IVF stands for in vitro fertilization. It's one of the more widely known types of assisted reproductive technology (ART). IVF works by using a combination of medicines and surgical procedures to help sperm fertilize an egg, outside a woman’s body and the thand help the fertilized egg implant in your uterus.In-vitro fertilisation, also known as IVF, is a medically assisted pregnancy procedure where the eggs are surgically taken from the ovaries and allowed to fertilize with the sperm in a specialised lab. After fertilisation, the eggs are once again transferred to the ovaries where they develop into a baby.It is typically used to combat disorders related to pregnancy, genetic or otherwise.
How In- Vitro fertilization is done:
The technique for in vitro fertilization is not that complicated, but to carry out the conceptual instructions on the practical level is not that easy either. Four things are needed for the whole procedure:ripe eggs ready to be fertilized, sperm, a medium in which to mix the two, and a medium in which to support embryo development. To obtain the ripe eggs, called preovulatory oocytes, the woman is injected a dose of the hormone human chorionic gonadotropin (HCG), which stimulates her ovaries to prepare eggs for release.
About 34 hours later, attempts are made to recover the eggs. If a few extra hours are allowed to elapse, the eggs will have been released from the ovary and will be unrecoverable. The woman is put under anesthesia for removal of these preovulatory oocytes. A small incision is made in her abdomen and a laparoscope inserted in it. Preovulatory oocytes are removed by suction. Most patients have between one and three preovulatory oocytes after they have been treated with HCG.
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Before or after the oocytes are removed, the woman may be treated with additional hormones to help prepare her uterus for the rest of the procedure. Before laparoscopy, the woman's husband donates a sperm sample, which is washed and diluted. The sperm are diluted in order to simulate conditions in the fallopian tubes where fertilization occurs. The sperm are put in a salt solution, where, within a few hours, they undergo capacitation, that prepare them to fertilize the egg.
Droplets of the solution containing the sperm are placed in a petri dish that is partly filled with inert oil. The droplets sink to the bottom of the dish. Each preovulatory oocyte is pipetted into one of these droplets. A few hours after the sperm and egg are combined, fertilization occurs. About 12 hours later, the embryo is transferred to a different solution that supports embryo development. After 2 days, the fertilized egg becomes an eight-celled embryo.
After 4 days, it is an approximately 100-celled embryo (called a blastocyst). Some time between 2 and 4 days after fertilization, the developing embryo is inserted into the woman's uterus. (The ideal time for insertion is yet to be discovered by the scientists). Insertion of the embryo into the uterus involves drawing up the embryo in a fine plastic cannula, inserting the cannula into the uterus, and ejecting the embryo. Now, if the procedure has gone on perfectly so far without any snag, the embryo will fertilise, and slowly develop into a baby.
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- Side-effects of injected fertility drugs: The injectable fertility Gonadotrophins given to the woman to stimulate the release of eggs can have several side effects like nausea, allergic reactions, fatigue and Ovarian hyperstimulation syndrome(OHSS).In very rare cases, the use of gonadotropins can lead to blood clots and kidney failure.
- Risk of miscarriage: It is very important to remember that IVF does not increase the risk of miscarriage. Studies show that the rates of miscarriage in IVF are about the same as natural conception. But after such an expensive and rigorous procedure, a miscarriage can be devastating for the mother.
- Risk of higher-order births: In vitro fertilisation carries an increased risk of higher order births with their attendant risk of major morbidity. Some countries have made efforts to limit replacement of embryos to two (Australia, New Zealand) or even one (Sweden, Finland), whereas other countries have not, despite clear evidence that replacement of three embryos increases only the risk of the birth of triplets but not the overall pregnancy rate.The frequency of higher order births (three or more) between 1973 and 1990 increased at about seven times that of singleton births. Triplets practically never go to term, if they survive the pregnancy process at all.Most are born six to eight months prematurely
- Ectopic pregnancy: Ectopic pregnancy is a condition when the fertilised egg doesn’t attach to the uterus. Instead it may attach to the fallopian tube, abdominal cavity, or cervix. The risk of such a condition is undeniably higher in IVF, and it could lead to vaginal bleeding, abdominal pain, and rise in pregnancy hormones.
- Side-effects after the IVF cycle: The painstaking procedure of IVF may have some side-effects after the process is completed, which include mild cramping, bloating, constipation,breast tenderness,etc.Although impossible to prevent, they are not very serious, and goes away after a time.
- Financial strain: IVF can be ridiculously expensive, more so since it has now developed into a full-fledged industry. Often the desire to have a baby outscores practical considerations, which then places financial burdens on families.
- Social stigma: Even in the supposedly progressive 21st century, ethical and social biases persist about in-vitro fertilisation. A woman undergoing IVF may face ridicule and isolation from her relatives or community.
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All things considered, the benefits of IVF far outweighs the risks. Most side-effects are manageable and can be controlled if caught early and properly treated. However, a healthy relationship between the woman and the doctors of the fertility team is integral to the process.
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