If you’re looking into In-Vitro Fertilisation (IVF) as a choice for your family, no doubt you’ve been flooded with information on the process. Success stories, horror stories, scientific articles, opinion pieces, much of it conflicting with one another. It can be confusing and frustrating to sort through all the information. Dr Parul Agarwal, Senior Fertility & IVF Consultant & Gynaecologist, Cloudnine Hospital, Noida, simplifies it, “IVF treatment is an Assisted Reproductive Technology (ART) that involves the process of a woman’s egg being retrieved from her body and fertilised in a lab. Once the embryo grows, it is returned to the woman’s uterus or frozen for use in the future.”
Since IVF is a long and complicated procedure, it works differently for everyone considering age, health of the couple, and various other issues that doctors explain beforehand. “IVF is a highly evolved process where you meet with specialists and undergo tests, you get injections, your follicles are stimulated, eggs are collected and embryos are created. Thereafter, embryos are transferred in the womb for their implantation. It takes time, hopefully not too much, but it differs for every couple because there are variables to consider. A few variables when it comes to IVF, are hormones, medication, sperm quality, egg quality, age of mother (or age of donor), and more. Sometimes your doctor will tweak a few variables to yield a different result,” explains Dr Parul.
Dr Parul Agarwal
IVF Affects You And Your Partner
In a typical IVF protocol (if ‘typical’ exists in a procedure like this), a woman will have ultrasounds and injections. She’ll experience side effects that range from bloating to nausea to fatigue, not to mention all the changes that will come with pregnancy and birth. Dr Sanjay Makwana, Senior IVF & Endoscopic Surgeon, and Director, Vasundhara IVF Hospital, Jodhpur, adds, “What perhaps does not get said enough is the impact it has on the partner. They aren’t going through the physical experience, but they are affected emotionally and psychologically. They, too, experience the highs and lows of the process, and can feel drained, discouraged, inadequate, frustrated and anxious. Often partners want to fix the problem and want to be supportive and feel useful. Working through the peaks and valleys together can be tremendously helpful for both parents. After all, parenting begins the moment you make any conscious effort to care for your own health in preparation for enhancing your child’s conception.”
Dr Sanjay Makwana
Alcohol Can Greatly Reduce Your Chances of Success
Factors including age, health of parents/sperm/eggs, sleep, stress and caffeine can affect the IVF outcome. One of the biggest negative contributors is alcohol, and not just for women; men’s consumption can also seriously impact success too. While you’re undergoing IVF, and even for a few months before starting the procedure, it’s best to seriously limit your alcohol intake.
Preconception Health Is For Men, Too
Women are given lots of information about preconception diet and health, be it through magazines, healthcare practitioners, friends and family. Men are typically not given the same information. Dr Haritha Rao, Director & HOD – Fertility & Reproductive Medicine, Ayaansh IVF Hospital, Bengaluru, says, “It is simply assumed that if a man can ejaculate, he can get a woman pregnant. But a single sperm makes up half of the embryo that develops into a baby. It makes sense that the man’s health is just as essential to IVF success as the woman’s.
And it helps to be a healthy man! Alcohol and smoking negatively impact sperm health, and so do stress, obesity, low exercise, heat exposure, and poor diet. In fact, many of the recommendations given to women for preconception can be applied to men. This includes stress management, moderate exercise, a nutrient-dense diet with supplementation where appropriate and abstaining from (or seriously limiting) smoking and alcohol.
Dr Haritha Rao
One May Need IVF Even After Having Conceived Naturally
Many people think that if they’ve conceived without assistance once, it will happen again. But that isn’t always the case. Secondary infertility can be traced to either partner or both partners. About 1/3rd of the cases originate in women and about 1/3rd originate in men. In the remaining 1/3rd, the cause is due to a combination of factors or isn’t known. Increased age, complications from prior pregnancy, increased weight, medications, sexually transmitted diseases, impaired sperm production, alcohol abuse and smoking are all examples of secondary infertility in men and women.
Causes of secondary infertility in women include:
- Problems In The Quantity Or Quality Of Eggs
Women are born with a limited supply of eggs and are unable to create new eggs after birth. As women approach their 40s and beyond, the number of eggs in their ovaries decreases and the remaining eggs have higher chance of chromosomal problems. For women where age isn’t a concern, there are other reasons that they might have a low number of good quality eggs, including autoimmune or genetic conditions and prior surgery or radiation.
- Problem With Fallopian Tubes
The fallopian tubes which carry the eggs from the ovaries to the uterus can become blocked due to pelvic infections such as chlamydia or gonorrhoea.
- Problem With The Uterus
There are many conditions related to the uterus that can cause secondary infertility. Scarring can occur during a dilation and curettage (D&C) or caesarean delivery that can create adhesion inside the uterus interfering with future pregnancies.
- Fibroids Or Polyps
These are benign (non-cancerous) growths inside the uterus that can impair pregnancy. A retained placenta can cause infection and uterine scarring.
Endometriosis is a condition where tissue that normally grows inside the uterus grows elsewhere in the body, such as on the ovaries or bowel surfaces. While endometriosis is common, not all endometriosis causes infertility.
- Polycystic Ovary Syndrome
This is a hormonal disorder characterised by longer-than-normal or infrequent menstrual periods. A woman with this condition has an excessive number of male hormones, and the ovaries fail to release eggs regularly.
- Weight Gain Or Other Lifestyle Changes
Weight gain can lead to ovary dysfunction in some patients. Certain diets or medications may affect fertility.
Causes of secondary infertility in men include reduced levels of testosterone, which plays a key role in sperm production. Testosterone levels can decline due to ageing, injury to urinary or genital organs, or certain medical conditions like genital infections, thyroid diseases, or diabetes.
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