVF children have been born, and over 2.5 million cycles are being performed every year, resulting in over 500,000 deliveries annually.

In IVF treatment, the ovaries of the woman are first stimulated by medicines to produce enough eggs for fertilization. Once the ovaries produce enough eggs, the doctor retrieves (in common terms, collects) the mature eggs and places them on a petri dish. Simultaneously, the male partner produces his semen from which the IVF doctor cleans and collects the healthy sperm and places it along with the eggs on the same dish to allow fertilization to take place. If the egg is successfully fertilized, the IVF team monitors the growth and development of the embryo for the next 4-6 days. If the embryo continues to develop, the doctor takes the embryo and implants it in the uterus of the female where the pregnancy takes place for the next 9 months.

Q. Who needs IVF treatment?

A. IVF is a good treatment option by any couple where the male or the female partner suffers from any of the following health problems/ conditions:

• Damage or blockage in the fallopian tube
• Ovulation disorders
• Uterine fibroids
• Endometriosis
• Unexplained infertility
• Low-quality sperm production
• Any genetic disorder
• Fertility preservation for cancer

Q. Is IVF painful?

A. Pain is subjective; it differs from person to person. IVF is not physically painful for most women. But, emotional pain is a bigger concern here. When it comes to physical pain, a woman who is more sensitive may experience a greater level of discomfort than a woman who is less sensitive. The only part of IVF where women have reported feeling pain is the egg retrieval procedure that involves the use of needles and injections.

Unlike any other treatment, IVF is more than just the physical pain. The treatment involves a good deal of emotional pain. When the treatment does not provide desirable results, it can cause a lot of emotional pain and stress in the minds of those who undergo the treatment. Of course, there is physical discomfort, but that is negligible and can be easily managed too.

Q. How is IVF done?

A. IVF treatment involves the following procedures.

• Ovarian stimulation - In ovarian stimulation, the doctor stimulates the ovaries to promote the growth of the follicles that contain the eggs. The common hormone medications that are used to stimulate the follicles are Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH).
• Trigger Injections - Once the doctor sees that the egg follicles in the ovaries are enough, he/she would stop the LH and FSH injections and would recommend the time when you need to administer trigger injections. Human chorionic gonadotropin (hCG) is injected in the ovaries to mature the eggs and help them get released from the ovarian follicle wall.
• Egg retrieval - Egg retrieval or 'egg picking stage’ is a daycare procedure. It is done under general anesthesia. During the procedure, the doctor inserts a fine needle with an ultrasound-guided probe through the vaginal canal of the woman to retrieve her mature eggs. On average, 8-15 eggs are collected during this process.
• Sperm collection - After retrieving/ collecting the eggs, the IVF doctor will need to collect the sperm from the male partner. The male partner is asked to produce his semen specimen. The male partner can produce his semen specimen at home or at the clinic where the semen specimen would be stored. In case the couple wants to use donor sperm or frozen sperm, the IVF team will get it ready in the lab.
• The collected sperm sample is washed and cleaned with medicine under a microscope to get rid of all sorts of dirt and debris. The cleaning procedure is done to get the healthiest sperm that can fertilize the eggs.
• Fertilization - The healthy sperm is placed in an incubator along with the eggs for fertilization. The process is very similar to that of natural fertilization where ‘sperm meets eggs’ inside a human body.
• Embryo development - The fertilized egg turns into an embryo. The IVF specialist will collect the embryo, place it in a special incubator and monitor its growth for the next 4-6 days. The developed embryo shall be mixed with amino acids and other medicines for proper growth. If the growth of the embryo is consistent, it is likely to turn into a 4-8 cell embryo by the 4th day.
• Embryo transfer - The developed embryo is transferred from the incubator and implanted in the uterine wall. The doctor will collect the embryo with a very soft, flexible, and thin catheter. Using a speculum, the doctor will open the cervix and insert the catheter through the cervix into the uterus to plant the embryo. An abdominal ultrasound is conducted to make sure that the embryo is placed at the correct location.
• Pregnancy check - The woman would be called to the clinic after 2 weeks for a blood test. If the blood test shows the presence of hCG in it, the pregnancy is successful. If the blood test does not show the presence of hCG, it indicates that the pregnancy is not successful. In that case, the doctor may either repeat the entire process once again or may determine another line of treatment.

Q. How many injections are required for IVF treatment?

A. Two different injections or injectable medications are involved in IVF. The first is Lupron, which is injected into the abdominal area or the thigh. The second injectable medicine is Follicle-stimulating Hormone (FSH), which is used to stimulate her ovaries so that they can produce several eggs.

Q. What is a good AMH level for IVF?

A. The full form of AMH is the anti-mullerian hormone. It is a substance produced by granulosa cells in ovarian follicles. AMH level that ranges from 1.5 – 4.0 ng/ml is medically considered normal. If the AMH level is over 4.0 ng/ml, it is considerd to be high. A low normal range of AMH ranges from 1.0 – 1.5 ng/ml. If the AMH level is anywhere between 0.5 – 1.0 ng/ml, it is considered to be very low.

