What To Expect When You Decide To Undergo IVF
In vitro fertilization, or IVF, is a term used to describe a set of medical procedures to encourage fertility and assist hopeful parents in conceiving a child (via Mayo Clinic).
"When IVF was created in the 1980s," says reproductive endocrinology and infertility expert Courtney Marsh, M.D., "it was for women with tubal disease, where tubes were damaged or blocked and the sperm could not meet the egg." However, "now, IVF is used for many factors, and success rates have dramatically improved with advancing technology" (via Forbes).
Whether you are a same-sex couple seeking to conceive, or you or your partner suffer from fertility troubles such as endometriosis or low sperm count, IVF is a wonderful method to help you achieve your dream of starting a family. According to Science Daily, there have been more than 8 million babies born using IVF ever since its arrival on the scene. Penn Medicine describes the process in five simple steps: First, the mother-to-be undergoes "superovulation' where egg production is increased using medication. Next, eggs are removed from the body during a simple surgery. Once sperm is collected from the father-to-be or a donor, the eggs are then inseminated. Finally, these fertilized eggs — now called embryos — are implanted back into the uterus, where they will hopefully flourish into a healthy pregnancy.
If you have ever been curious about this process known as IVF, these are 10 things you need to know before diving headfirst into your fertility adventure.
Your health needs to be in tiptop shape
The first step in your IVF journey is to focus on your health. Just as any expecting parent might make lifestyle changes to prepare for their new addition, it's important for those who wish to become pregnant via IVF to prepare their bodies for the adventure ahead (via ABC IVF).
As Deirdre D. Gunn, M.D. tells Parents, "limiting alcohol intake and quitting tobacco and other substance use can greatly improve IVF success rates." The assistant professor of reproductive endocrinology and infertility at the University of Alabama at Birmingham went on to say that couples should take the time to have conversations with their doctors about mitigating conditions like diabetes or high blood pressure before beginning IVF.
From there, you and your partner will be ready to begin the first step in the process — "Stimulation." Otherwise known as "Superovulation," this involves introducing specialized fertility drugs into your system that will kickstart the production of multiple eggs per month rather than the average single egg (via Penn Medicine). As this will be a big change for your body, it is important that your health is in tip-top shape.
Weight also plays a role in preparing the body for IVF, but the Fertility Center of San Antonio reports that "IVF treatment is not a time to diet or try to gain weight, but rather a time to ensure that the body receives a balanced diet that will provide proper nutrition."
It's a big financial commitment
Discussing finances may not be as exciting as buying maternity gear or thumbing through baby name books, but building a realistic budget is an important step in the IVF process.
In the United States, a single round of IVF — including the full cycle of ovarian stimulation, retrieval of the egg, and embryo transfer — can cost anywhere between $12,000 to $14,000 (via Forbes). This price tag will only go up if your version of IVF requires an egg donor, sperm donor, or surrogate.
The clinic you choose can also highly affect the cost of IVF, as some centers will offer you a quote that includes the cost of the fertility hormones, ultrasounds, and bloodwork that are necessary to get the IVF process rolling, while others require additional payment for these procedures later on (via Advanced Fertility). Forbes advises their readers to have a frank discussion with their fertility specialists and to request "a clear list of what the base fee includes and what will be charged as additional fees."
If you're finding these numbers disheartening, don't lose hope, as there is an ever-expanding landscape of agencies throughout the U.S. that are committed to making IVF treatments more financially accessible (via Parents). Exploring on Your Family Fertility will even show that many of these agencies target marginalized demographics, with Family Equality, Men Having Babies, and Gay Parents to Be targeting LGBTQ families and Hasidah seeking to support prospective Jewish parents.
Most women experience side effects
Although IVF is "generally very safe," according to the U.K.'s Human Fertilisation & Embryology Authority, the fertility medications involved in the process can cause myriad physical and emotional side effects. The Pacific Fertility Center of Los Angeles reports that the most common side effects include breast soreness, spotting, constipation, headaches, mood swings, hot flashes, and abdominal pain.
