by The Welthi Bureau | 22 NOV 2017
Bramarika (name changed) is a 35-year-old management professional. Married for six years, she had suffered four miscarriages. This not only affected her physically, but also left her emotionally very raw and vulnerable. The divergent suggestions by her extended family certainly did not help in any way. Eventually, Bramarika decided to go for IVF, although in much confusion. At Nova IVI Fertility, she was properly counselled about everything, from the process to the finances. After one failed attempt, Bramarika continued the treatment with hope to go for the second cycle, which became a success.
IVF or in-vitro fertilisation involves fertilising the egg with the sperm in the laboratory, and then reintroducing the early embryo to the uterus. In recent years, the success rates of IVF have greatly improved, thanks to the significant advances in Assisted Reproductive Technology (ART). Although IVF has several success stories, there are still many myths related to this procedure. Here is a lowdown on some of them.
MYTH 1: The age of the man does not matter to achieve pregnancy
Only women have a ticking biological clock – recent studies have discarded this belief, warning that the chances of having a baby naturally or through IVF may depend on the age of the male partner as well, and not just the age of the woman.
Age is no barrier to achieving many things. But it can reduce the chance of a man fathering a healthy child, according to recent studies. While a woman’s age is the single most important factor in conception, the man’s age also matters. The ideal age for women to achieve pregnancy is between 25 and 30 years, however, men’s fertility potential is at the peak only until the age of 35-40. After that, there is a deterioration in the quality of the sperms and the sperm count. Male factors account for about 40-45% of all infertility cases, and about 20-30% of these patients in Hyderabad are over 40 years old..
MYTH 2: Women can conceive at any age through IVF
There are conditions such as endometriosis and unexplained infertility that cause difficulties for women to conceive even through IVF. The success of IVF depends on a number of factors apart from the quality of the eggs and the sperms, such as the condition of the woman’s uterus or receptivity of endometrium, undamaged fallopian tubes, and other biological and hormonal conditions. As women age, complications also rise, thereby leading to a high risk pregnancy even if successfully conceived. Hence, it is important for women to plan pregnancy as early as possible, and when the infertility diagnosis is made, they should not delay taking the treatment.
MYTH 3: IVF guarantees 100% success; there’s no hope after an IVF failure
The success rate of IVF is about 50-60% in women below the age of 35. As the age increases, the chances of success go down. A thorough evaluation of the couple reveals the best way optimise the treatment. So, it is important to understand from the fertility specialist what the underlying cause of infertility is. The more informed you are, the better you will understand what IVF success entails. The global average success rate of one cycle of IVF is 35% only.
Couples undergoing IVF need to have the right understanding of the associated success rates. This is essential as several couples often get dejected that the first IVF cycle failed. For a majority of the cases, IVF often is successful over multiple cycle, which is why couples should continue the treatment with hope. Dropping out after one failed cycle to try again later will only further reduce the chances of success in the future.
MYTH 4: IVF involves donor gametes only
IVF is usually done with the wife's eggs and the husband's sperm unless indicated otherwise. There are chances that even women with a low ovarian reserve or men with azoospermia (absence of viable sperms in the testes) may conceive with their own gametes. Donor gametes are advised only in selective situations, like advanced maternal age, premature ovarian failure, menopausal women, or men with no sperms even after surgical retrieval. Donor gametes are used only after adequate counselling and proper consents.
MYTH 5: Frozen embryos are not as effective as fresh embryos
A common myth surrounding IVF treatment is that freezing your embryos will make them weaker and less effective. However, this is inaccurate as patients who use frozen embryos have equal chances of success as those who use fresh embryos.
The most important point to keep in mind is that the quality of embryo frozen depends on factors like age of the couple, quality of the gametes, etc. Vitrification is a process that allows quick freezing of the embryos, thereby preserving its original quality for years. Men and women who plan to postpone pregnancy for social or medical reasons are recommended to freeze their gametes – sperms or eggs – if they would like the maximum chances of success with IVF using their own gametes later in life.
MYTH 6: Stick to bed rest after IVF
There's no need to put your life on pause after the embryo transfer. This idea is an absolute myth. An IVF pregnancy has to be treated like a normal pregnancy. IVF is nothing but an assisted process in the genetic composition of the man and the woman to form a baby. Since this process is not possible inside a woman’s body either because of tubal blockage or poor sperm count or other reasons, IVF helps in bringing the egg and the sperm together outside the body. Once the embryo goes back into the woman’s body, it needs care just like a naturally conceived embryo. Women can go back to their routine, and the usual pregnancy care should be taken.
MYTH 7: IVF always results in twins
While it is true that multiple pregnancies are more common in those undergoing IVF treatment than in those having a natural pregnancy, advancements in ART techniques allow for effective single embryo transfers these days.
Yes, IVF is a complex infertility treatment and multiple births have always been complicated. So when you put two and two together, multiple pregnancies can cause potential problems. There are several couples who even hope for a multiple pregnancy. However, the risk involved is high as it poses a threat to both the mother and the new-born baby both during and after pregnancy. Instead, it is advisable that couples should look at transferring a single, healthy embryo.
MYTH 8: Babies end up with genetic abnormalities when conceived through IVF
On the contrary, advanced ART techniques like Preimplantation Genetic Screening (PGS) and Preimplantation Genetic Diagnosis (PGD) allow accurate detection of chromosome errors in the embryo before transfer, increasing the chances of a healthy and genetically normal baby. Chromosomal abnormalities are responsible for more than 50% of miscarriages in early pregnancy. Chromosomally abnormal embryos may lead to birth defects in the babies. Fertility specialists are vouching for the modern technology like PGS and PGD, which have a predicted accuracy of 98% for detecting any chromosomal abnormalities in the embryos.
MYTH 9: Infertility is a standalone problem
Infertility occurs as a problem associated with other major health problems such as obesity, diabetes and even cancer. Cancer treatment can also increase the risk of infertility in women. The usage of anti-cancer drugs that can lead to a drop in the quality and quantity of sperms and eggs, negatively impacting the reproductive capacity of men and women. Women are born with a finite number of eggs and in some, the treatment with chemotherapy and radiotherapy may lead to a partial or complete loss of fertility potential.
Young women in their child bearing years diagnosed with cancer should be prescribed with techniques such as oocyte (women who do not have a partner) or embryo (married women) freezing. Post their cancer treatment, if infertility happens, they can conceive through IVF. While sperm production in men usually returns to normal after cancer treatment, there have been cases where the quality of sperms has reduced. Hence, in such cases, freezing a sperm sample before cancer treatment helps, and it is not very expensive either. Fertility preservation is not restricted to only those undergoing cancer treatments. Career-oriented women, or people with other major ailments that could potentially affect fertility can also opt for fertility preservation.
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