Dr Santosh Gupta, Fertility Consultant, Nova IVF Fertility, Bangalore
Infertility is often a silent struggle and despite the high prevalence of infertility in India, it has become a stereotype where the majority of infertile women do not share their story with family or friends, which often leads to psychological stress and breakdown.
Though scientific advancements are rapidly growing with success stories around assisted reproduction processes, yet the necessity of awareness around infertility and scientific approaches to curing the same is a must.
Myths About IVF Treatment
The idea behind a successful IVF is a myth to many. Patients, planning to undergo assisted reproductive treatment (ART) like IVF, should first be aware that the procedure is usually done using their own eggs and sperm, that is, their own gametes. People are often under the impression that IVF involves eggs, sperm or embryos from an anonymous donor, but that is not true in all perspectives. IVF being a time-sensitive procedure, a delayed decision can often lead to complicacy, where donors become instrumental in the procedure.
However, if timely intervention made, then self IVF can be a realistic possibility. Depending on the criticality, patients might opt for less invasive treatment options before going ahead with IVF, which includes oral medications to induce production of eggs, then trying naturally or Intrauterine Insemination(IUI) can also be tried.
What Happens If A Couple Has Failed Three Cycles of IUI
However, if a couple has failed three cycles of IUI, or age is more than 35 years, especially the female partner age, with low ovarian reserve or low sperm count or tubal blockage can opt for IVF/ICSI. It still requires a lot of social awareness and understanding, where people can come without the fear of IVF centre using donor gametes. We must understand the effect of age on egg reserve and treatment success. After 35 years eggs start depleting very fast and reach almost zero levels around 40 years of age. With low egg reserve and advanced age, chances of success reduce.
Normally in the IVF cycle, there are roughly 10 days of injections to stimulate egg growth and get multiple eggs. Usually, around the tenth day, an egg releasing injection is given and eggs are collected roughly on 12th day through a needle. It is followed by fertilization of egg with the partner’s sperm.
The embryo is cultured in the laboratory for 3 to 5 days and the best quality embryo is selected and placed in the uterus during embryo transfer procedure and two weeks later, pregnancy can be tested. Keeping everything in view, it is advisable to discuss the process of self-cycle IVF to get better clarity throughout the path to parenthood. This requires a little medical push and a lot of awareness about the whole process from self-cycle to embryo transfer in ensuring a successful conception.
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If the first attempt of IVF fails, the couple can try few more attempts of IVF with their own gametes before really jumping on to donor gametes. In general, we need 12 to 15 eggs to have a live birth. So if egg numbers are less, probably doing multiple attempts will help. Whatever number of eggs we get that should be cultured in optimum and technically most advanced culture conditions.
That is why good quality labs with proper quality control become very important. If the husband’s sperm count and motility are bad we use various methods to improve the quality otherwise, improve the selection process of sperm to be injected. Men with no sperm can be tried for surgically removing the sperm by PESA/TESA/TESE and can try IVF with their own sperm
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Parenthood is a beautiful journey, discuss it with your doctor with an open mind. Most of the IVF cycles are done with the couple’s own eggs and sperm. If there is a need for donor egg or sperm, without your knowledge and consent it cannot be done. Do not let doubts and misconceptions become an obstacle in the beautiful journey to embrace parenthood.