In some cases, women will contract ovarian hyperstimulation syndrome (OHSS), a condition where the ovaries become swollen in response to "excess hormones" (via Mayo Clinic). Mayo Clinic goes on to report that the majority of women who contract OHSS will experience only a mild form that "usually goes away after about a week." However, if OHSS occurs during an IVF cycle that does result in pregnancy, symptoms may return later on in the process. In cases where women contract a more serious case of OHSS, symptoms like uterine pain and nausea will become heightened and often accompanied by sudden weight gain and blood clots. The first step in treating OHSS is visiting your doctor for an ultrasound exam to check for fluid in the abdomen. If fluid is found, your doctor will most likely perform a paracentesis, where fluid is removed with a syringe (via Reproductive Facts).
Reproductive Facts reports that "One out of three women has symptoms of mild OHSS" while undergoing IVF, so it is crucial that women educate themselves on the risks of this syndrome.
You may be able to choose your baby's sex
Have you ever heard of preimplantation genetic testing? This is where, during the IVF process, fertility specialists will test your embryos for genetic abnormalities, such as cystic fibrosis or sickle cell anemia, before implantation occurs (via UCSF Health).
The president and medical director of Chicago's Reproductive Medicine Institute, Dr. Elena Trukhacheva, tells Parents that these tests are run "in response to medical indications, such as multiple miscarriages or failed past IVF cycles or advanced maternal age" and that "using a screened embryo increases" one's chances of having a successful pregnancy. If testing reveals that there are healthy embryos with both XX and XY chromosomes, then your doctor may offer you the chance to choose the sex of the embryo that will be implanted into the uterus.
There are many reasons why prospective parents may want to choose their baby's sex, including a desire to prevent sex-based genetic disorders or to attempt "family planning," where parents who have several children of one sex may desire to have their next child be the opposite sex (via Health).
There has been a fair amount of pushback against choosing an unborn baby's sex, especially when this decision is made based on non-medical reasons. Publications in the Journal of Obstetrics, Gynaecology and Reproductive Medicine sometimes use the phrase "designer babies" to refer to these infants. However, the decision is a personal one wholly up to you and your fertility specialists.
IVF can put stress on your romantic relationship
Between the financial cost and the physical trials, IVF has been known to put romantic partnerships through the wringer. If you're going into IVF with a hopeful co-parent by your side, it's important that the two of you practice coping mechanisms and prepare for some intense decision-making (via SART).
While everyone's experience with IVF is different, with some parents enjoying a healthy pregnancy after a single round and others struggling to conceive for years, the process will nevertheless come with some big life changes. The Society for Assisted Reproductive Technology reports that many IVF recipients compare the emotional experience of undergoing IVF to the experience of a death in the family, a separation, or divorce. The Center of Perinatal Excellence warns that hopeful parents who undergo IVF often notice an increase in anxiety and depression and a decrease in self-esteem, especially if they fail to conceive in the first round.
For this reason, the Center recommends that couples who have chosen the IVF route reach out to mental health professionals to help guide them through these emotional trials. There is even evidence that therapy can "improve the likelihood of becoming pregnant one year on." With good communication and therapeutic help, then, you and your partner will have all the tools you need to weather the storm of IVF. SART encouragingly repo s that there is no scientific evidence of IVF causing "long-term" damage to "the marital relationship."
It can take multiple tries
While it's natural to dream of the day when you get to hold that positive pregnancy test in your hands, individuals who choose to go the IVF route need to be aware that the process is often a lengthy one and it can take several rounds of ovarian stimulation, egg retrieval, and embryo transfer for your dream to be fulfilled (via Verywell Family).
Most recently, a new study out of the Medical Journal of Australia finds that only 33% of women will find success on their first round of IVF (via the BBC). Rather than processing this information as a negative, co-author of the study and researcher at the University of New South Wales, Prof. Michael Chapman, encourages prospective parents to view this number as a positive revelation.
"If you keep coming back for more treatment," he says, "your success rate ends up being higher." With this in mind, failure to conceive on the first round is not the end of the road but only the beginning.
Medical history and maternal age are the two most critical factors in determining the success of your IVF journey, with live birth rates decreasing for women as they age. For women above the age of 42, the "percentage of live births per egg retrieval" is only 4.2%. However, no matter which boxes you tick, it's important to remember that statistics are not destiny and that there are multiple paths to parenthood available to you.
All clinics are different
From choosing a name for your new bundle of joy to deciding on colors for the nursery, parenthood involves a lot of decision-making. For parents who choose to go the IVF route, one crucial decision will be deciding which fertility clinic will help guide them through the journey (via Parents).
