IVF: What you need to know
One in six Australian couples suffer from infertility. It’s important to remember not everyone who is having trouble conceiving will need to undergo IVF (in vitro fertilisation).
Dr Scott Pearce, a senior specialist in Infertility & IVF, Gynaecology and Obstetrics explains what you need to know.
What is in vitro fertilisation (IVF)?
IVF is where hormones are given to stimulate a woman’s natural egg production. A doctor steps in at the right moment to extract the eggs. These are then brought together with sperm in a laboratory dish (rather than a woman’s fallopian tubes) to create embryos. The embryo grows under laboratory conditions for five days, to the stage where it is called a blastocyst. This is the ideal time to transfer the fertilised embryo back to a woman’s uterus.
IVF has helped thousands of couples fall pregnant, however there is no guarantee it will work for everyone.
When should you seek fertility help?
If you’re over 35 years old and you’re not falling pregnant naturally within about six months of trying, you should consider seeing a fertility specialist. If you’re under 35, it’s recommended you try for a year, unless you have any health concerns like pelvic pain or irregular periods.
Having trouble conceiving doesn’t automatically mean you need IVF. Talk to a fertility specialist about your individual situation and they will investigate why you’re not falling pregnant. The doctor might arrange some tests for both of you.
About a third of the time when a couple are having trouble falling pregnant it can be due to a sperm problem. The doctor will arrange for a sperm test to analyse numbers and function. Women are usually asked to take a blood test to make sure ovulation is normal.
An ultrasound to check the uterus and ovaries may also be needed to check for any cysts or abnormalities that may affect fertility.
How successful is IVF?
IVF can be very successful for some couples, but again, one of the main factors is a woman’s age. If a woman is in her 20s or early 30s the chances of an embryo, known as a blastocyst, taking in her womb is about 50 per cent. For women in their late 30s it’s a bit lower at about 40 per cent. When a woman is over 40, the chances drop to around 25 per cent for each embryo transfer.
Fortunately with IVF a lot of couples do get more than one embryo (blastocyst) formed in the laboratory. If you have more than one healthy blastocyst you can freeze the remaining embryos to try again if implantation is unsuccessful, or to achieve a second pregnancy. Embryos can freeze well and over 90% will usually survive being thawed out, and their pregnancy potential is about the same as using a fresh embryo.
If IVF isn’t successful the first time, the first option is to use any frozen embryos. If a couple aren’t pregnant after using their frozen embryos the next step is to see their fertility specialist again to go over their treatment. It’s really an individual approach and their IVF cycle can be tweaked to meet the needs of the couple to ensure their best possible chance of conception.
One of the other options is a more advanced IVF process known as advanced embryo selection. It’s where a biopsy is performed to remove a few cells from the embryo before it’s transferred to the woman to make sure that an embryo with no detectable chromosomal abnormalities is placed back into the uterus. It doesn’t change the embryos you’ve got but it’s a way to know which ones have a normal chromosomal make up and therefore are more likely to give you a healthy baby.
How can you increase your chance of IVF success?
The best way to increase your chances of conceiving a baby either naturally or with IVF, is to avoid leaving it too late. A woman’s fertility starts to decline significantly by the time she is 35, so it’s ideal to start trying before then.
Your health - and your partner’s health too - are also really important. Touching base with your GP for a general health check, eating a healthy balanced diet and exercising regularly can boost your chances of having conceiving.
If you’re overweight, it’s a good time to make some lifestyle changes. Smoking or taking illicit drugs can also reduce your chances of falling pregnant so it’s best to quit if these are things you currently do.
For men, alcohol intake of more than two standard drinks a day can affect sperm quality so it’s important to moderate your drinking. Try for at least two to three alcohol-free days a week. For women it’s a good idea to minimise alcohol intake when you’re trying to conceive. No amount of alcohol has been proven to be safe during pregnancy, so you’re advised not to drink at all while you are pregnant.
If you have any ongoing medical conditions like asthma or diabetes, it’s important your condition is well managed, and there are asthma and diabetes medicines that are safe to use if you are trying to conceive, or are pregnant.
Significant emotional stress can also affect a woman’s period cycle and can impact on your chances of falling pregnant.
Trying to conceive naturally can be a time of ups and downs, and IVF for many couples is an emotional journey too. Melbourne IVF recommends where possible to plan when you’re going to do IVF, to ensure that it’s at a time in your life which is relatively stable if possible. Couples who undergo IVF have to attend mandatory counselling and Melbourne IVF also has supportive counselling as some couples need help along the way.
Overall, the objective is to ensure you’re as healthy as possible, both mentally and physically, not only to help with conception, but to maximise your chances of having a healthy, uneventful, uncomplicated pregnancy.
Note: The views and advice expressed on this blog post are those of the author and are not representative of the Pregnancy Babies & Children's Expo.