Everything you ever wanted to know about IVF

Science has certainly come a long way in its ability to help those who struggle with firtility issues.

In Vitro Fertilization, better known as IVF, was developed in the mid-1970s, though research on IVF had been conducted since the late 1800s, according to Laura Simis, inbound specialist at the Duke Fertility Center, in Durham, North Carolina. She said, "There were several claims during that time period of successful in vitro pregnancies, but the first proven birth as a result of IVF occurred in England in 1978." Since then, IVF has assisted in the conception and birth of tens of thousands of babies each year in the United States alone.

However, while statistics sound promising, that doesn't mean that it always comes easy for everyone. The IVF process can actually involve a lot of potential roadblocks. You'll need to be patient, and above all, committed to the process, as it can be an arduous one. Here are some important things you need to know if you are considering IVF to help you conceive.

How does IVF work?

Depending on who you ask, IVF can sound like a miracle or an intense medical process with no guarantees. However, before you draw conclusions, you should know exactly how it all works.

IVF is a procedure that begins by removing a woman's eggs from her ovaries and then fertilizing them outside of the body. According to the Duke Fertility Center, "The eggs are fertilized either by placing sperm on the eggs or by injecting a single sperm into each egg using a technique referred to as 'intracytoplasmic sperm injection' (ICSI)."

Simis explained that if IVF is successful, the embryos that result from the treatment are monitored and grown in a lab, where they are graded for quality and then transferred back to the recipient's uterus.

Who needs IVF?

How do you know if IVF is the appropriate treatment for you? First, there are a number of reasons an individual or couple might require in vitro assistance. Simis told me that "One in eight couples in the U.S. experience infertility problems."

This could be due to anything from hormone imbalance, low sperm count, low egg count, blocked or absent fallopian tubes, male infertility, and a "variety of other reproductive issues may cause a couple difficult in conceiving," she said. As well, "cancer survivors or people with lupus and need egg donors (or froze their eggs before treatment)," could benefit from IVF treatments, said Tasha Blasi, fertility expert, coach, and former IVF patient.

In some cases for people who are otherwise able to reproduce, in vitro fertilization may also help, perhaps if they're "single or part of the LGBTIQ community, and are planning to start a family using a surrogate," Simis said.

What you have to do

Of course, before deciding whether or not you want or need IVF treatments, your physician will walk you through the process, which can be a tricky one. According to Dr. Carolina Sueldo, a reproductive endocrinologist and infertility specialist in Miami, Florida, a full course of IVF treatment can take about two months. This timeline will depend on how quickly or how well your body responds to various medications necessary for the treatment.

There are many steps in the IVF process. The first step requires the suppression of the woman's natural menstrual cycle. This is where daily hormone injections or hormonal birth control come in and this process can last for a few weeks. The next step is called ovarian stimulation and is when you will be required to give yourself shots (ouch), anywhere from one to three times a day. This process is heavily monitored to make sure your eggs are growing the way they should be. Once your eggs have fully matured, they'll be retrieved in 34-36 hours after a human chorionic gonadotropin (HCG) injection.

After the eggs are collected, they are then immediately fertilized and monitored for their quality. Finally, once a viable embryo is chosen, it's transferred to the woman. "Embryo transfer is a simple procedure that does not require any anesthesia," Dr. Sueldo said. "Embryos are loaded in a soft catheter and are placed in the uterine cavity through the cervix."

IVF efficacy

You might be thinking that with all of those steps, IVF treatments have to be fool-proof, right?

Unfortunately, the delicate nature of the treatment and how perfectly timed things need to be is why it doesn't always work. Blasi said that "The national rate of success is 30 percent," but that at most of the reputable clinics the rate increases, and "is around 60 percent"

Dr. Sueldo told me that while the success of IVF has increased dramatically over the last several years, this is still impacted by a number of factors. "The woman's age plays a very important role, along with other reasons why the couple may be proceeding with IVF treatment," she said.

How many treatments will you need?

Because IVF treatement success depends on so many factors, there are no concrete statistics as to how many treatments any one person will need before IVF works. This is a daunting thought, which is just another reason why IVF really takes a lot of commitment.

For some people, it may take a few tries, but sometimes, it does work the first time around. "Per CDC national data, in 2014 the average number of cycles resulting in a pregnancy varied, based on maternal age," said Dr. Sueldo, "from 42.6 percent in women under 35 years of age to 2.7 percent in women who were 44 years of age or older."

"I tell my clients that the first time is trial and error because the doctors will not know how one will respond to the medicine until they start taking it," said Blasi. In fact, she herself has undergone ten IVF treatments to conceive her two children.