As with any major medical decision, the first step is to do your research. It's important for hopeful parents to understand the exact reproductive technologies available at their local clinics, as some clinics may be better equipped to assist in your personalized journey than others. Additionally, some clinics may provide more funding than others (via PFCLA).
According to the Pacific Fertility Center of Los Angeles, the most important criteria that prospective patients should be thinking about when choosing a fertility clinic are the friendliness of the staff, available services, ease of communication, pricing, accessibility, and the success rates reported at this specific clinic. While you may have to compromise in some of these areas, such as choosing a clinic that is a bit far away from home, PFCLA encourages readers to remain careful and analytical and to trust their gut when choosing a fertility clinic.
The chief of reproductive endocrinology and infertility at New York-Presbyterian/Columbia University Irving Medical Center, Dr. Zev Williams, also tells Parents that his top tip in choosing a fertility clinic is to find a place that expresses a genuine care for you as their patient and where "where treatment is personalized."
IVF doesn't work for everyone
Despite scientists' and doctors' best efforts, IVF is not a cure-all for infertility. For IVF patients who desire to have children via pregnancy, it's essential to consider what options might be available if conception remains elusive after multiple rounds of IVF (via L.A. IVF Center).
According to Advanced Fertility, the most common reason women fail to conceive following IVF is the "arrest of the embryo." This occurs most often with couples who forgo preimplantation genetic testing; therefore, the unscreened embryo that ends up being implanted into the uterus will sometimes have genetic abnormalities or other issues that make it too "weak" to thrive. For many couples who are disappointed after several cycles of IVF, embryo adoption may be the way to go. This is where donor embryos from previous IVF patients are used in lieu of an embryo fertilized using either of the patients' genetic material (via Parents).
When couples succeed in their IVF journey, they will often have multiple fertilized eggs frozen by their clinic in case they decide to undergo the process once more. Couples who choose not to expand their family using these frozen embryos can donate them to another couple still struggling to conceive (via Embryo Adoption). While babies born through embryo adoption will not be genetically related to their parents, this alternate route allows parents to experience the magic of pregnancy and birth.
There are health risks involved
It's no secret that IVF takes a toll on your body. From injecting hormones to egg retrieval, the process involves a series of medical interventions that come with their own medical risks. While most women won't experience anything more than the expected minor side effects, there are instances where IVF can cause more serious ailments (via Reproductive Facts).
As with any big medical decision, it's essential to be aware of all the possible risks when choosing IVF. One important step in the process is the egg retrieval procedure. Using a thin needle, your doctor will pierce the vaginal wall to gain access to the ovaries, allowing your eggs to be collected. The goal is to retrieve the most viable ones that can be fertilized in the fertility clinic's laboratory (via Extend Fertility).
This 15-minute surgery is minimally invasive and is "essentially painless," according to Extend Fertility. However, as with any invasive surgery, you do run the risk of injuring neighboring organs to the ovaries, such as the bowel, bladder, and blood vessels. Some women have also been known to contract pelvic infections following an egg retrieval surgery. Still, Reproductive Facts reports that this response is becoming "uncommon" thanks to the antibiotic medicines administered during the procedure.
The risks also continue after conception, with Mayo Clinic claiming parents should be aware that "IVF slightly increases the risk that the baby will be born early or with a low birth weight."
Fertility science is always evolving
One thing to remember when planning your fertility journey is that science is constantly evolving. Just as many of the reproductive technologies available today were not accessible ten years ago, the same could be said for 2033; time will only tell what paths to parenthood the future has in store (via The Guardian).
One of the latest advancements in IVF technology is the advent of "needle-free" medication, pioneered in 2019 by the New Hope Fertility center of New York. This experimental method uses "oral pills, vaginal suppositories, and nasal spray" instead of the usual method of needle injections and bloodwork (via Parents). The director of IVF research at the New Hope Clinic, Dr. Zaher Merhi, is excited to make this technology the new norm, telling Parents, "It is about time to update IVF protocols to minimize risks and inconvenience related to conventional IVF." He says that the "conventional IVF" methods "are too intense and heavy on patients' body and mind."
The Guardian also reports that scientists have made recently broken ground on a new method of IVF that produces "three-person babies." This version of IVF seeks to "eliminate certain incurable genetic diseases" by replacing a parent's diseased mitochondrial DNA with healthy DNA from a third-party donor. While these procedures are still in their infancy, the future is bright, and IVF hopefuls will soon have many more avenues for creating the happy, healthy family of their dreams.