“Adopt the pace of nature: her secret is patience.”

– Ralph Waldo Emerson

These words by Ralph Waldo Emerson could inspire many couples considering in vitro fertilization (IVF) to start their family. While the journey to conceive could be easier for some females, it can be pretty difficult for others. Infertility takes a toll on young couples, who have been trying to conceive, however, are failing all the time. It could be frustrating, tiring, sad, or anxious and affect your relationships.

Recently, the number of people opting for IVF has seen exponential growth. IVF has become the go-to solution for many couples for various medical reasons. The procedure has also been gaining prominence among same-sex couples.

Nevertheless, the rollercoaster of IVF can be stressful for many couples who are either considering it for the first time or have been through it before.

Going into the scenario blind and attempting to figure out how to get through it alone can add to the tension. As a result, we hope this blog post will address your questions concerning the IVF procedure from beginning to end.

What is IVF treatment?

Let’s start with a definition of IVF: in vitro means “in the lab,” and this procedure is also known as “lab assisted conception.” Simply explained, an AFAB (assigned female at birth) takes hormonal drugs to increase the creation of more eggs.

In a natural cycle, you only release one or two eggs; however, conventional IVF requires many eggs. If you don’t want to take injectable medicines, minimum stimulation IVF is an option (aka mini-IVF). IVF cycles can be ‘long’ or short,’ depending on your medical needs and concerns; both are equally effective.

Typically, injectable fertility medicines are used to stimulate the ovaries so that numerous eggs are available during retrieval. Ultrasound guides a hollow needle into each follicle during the egg retrieval procedure. The liquid surrounding each egg is drawn out (“aspirated”).

An “aspiration” is the name given to this procedure. The fluid is transported to the laboratory, where the egg is separated from the rest of the fluid and placed in a nutrition media-filled dish for fertilisation.

If a woman does not have a partner who produces healthy sperm, she may use donated eggs or sperm. The sperm should fertilise some of the eggs and develop into embryos.

 If a fresh transfer is appropriate, the doctors will transfer one or two embryos into her uterus, with the goal of an embryo implanting and growing.

What are the success rates of IVF? Let’s find out

IVF can be effective, but it’s crucial to remember that it’s all about the numbers. With each IVF cycle that you undergo, your odds of success improve.

According to a study of 156,000 women in the United States, 29.5% of women under 35 had a successful first cycle. The same study discovered that the live birth rate was 65.3% throughout six cycles (typically two years).

IVF success rates, on the other hand, fall as you get older. According to National Health Service (NHS) data, the following are the success rates per embryo transferred:

• For women under the age of 35, the percentage is 29%
• For women aged 35 to 37, the ratio is 23%
• 15% for women between the ages of 38 and 39
• The rate is 9% for women aged between 40 and 42
• 3% for women between the ages of 43 and 44
• 2% for women over the age of 44

The Cost of IVF Treatment Worldwide

To begin with, IVF can be a huge financial investment as well as a mentally and physically draining experience. The main point is that you should do your homework before agreeing to treatment at a fertility clinic.

We want you to know that IVF is a cumulative process, and no one can guarantee that your first round will be successful. In fact, a live birth can take up to three rounds of IVF on average. This is something to keep in mind if you have to pay for your IVF rounds out of pocket.

The following are some instances of costs:

• The average cost of a IVF cycle in the United States is over $12,000, with prescription costs around $7,000.
• Each IVF cycle costs around 70,000 to 1,25,000 INR on average. IVF treatment costs differ from one hospital to the next.
• A single cycle of IVF costs between £4,000 and £6,000 in the UK, depending on the clinic.
• In Spain, an IVF cycle might cost anywhere between 4,500 and 7,000 euros.
• In the United Kingdom, private IVF treatment costs between £4000 and £7000 each cycle, plus extra fees for add-ons like ICSI. These figures exclude the high-cost drugs, which can range from £500 to £2000 per cycle.

Let’s walk you through every step of the IVF procedure here

Downregulation

Downregulation is a procedure in which your doctor temporarily disables your ovaries in order to manage ovulation and egg maturation while you are undergoing therapy. Drugs termed GnRH antagonists and GnRH agonists are used to inhibit GnRH production. Depending on the individual response, down-regulation can last anywhere from 8 to 21 days.

Stimulation of the Ovaries

The most widely utilised injections to produce a good number of follicles in the ovary are gonadotropins. Starting on day 2 of the menstrual cycle, they are given every day until the follicles attain a diameter of 18 to 22mm. This takes 10 to 12 days of IVF treatment on average.

Ovulation Trigger

This is performed by administering another medication called Human Chorionic Gonadotropin, or HCG, which is required for the egg’s final maturation and release, commonly known as ovulation.

Oocyte Retrieval or Ovum Pick-Up

This is a quick, painless outpatient operation that is done vaginally under ultrasonographic guidance. The oocyte retrieval procedure will take place 34 to 36 hours following the HCG injection.

It’s normally done under sedation, although it can sometimes be done under general anaesthesia. Prior to the surgery, the patient must fast for at least 5 hours. The eggs are identified by looking at the aspirated fluid under a microscope.

In IVF treatment, the eggs are extracted, cleansed, and deposited in little dishes containing the culture media, which is then preserved in a special incubator.

The patient may suffer mild cramping or slight bleeding from the vaginal area after the oocyte retrieval, which will go away in a few hours.

Preparation of Sperm

On the day of egg collection, the husband must provide a sperm sample in a clean wide-mouthed container provided by the lab. A two to three day period of abstinence is observed. If the spouse is unable to attend the appointment on time, a semen sample is taken in advance and frozen for use throughout the IVF procedure.

Fertilization

3 to 6 hours after oocyte retrieval, a measured volume of the prepared sperm suspension is added to the dish holding the oocytes. The eggs are tested for fertilisation the next day in the dish. They are then placed in new culture media dishes and returned to the incubator.

Embryo Transfer

ET can be done on any day between the second and fifth day after the oocyte retrieval procedure. It’s a simple and painless treatment carried out under aseptic settings. There’s no need for sedation.

The embryos are gently implanted in the uterine cavity using a fine hollow tube (cannula) that is inserted into the uterus via the vaginal and cervix. Following the ET, the patient is instructed to stay in bed for roughly 6 hours. She can then return to her regular activities.

Implantation

After the embryos have been transferred, the natural event of implantation should occur. The embryo emerges from its protective shell and burrows into the endometrium to implant. The foetus then continues to develop.

The embryo begins releasing a hormone called Human Chorionic Gonadotropin two weeks after embryo transfer (HCG). The presence of pregnancy is confirmed when this is discovered.

Result

On the 28th day of the cycle, a blood test for hCG levels is performed to confirm the pregnancy. Progesterone is administered to the woman in the form of injections, oral tablets, or vaginal pessaries to help her conceive.

Testing For Pregnancy

Your doctor will order a blood test around 9–12 days after your transfer. Your HCG and progesterone levels will be monitored, and you may need to come in for more testing to ensure your levels are rising. Congratulations if your test is positive! Your doctor will advise you on what to do next, including continuing to take progesterone for at least a few weeks longer.

Refrain from taking a home pregnancy test, or at the very least, wait a week after your transfer! Many women begin testing right away, which can be stressful.

So, what’s next?

When a pregnancy test comes out negative, it can be a devastating blow; it’s natural to feel loss and despair. Seek the help of a therapist and look for an online or in-person support system. In addition, there are numerous IVF and infertility support groups available online.

Your doctor will tell you to stop using progesterone, and you should start getting your period in a few days. They’ll also set up a follow-up call or meeting to talk about what went wrong and how things might be improved for the future.