Understanding IVF: What Every Couple Needs to Know
2 months ago, 7 minutes read
In Vitro Fertilization (IVF) is a significant decision for many couples, particularly within the context of Nepal's societal norms, where discussing fertility issues can often be a source of shame and stigma. As a fertility doctor, I frequently encounter couples like Sahara and Pratik. They are well-educated yet come to me with a sense of guilt and nervousness, seeking to keep their consultations and treatment private, even from their families.
One of the greatest challenges I face is explaining that IVF is merely an assistance in their pregnancy journey. IVF involves the fertilization of an egg outside the human body, after which the embryo grows in the mother's womb just like any other baby. Despite this, many people still view IVF as a last resort, something to try only after exhausting all other options.
It is important to acknowledge that IVF is not just a medical procedure; it requires immense determination, mental and physical preparation, emotional and financial investment, hormonal changes, and significant expectations. Couples often ask me, "Will the baby born through IVF be my own?" and "Are they as healthy as a baby conceived naturally?" I reassure them that as long as the individuals are healthy enough to carry a baby and have healthy sperm and eggs, they will have their own biological child. However, there are cases where egg, sperm, or embryo donors are needed. In such cases, the baby may not be entirely genetically yours, but the experience of carrying the child for nine months creates a profound connection. In some countries, surrogacy is also an option, where another woman carries your baby to term.
IVF opens up many possibilities for couples to have children, but it depends on individual circumstances. Donor treatments and advanced IVF techniques can be costly, and clinics will only proceed with treatments that have been agreed upon with the couple.
There is a lot of misinformation about IVF, and couples often ask questions like, "How many days do I need to stay in the hospital?" "How much leave do I need during the IVF process?" and "How long does the IVF process take?" The answer is simple: the IVF process is typically an outpatient procedure, meaning no hospital admission is required.
The IVF journey begins with ovarian stimulation, where we prescribe medications to help the ovaries produce multiple eggs instead of just one. This phase is crucial because the more eggs retrieved, the better the chances of successful fertilization. Patients often ask, "Does it hurt?" or "Are there side effects?" The injections can be uncomfortable, and while many couples do not experience side effects, some may experience mild bloating or mood swings. It's important to monitor the patient's response to the medication closely to adjust dosages as needed.
Once the eggs are ready, we retrieve them through a simple procedure under light sedation. This usually takes about 20 minutes and carries minimal risks. At the same time, a sperm sample is collected from the partner or a donor. In the lab, we combine the eggs and sperm to allow fertilization to occur. After a few days, we assess the embryos' development and select the healthiest one for transfer. Some patients ask if they can choose the baby's gender or what happens to extra healthy embryos. In Nepal, gender selection is not legally permitted, but it is possible through Preimplantation Genetic Testing (PGT). Extra embryos can be frozen for future use or donated to those in need.
The embryo transfer is a simple procedure, that takes roughly around 30-40 minutes. Patients are generally advised to take rest for around 30 minutes after that and discharged. Many people often have a fear our embryo falling out but it’s just a myth and nothing happens alike. Patients often ask, "When can I take a pregnancy test?" or "What are my chances of success?" We typically wait about two weeks to test for pregnancy, and success rates depend on factors like age and overall health. For women under 35, the success rate is often around 40-50% per cycle.
The emotional aspect of IVF can be challenging, and I always encourage patients to seek support from counselors or support groups. Concerns about costs are common, and we provide resources to help manage these issues. When a cycle doesn't result in pregnancy, it can be heartbreaking. I explain that more than one attempts of IVF/ET cycle may be required in few cases and we review the process to improve the chances of success in subsequent cycles. Some couples may need a break between cycles to regain emotional and mental stability.
For those who achieve a positive pregnancy test, the joy is immense. Early monitoring and regular care are crucial to ensure a healthy pregnancy. We advise patients to maintain a healthy diet, engage in light exercise, and avoid a sedentary lifestyle. It is important to dispel myths such as the need for complete rest after IVF or avoiding certain activities like climbing stairs or swimming.
Here are some tips I share with patients preparing for IVF:
Helping couples like Sahara and Pratik through IVF is one of the most rewarding aspects of my job. While the process can be challenging, the joy of helping them achieve their dream of parenthood makes it all worthwhile. If you're considering IVF, remember that you are not alone. There are people and resources ready to support you every step of the way.
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