Introduction
In vitro fertilization is a process involving monitoring and stimulating a women ovulatory process, removing ovum and letting sperm fertilization in the laboratory under favorable condition. It is one of the most common method of treatment of infertility. It is an invasive procedure involving lots of emotional, psychological and financial problems. It includes the risk of ovarian hyper stimulation syndrome, pain, ectopic pregnancy, birth defect, etc. And its success depends on age and pregnancy history of women.
In vitro fertilization is an assisted reproductive technology(ART) which includes a series of complex procedure which include fertilization of egg and sperm manually in a laboratory. Eggs/sperm involved can be obtained from the partner itself or from donor. To proceed with own egg it requires hormone treatment to control the egg production which is done to prevent the unpredictable ovulation.
Why is it done??
Factors related to fallopian tube:
i. Fallopian tube damage or blockage
ii. Tubal ligation or sterilization
iii. Previous fallopian tube removal
These factors interfere with the fertilization or for an embryo to travel to the uterus. IVF may be an alternative to tubal sterilization reversal.
Factors related to ovulation:
i. Absence of ovulation
ii. Infrequent ovulation
iii. Availability of less number of quality egg
All these factors interferes with the process of fertilization due to less chance of fertilization.
Premature ovarian failure:
It is the loss of normal ovarian function before the age of 40. Functions of ovary include production of hormones i.e. estrogen and progestron and release of mature egg which has direct effect on fertilization is present in premature
ovarian failure.
Factors related to uterus:
i. Endometriosis: It simply means the presence of uterine tissue outside the uterus such as ovary, fallopian tube, pelvic cavity etc. often affecting functions of ovaries, fallopian tube and uterus leading to infertility.
ii. Uterine fibroid: Fibroids are the benign tumor of uterus which interfere with the implantation of the fertilized egg.
Factors related to male infertility:
i. Low sperm count
ii. Poor sperm quality
iii. poor sperm motility
iv. unusual sperm shape and size
These all factor makes sperm unable or poorly fertilize the egg, hence leading to failure of conception.
Risk factors of IVF:
There is a high chance of multiple pregnancy if more than one embryo is implanted which increases the risk of low birth weight and premature delivery.
The rate of miscarriage increases with increase in maternal age. Use of frozen embryo during IVF increases the risk of miscarriage.
During egg-retrieval procedure there may be chance of bleeding, infection or damage to the bowel and bladder or a blood vessel.
There is also the risk of ectopic pregnancies if embryos are implanted outside the uterus i.e. in fallopian tube, ovary in which embryo is not able to survive for longer period of time and hence pregnancy cannot be continued.
Birth defects directly proportional to the increase in maternal age. More Research is needed to determine whether babies conceived using IVF might be at increased risk of certain birth defect.
IVF is a medical procedure which involves lots of emotional, psychological, and financial problems to the partners.
How well does it work?
Maternal age:
Birth rate resulting from single cycle of IVF are about 30- 40% for women of age 34 and younger and the rate decreases after age 35.
Pregnancy history:
Women with previous live birth has more successful IVF procedure than women who hasn’t given birth before.