IVF for women over 40

As women age, the genetic material "is sticky and does not always separate normally like it does in younger women," according to Dr. Hal Danzer, co-founder of the Southern California Reproductive Center. However, this doesn't mean that IVF won't work for older women. He says that "genetically testing embryos helps to select the genetically balanced embryo and can increase chance of success."

While Simis agrees that there are women of advanced age who experience success with IVF, she said that "after the age of 36, women usually have fewer eggs and respond poorly to ovarian stimulation." In these cases, physicians will recommend the use of donor eggs, especially for mothers over the age of 40.

IVF costs

There are a number of factors specific to each individual that can affect the cost of IVF, Simis told me. Regardless of those factors, however, you should note that there is usually a significant financial investment associated with IVF treatments.

According to Dr. Danzer, "in general, the cost can be anywhere from $12,000-20,000 per treatment." Already quite expensive, that can add up to a much larger sum, considering you may need more than one treatment. Dr. Danzer also told me that "many centers have financing options available," so don't be discouraged if finances are an issue, as there may be solutions and assistance available to you.

Risks

Like any medical procedure, there are a number of side effects and risks possible for women undergoing IVF. Simis told me that these risks and side effects include, "complications during the egg-retrieval procedure, ectopic pregnancy, ovarian hyperstimulation syndrome, and premature delivery."

Miscarriage is also a concern for women trying to conceive using IVF. However, Simis said that rates for women conceiving using IVF with fresh embryos are similar to those of women who conceive naturally, "which is around 20 percent, though again, maternal age is a factor. Miscarriage rates are also slightly higher for women using frozen embryos."

Another concern may be side effects from the medications. For Blasi, the medications were not that bad. "Clomid is a pill and causes the most adverse reactions," she said. "Progesterone also seemed to cause adverse reactions, but it is also given at the end of the IVF cycle so it might have been the stress causing the reactions combined with the progesterone." If you have any concerns about any part of the treatment, including side effects of certain medications, make sure that you discuss all of that with your physician, so he or she can further explain exactly what may happen in your case.

Stress

Family planning can be stressful, especially if you're having difficulties conceiving. Some believe that stress can make it even more difficult to conceive, especially when you're going through something as serious as IVF treatments to try and get pregnant.

"Scientifically, when you are stressed there are hormones released (cortisol) which basically shuts down your reproductive system (and digestive system)," said Blasi, adding that this imbalance in hormones could affect fertility. "There are three times during IVF where anxiety is off the charts," she told me. "So, I set up my clients to anticipate these times, and be prepared with strategies to help them get through it with a little less anxiety."

According to Simis, one of the main reasons fertility patients discontinue medical treatment isn't poor prognosis or high costs. It is usually the emotional stress and burnout from continued treatments. "Patients struggling with infertility often experience feelings of inadequacy, sadness, and shame over their inability to conceive, as well as extreme worry, difficulty sleeping, less pleasurable intercourse, and feeling out of control," she said. "This anxiety only adds to their original infertility concerns, making it even more difficult to conceive." It is completely normal to feel stress and anxiety during this time, but if you feel as if it's negatively affecting your treatment, it may be a good idea to see a professional, like a fertility coach, who can help you through it.

The fun stuff

Arguably one of the more light-hearted aspects of going through IVF treatments is the potential ability to get to choose the sex of your baby! Simis said that "once IVF embryos have been created, they are sometimes screened in order to choose the healthiest to implant. Some clinics allow patients to choose which gender to implant if a screening indicates that there are healthy embryos of both sexes."

The most famous case of this so far has to be model Chrissy Teigen and singer John Legend's baby Luna. The couple openly spoke about their fertility struggles, and how they chose to have a girl for their first child. While many people were against the idea of choosing your baby's sex, you have to admit that it is nothing short of a medical miracle that in this day and age, this is even an option for people.

Another thing to note before undergoing IVF treatments, is that you're more likely to conceive multiples (twins, etc.). Statistically, "about one in six IVF pregnancies result in a multiple birth," whereas only one in 80 births from natural conception result in multiples. So, just in case, be ready to have a larger family than you originally anticipated.

Good luck!

The idea of beginning the IVF journey to help you conceive can seem intimidating and stressful. However, while there are many statistics and studies out there that you can read, it's important to keep an open mind and trust the process. Yes, it is true that not all IVF attempts are successful, but who is to say that you will be part of that statistic?

Try to focus on the positive. It will help ensure you're less stressed and, if you are able to conceive, you can say that you were present for all of it, taking it all in and reveling in the amazing process.

"Emotionally, I say that I am forever changed, for the better," Blasi told me about her IVF treatment experience. Surely, like everything in life, there will be ups and downs, but again, like everything in life, you just never know, so hang in there and good luck!