Q. Is IVF a safe treatment?

A. IVF is generally a very safe and effective fertility treatment and most women do not experience any problems during IVF treatment. However, there are some risks and complications that can affect the outcome of the treatment too. In order to avoid complications, it is important that you undergo the treatment only at the hands of a trained IVF doctor.

Q. Are IVF babies healthy?

A. Yes, IVF babies are healthy and look the same as normal babies. The primary difference between IVF babies and normal babies lies only in the conception procedure. IVF babies are completely normal with similar features to those of other babies. The babies can undergo normal delivery too. Once born, nobody can differentiate whether the baby is born through IVF or otherwise.

Q. Who is not a good candidate for IVF?

A. IVF treatment is most often a very successful and safe fertility treatment for any woman who is not being able to conceive naturally. But in certain cases, IVF may not yield successful results. Some of the health conditions that may create not warrant a woman as a good candidate for IVF are hormonal imbalance, ovarian dysfunction, uterine abnormalities, fibroid tumors, and uterine fibroids. If the woman has any of these health conditions, the IVF doctor will most likely not recommend IVF treatment to the couple.

Q. What to do after embryo implantation in IVF?

A. There are certain dos and don'ts that you need to follow after embryo implantation in IVF for better pregnancy outcomes.

• Prioritize self-care for the next couple of days. Indulge in pampering yourself.
• Take the medicines that the doctor has recommended. Do not skip medicines. But most importantly, do not take medicine without the knowledge of your doctor.
• Eat a healthy diet. Embrace good food habits. Eat a lot of fruits and vegetables, foods rich in iron, calcium and vitamin B.
• Take folic acid supplements. You will need 400 mcg of folic acid to ensure a healthy pregnancy and to prevent neural tube defects.
• Refrain from sex until the doctor says it is fit to do so. Sexual intercourse can trigger contractions in the uterus. In worst cases, it can prevent the embryo from getting attcahed to the uterine wall.
• Pay attention to symptoms such as nausea, vomiting, unusual abdominal pain, diarrhea, spots etc. In any of these cases, check with your IVF doctor without any delay.

Q. Can I travel after IVF?

A. Yes, but with preventions and precautions. Make sure to inform your doctor regarding your travel plans. There is no medical evidence that states that traveling can cause harm either to the mother or the fetus. Here are a few travel tips during IVF that can help you:

• Check on the government websites of the respective country and understand the travel related regulations. Most of the information shall be available on the WHO and CDC website.
• Talk to IVF doctor. Tell them about your travel plans, how long ould it last and how the treatment would proceed in another city. Check if your travel would interfere with your doctor visits and appointments.
• Prep up your medical supplements. Store your medicines before you travel. Carry a note for the medicines from your doctor, just so you need.

Q. Can IVF lead to ectopic pregnancy?

A. No, IVF treatment does not lead to ectopic pregnancy. The incidence of ectopic pregnancy is 1% of all pregnancies and for in vitro fertilization (IVF) case it is estimated to be 1-3%. If performed under expert supervision, IVF does not lead to ectopic pregnancy.

Q. Are there any side effects of IVF treatment?

A. Yes. IVF treatment involves the use of very strong hormone medications and medicines to stimulate the ovaries. Commonly reported side effects of IVF treatment may include - multiple births, premature delivery, low birth weight, ectopic pregnancy, complications during the egg retreival procedure, miscarriage, birth defects and in rare occassions, ovarian cancer.

Q. Can age affect the outcome of IVF treatment?

A. Yes, age is a very important deciding factor in case of IVF success or failure. The success rate of an IVF treatment depends highly on the age of the woman. As a woman ages, her chances of having a successful career gradually go down.

• If the woman is below 35 years of age, the percentage of live births per egg retrieval is 54.4%.
• For a woman between 35 to 37 years of age, the percentage of live births per egg retrieval is 42%.
• For a woman between 38 to 40 years of age, the rate of live births per egg retrieval is 26.6%.
• For a woman aged between 41 to 42 years, the rate of live births per egg retrieval is 13.3%.
• If the woman aged 43 or above, her chances of live births per egg retrieval go to as low as 3.9%.

Q. What is the difference between IVF and test-tube babies?

A. IVF and test-tube babies are two different names used for the same procedure. Before the term, IVF came into medical existence, the entire procedure used to be known as test-tube babies since the fertilization was done in a tube-like medical device. But the modern-day IVF is done on a petri dish but the procedure remains the same.

Q. Is IVF and surrogacy the same?

A. Although IVF and surrogacy are two of the most common treatments recommended to people who face trouble bearing a child through a natural process, the two terms often confuse people.IVF or in-vitro fertilization is a process where the fertilization is made to take place inside a glass tube or a dish. Surrogacy is a process where an infertile couple who wants to bear a baby, hires a surrogate mother. This treatment is mostly done in cases where the woman is unable to carry the baby inside her womb and hence hires another womb where the fetus develops.

In IVF, the carrier of the baby is the biological mother. In surrogacy, the carrier of the baby does not share any genetic connection with the baby. IVF is a modern age fertility treatment. On the other hand, surrogacy is the conventional procedure for infertile couples. In both the techniques, the eggs and sperm of either the real parents or a donor can be used.

Know More - Cost of IVF Treatment