What exactly is IVF?
IVF or In-Vitro fertilization is a process by which the
eggs or the oocytes of the women are fertilized by the sperm of male partner
outside the human body in the laboratory. Though it is commonly called as test
tube baby the eggs are actually fertilized in small dish. In nature, this
process of fertilization takes place in the fallopian tube of the women. This
is called in-vitro fertilization.
After fertilization an embryo is formed which grows for 4
days in the fallopian tube and then it is transported by the fallopian tube
into the uterus or the womb where it grows into full term baby in 9month time.
In IVF this process happens in a small dish outside the human body and the
embryo or embryos are transferred directly into the womb or the uterus thus
bypassing the fallopian tube. It is important to know that not all embryos grow
into a child. Some stop developing at an early stage and the pregnancy does not
continue and this is one of the major reasons why multiple embryos are
transferred into the uterus in the process of IVF.
How long should I wait
before consulting a fertility doctor?
According to the world health organization (WHO)
Infertility is “a disease of the reproductive system defined by the failure to
achieve a clinical pregnancy after 12months or more of regular unprotected
sexual intercourse.”… (WHO-ICMART glossary1). “Infertility is the inability of
a sexually active, non-contracepting couple to achieve pregnancy in one year.
If you have been having regular sexual intercourse and are not using any
contraception and cannot get pregnant after a year you should consult a
fertility specialist. These definitions and timelines are modified in special
circumstances for example if you are over 35 do not wait for longer than six
months and if over 40 years then it is better to seek guidance sooner than
later as fertility is highly dependent on the age of the female partner. This
is called as biological clock and as the human body ages there is damage to the
DNA inside the cells which makes pregnancy difficult and many couples will need
assistance. In some cases the woman is born without a uterus called as MRKH
syndrome and needs IVF Surrogacy to achieve a pregnancy. In other conditions
for example if you have a history of genetic disorders in your family you
should seek fertility counseling to determine the risk of transmission to your
body.
How successful is IVF?
The success rates of IVF vary from high (50 to 70%) in
young couples to very low (less than 10 percent) in woman aged above 42 years
using their own eggs. It also depends on the quality of sperm of the male
partner but in general techniques like micro test have now made it possible for
men with zero sperm count also to achieve fertility by surgically finding sperm
in the testis. The success rates also depend on the uterus and uterine lining
for example women with uterine damage after tuberculosis infections may find it
difficult to achieve a pregnancy.
How long
does IVF take?
An IVF treatment involves 3 stages:
1.
Pre IVF investigations which take a few days or
a week (some special tests can take 3 to 4 weeks to get result but these are in
rare circumstances).
2.
The IVF procedure of injections and regular
ultrasound san and blood tests monitoring and the egg collection and embryo
transfer process into the uterus. This takes 2 to 4 weeks depending on whether
your doctor has put you on the short or long protocol.
3.
Post procedure waiting for the pregnancy test
results which is 2 weeks.
What happen if I become
pregnant?
If you are fortunate to achieve pregnancy you will first
need to find out if this is a singleton pregnancy or a multiple pregnancy
(twins/triplets). The first 2 months of the pregnancy are crucial and you will
be advised some extra medication like progesterone in addition to routine
medications given to women who conceive naturally. The purpose of these
medications is to support the pregnancy. After this time period the pregnancy
is then considered as any routine pregnancy with its monitoring. However IVF pregnancies
tend to have a slightly higher rate of complications like bleeding in pregnancy
high blood pressure diabetes etc. So your doctor will probably monitor you more
closely as compared to a spontaneous pregnancy.
Are there any effects
associated with IVF?
Side effects of the IVF medications include short term
once like stomach upset headaches breast tenderness mood changes feeling of
bloating etc. These are generally short term and pass off in the first 2 months
if you are pregnant. If you do not get pregnant these pass off in 2 weeks when
you get your next period. Many studies have looked at the link between cancer
and infertility. A woman who is infertile and doesn’t breast feed her baby has
a slightly higher risk of ovarian cancer. No link between IVF and cancer has
been established in fact one cloud argue IVF is protective to women with
infertility.
What about in India IVF
Market?
India by virtue of its large population projected
to be 1.25 billion has a large number of couples who require assistance to
achieve a pregnancy. Infertility in the country is rising in line with a global
trend in rise in infertility. According to the ICMR Publication approximately
1.8 million couple in the country needs infertility treatment. The ICMR study
put the incidence of infertility in India at approximately 4% which is lower
than approx. 10% seen in Western countries. To put things in perspective some
numbers are below: India projected population – (2009) – 1166 million. 604
million male and 562 million female. Age group 15 to 49 years – Rural – 3.38
million, Urban – 4.82 million total 8.2 million married female population 15 to
49 years – 216 million (38.5%) Prevalence of Infertility approx. 3.8% (Source:
Registrar General of India 2005/ Sample registration system / ICMR Study 2011)
Countries which have a population of approx. 8.2 million or lower include
Austria, Hong Kong, Libya, Finland, Denmark, Norway, New Zealand, Singapore,
Israel, Switzerland. India’s demographic shows population that is young and
thus a greater need for fertility treatment options. Today, at approx. 1.2 to
1.5 lakh IVF cycles a year, India performs only approx. 90 cycles per million
population compared with 3,000 per million populations in Israel, 1,500 in Australia,
500 in the US and 220 in Egypt. Varying reports put the Assisted Reproductive
Technology (ART) market in India to be worth at $1 billion (Rs. 5000) in the
next 1-2 years and forecast to cross the Rs. 10,000 crore marks by 2018. In
2012, global IVF market had a value of $9.3 billion which is projected at %21.6
billion by the end of 2020. A worldwide decline in sperm parameters, late
marriages and pregnancy, decline in egg quality, environments factors like
pollutions, pesticide use, even mobile phone use or stress may play a role in
the environmental factors contributed to rising rates of infertility. Along
with these increasing availability even in small towns of advanced fertility
treatment and options of third party reproduction like Donated gametes and
surrogacy offer more options to couples unable to achieve pregnancy by other
means such a conversational IVF increased demand is mainly due to current
trends of late child bearing, environmental factors etc. Increased availability
with even smaller towns and semi rural areas having new fertility centers, plus
scientific advance leading to a range of treatment options to treat infertility
are readily available in India. These include medications for ovulation
induction, endoscopic surgery to correct or minimize anatomical and medical
conditions, and the assisted reproductive technologies, include IUI, IVF, ICSI
(Intra cytoplasmic sperm injection) and many more. India has foreign trained
highly skilled doctors and fertility treatments are available at very
competitive prices which is why many more people are able to access it now.
Patient awareness camps that are being regularly conducted by corporate and
medical institute along with celebrity real life stories of success with
fertility treatments have given acceptance to this in the Indian context and
have raised its profile. Medical Tourism in the country for fertility treatment
is also rising.
