The struggle to fall pregnant is something many couples face. Thanks to medical innovations like IVF (in vitro fertilisation), however, couples can realise their dream of becoming parents – but it’s not an easy decision to make.

 

IVF is a procedure where eggs are extracted from the ovaries of a woman, sperm is taken from a man, and both are combined outside of the body in a laboratory to form embryos. These embryos are later implanted back into the woman’s uterus and, should the embryo(s) attach successfully, the pregnancy usually continues like any other.

IVF can help with a variety infertility issues such as:

• Low sperm count or motility (‘slow swimmers’)
• Blockages or damage to the fallopian tubes
• Ovulation problems
• Endometriosis
• Inability of sperm to survive in cervical mucus
• Genetic problems that cause infertility (from either the man or woman’s side)

 

IVF is usually the last resort, as it’s not an easy decision for couples to make, for multiple reasons:

• It’s a complex and expensive procedure that is not 100% guaranteed
• It’s invasive and painful for the woman who has to go through it
• It’s something that many couples find uncomfortable because it’s clinical and involves a third party – the ‘magic’ of conception is lost
• It comes with a variety of risk factors

 

How does IVF work and what can you expect?

The first step in the IVF process is the injection of hormones into the woman. These hormones stimulate the ovaries to produce multiple eggs in a monthly ovulation cycle instead of just one. This increases the chances of embryos being produced during fertilisation, in case one or more do not take. This is also done in case the first round of IVF is not successful. Embryos may be frozen and stored to be used at a later stage, without having to endure the cost and pain of the retrieval stage.

The retrieval of the eggs is a complex procedure because it is time-sensitive. It needs to be done before the eggs emerge from the follicles of the ovaries. Eggs taken out too late or too early won’t develop properly. The retrieval process is a painful one but it also depends on each woman’s pain threshold. During this procedure, some women are given pain medication while others are mildly sedated, and others even get put under general anaesthesia. Luckily, the whole process is relatively short, taking only around 30 to 60 minutes.

During this time, the man will give a sperm sample, which will need to be donated on the same day. Immediately after both sperm and egg have been extracted, they get sent to the laboratory for fertilisation and observation. After a few days, the embryo(s) matures to a stage known as the blastocyst stage. This is when the embryo(s) is ready to be placed in the uterus. Fortunately this part of the IVF process is relatively quick and easy: the doctor will insert a catheter (a flexible tube) through the vagina and cervix and into the uterus, then the embryos are implanted there so that they attach to the uterine wall.

To ensure the best chance of the embryo(s) successfully attaching, you will be left to stay and rest in the hospital bed for four to six hours before being discharged.

Around two weeks later, you will visit your doctor to take a pregnancy test to see if the procedure was successful. If it is, the pregnancy should continue like any other. If it was not successful, you can choose to try again with the remaining embryos.

Because there will be multiple embryos (three to four) placed in your uterus to increase the chances of pregnancy, you need to consider the possibility of having multiple births. Naturally, the more babies you are expecting the riskier the pregnancy is likely to be, never mind the mental, emotional, physical and financial cost of having multiples.

IVF is something that needs a lot of thought and consideration. It is a big decision and every couple’s IVF journey is going to be different. Make sure that you speak to your doctor about any potential risks there are to you, as well as all the options that are available to you.