IVF is the most successful method of fertility treatment utilized today to help couples to conceive. The basic components of the IVF process include stimulation of the ovaries to produce multiple eggs at a time, removal of the eggs from the ovary (egg retrieval), fertilization of the eggs in the laboratory, and subsequent placement of the resulting embryos into the uterus (embryo transfer). The chance of pregnancy from IVF depends primarily on the age of the woman, the cause of infertility, and factors related to the quality of the IVF laboratory.
Other health related problems could also cause poor egg health, low ovarian reserve, or abnormal immunological responses, which can affect conception. Stress could also play a role. We all know that menstrual cycles can be altered during times of extreme duress- and this can be emotional, physical, or environmental stressors. In these instances, the first steps should be to avoid life stressors, maintain a healthy weight, routinely exercise, avoid smoking, and reduce alcohol intake, all of which may be contributing to unexplained infertility issues.
Many women spend much of their early adult lives trying not to get pregnant. But when you finally do want to start a family and it doesn’t happen right away, it can leave you feeling frustrated. Not to mention, trying to get pregnant month after month unsuccessfully can be emotionally taxing. You should know that you are not alone, and that unexplained infertility is exactly that– unexplained– so no finger pointing as to who is at fault!
Egg Development – This step is either part of the woman’s natural egg development or stimulated with medications and lasts roughly 5-14 days. Once your follicles are optimal size, a trigger medication may be given to finalize egg maturation and trigger ovulation. This phase of egg development may or may not be accompanied by ultrasound and bloodwork monitoring.
In order to have a successful IVF pregnancy, the first few weeks need special care. When you undergo IVF, you will be continuously monitored throughout the process by skilled doctors. Constant supervision reduces the complications associated with pregnancy. By understanding the IVF process and following your doctor’s instructions, you can enjoy the journey of your healthy pregnancy.
When you face secondary infertility, you’re dealing not only with the typical ups and downs of TTC, but also with the additional emotional fallout that is unique to those having difficulty getting pregnant with baby number two. In addition to feeling disappointed and upset, you may also be feeling shock (“I got pregnant so easily the first time, there’s no way I could have infertility problems”), guilt (“I already have a child, so I should be happy”) and even isolation (“I can’t connect with the people facing primary infertility and I can’t connect with my friends who have multiple kids”). How do you reconcile these conflicting emotions — and how do you tackle them while trying to raise the child you already have?
Cancer. Although some early studies suggested there may be a link between certain medications used to stimulate egg growth and the development of a specific type of ovarian tumor, more-recent studies do not support these findings. There does not appear to be a significantly increased risk of breast, endometrial, cervical or ovarian cancer after IVF.
According to the data collected for 2014, these are the IVF success rates nationally, when using non-donor eggs, per egg retrieval. (These are not per cycle. In other words, these are the odds of a live birth after one egg retrieval, which may mean conception with fresh eggs/embryos in the cycle of the egg retrieval or after a frozen embryo transfer cycle in the following months.)
Secondary infertility can be traced to either partner or both partners. About one-third of cases originate in women and about one-third originate in men. In the remaining one-third, the cause is due to a combination of factors or isn’t known. Increased age, complications from a prior pregnancy or surgery, increased weight, medications, sexually transmitted diseases, impaired sperm production, alcohol abuse, and smoking are all examples of secondary infertility in women and men.
One in 8 couples (or 12% of married women) have trouble getting pregnant or sustaining a pregnancy. Infertility is defined as the inability to get pregnant after regular sexual intercourse without the use of any contraceptive methods for 6 months for those 35 years old or over, or 12 months for those under 35.(1) Under normal circumstances the ability to get pregnant is at the most 25% each month. This number declines over time and starts to decline more rapidly once a women reaches her thirties, so that by age 35, the likelihood of getting pregnant each month is down to about 15%, and by age 40 it’s down to less than 10%.
The severity or complexity of infertility for you and your partner as a whole is also critical. Generally, patients are characterized as “subfertile” if there is only one infertility factor such as mild endometriosis, which can be improved through surgeries like laparoscopy. However, if both partners contribute infertility factors or one partner has multiple infertility factors, the chance of IVF success is significantly decreased.
Laboratories have developed grading methods to judge ovocyte and embryo quality. In order to optimise pregnancy rates, there is significant evidence that a morphological scoring system is the best strategy for the selection of embryos. Since 2009 where the first time-lapse microscopy system for IVF was approved for clinical use, morphokinetic scoring systems has shown to improve to pregnancy rates further. However, when all different types of time-lapse embryo imaging devices, with or without morphokinetic scoring systems, are compared against conventional embryo assessment for IVF, there is insufficient evidence of a difference in live-birth, pregnancy, stillbirth or miscarriage to choose between them. Active efforts to develop a more accurate embryo selection analysis based on Artificial Intelligence and Deep Learning are underway. Embryo Ranking Intelligent Classification Assistant (ERICA), is a clear example. This Deep Learning software substitutes manual classifications with a ranking system based on an individual embryo's predicted genetic status in a non-invasive fashion. Studies on this area are still pending and current feasibility studies support its potential.
Book an appointment with Miss Despina Mavridou for any general infertility concerns, preconception advice, fertility consultation, ovarian reserve screening, polycystic ovaries, endometriosis, follicle tracking (natural and treatment cycle), ovulation induction, fertility assessment and fertility preservation-egg freezing, intrauterine insemination, IVF and HyCoSy.
^ Baker VL, Luke B, Brown MB, Alvero R, Frattarelli JL, Usadi R, et al. (September 2010). "Multivariate analysis of factors affecting probability of pregnancy and live birth with in vitro fertilization: an analysis of the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System". Fertility and Sterility. 94 (4): 1410–6. doi:10.1016/j.fertnstert.2009.07.986. PMID 19740463.