In vitro fertilization, known as IVF, is one of the most successful methods of assisted reproduction used for couples who cannot achieve pregnancy naturally.
The process involves fertilizing an egg from the woman with a sperm from the man in a laboratory environment and transferring the resulting embryo into the uterus.
The method has been applied since the late 1970s, when the first "in vitro baby" was born - Louise Brown. Since then, the technology has been continuously improved and today enables millions of couples around the world to become parents.
How does natural pregnancy occur
Under normal conditions, pregnancy occurs when, during ovulation, a mature egg is released from the ovary and is fertilized by a sperm in the fallopian tube. The resulting zygote divides and implants in the wall of the uterus, where embryo development begins.
When this process is hampered due to problems in the woman or man, in vitro fertilization comes to the rescue.
The IVF process step by step
1. Hormonal ovarian stimulation
In a natural cycle, a woman produces one egg a month, but more are needed for successful IVF.
With the help of hormone injections (FSH and LH), the ovaries are stimulated to produce several eggs at the same time.
The process lasts about 10-12 days, with follicle development monitored by ultrasound and blood tests. When the eggs reach the required maturity, an injection of hCG is administered to prepare them for retrieval.
2. Egg retrieval
About 36 hours after the final injection, under light anesthesia, an ovarian puncture is performed. With a fine needle and ultrasound control, the eggs are extracted from the follicles. The procedure takes about 15-30 minutes and usually does not require a hospital stay.
3. Sperm collection
On the same day, the partner gives a semen sample, which is processed in a laboratory to isolate the most healthy and motile sperm.
If there are no sperm in the ejaculate, microsurgical extraction from the testicles (Micro-TESE) can be performed.
4. Fertilization in the laboratory
In laboratory conditions, eggs and sperm are combined. In the classical method, they are left in a special culture medium where fertilization occurs naturally.
In the microinjection method (ICSI), a single sperm is introduced directly into the egg under a microscope. This method is most commonly used for male factor infertility.
5. Growing and embryo selection
After fertilization, embryologists monitor the development of embryos for several days. Usually on the 3rd or 5th day, the best quality embryo is selected for transfer.
The remaining healthy embryos can be frozen for future use.
6. Embryotransfer
The embryo is inserted into the uterus through a thin catheter - a painless procedure lasting a few minutes. No downtime is required afterwards, apart from a short rest.
The woman starts taking progesterone to maintain implantation.
After about 10-12 days, a pregnancy blood test (β-hCG) is done.
In which cases IVF is recommended
In vitro fertilization is appropriate for various causes of infertility, including:
- blocked or damaged fallopian tubes;
- lack of ovulation or low ovarian reserve;
- endometriosis;
- myomas interfering with implantation;
- male factor - low sperm count or motility;
- unexplained infertility (when all tests are normal);
- genetic diseases for which preimplantation diagnosis (PGD) is recommended;
- a desire to preserve fertility in the event of imminent chemo- or radiotherapy.
What affects the success of IVF
In vitro fertilization results depend on several key factors:
- Age of woman - success is highest under 35, after 40 the probability decreases significantly.
- The quality of eggs and embryos - not all develop normally.
- Previous pregnancies - women who have given birth before have a higher chance.
- The cause of infertility - with endometriosis or severe male factor, the results are lower.
- The lifestyle - smoking, obesity and stress lower the chances of success.
On average, the success rate for IVF is 40-50% for women under the age of 35 and about 20% after the age of 40.
Possible risks and side effects
IVF treatment is safe, but like any medical procedure, it carries certain risks:
- Multiple pregnancy - when transferring more than one embryo.
- Premature birth and low baby weight - more common in multiple pregnancies.
- Ovarian hyperstimulation syndrome (OHSS) - excessive ovarian response to hormones causing swelling and discomfort.
- Ectopic pregnancy - about 2-5% of cases.
- Mild pain or bleeding after puncture - pass quickly.
- Emotional and physical stress - treatment can be overwhelming, so psychological support is important.
There is no evidence that the hormone medications used increase the risk of cancer or lead to early menopause.
Frequently Asked Questions
How many embryos are transferred?
According to the rules it is usually transferred an embryo in women under 35 and up to two in women over this age or after unsuccessful attempts. The aim is to avoid multiple pregnancies.
What happens to the remaining embryos?
Excess embryos can be frozen and used in subsequent attempts or for a second child. The success rate of a frozen transfer is similar to that of a fresh transfer.
How long does the treatment last?
Usually an IVF cycle lasts about three weeks - from the beginning of stimulation to the pregnancy test. It can sometimes be extended according to the chosen protocol.
Is it painful?
The procedures are almost painless. Puncture is performed under anesthesia, and embryo transfer does not require anesthesia.
Can you work during treatment?
Yeah. Rest is only needed on the day of the puncture and transfer. Prolonged lying does not increase the chances of success.
Can the sex of the baby be chosen?
No, sex selection is forbidden, except in the case of sex-linked genetic diseases.
Is there a difference between babies conceived through IVF and naturally?
No. Babies conceived through IVF develop completely normally and do not differ in health or intelligence.
Preparation for IVF and lifestyle
The success of the treatment also depends on the general state of health. Some important recommendations:
- Keep normal weight - obesity reduces egg quality.
- Give up cigarettes and alcohol.
- Eat a balanced diet - include more fruits, vegetables, fish and foods rich in folic acid.
- Drink enough water - at least 2 litres daily.
- Reduce stress - practice walking, yoga, light exercise.
- Use supplements only on medical advice.
Psychological attitude is also important - calmness and optimism help the body to accept the process more naturally.
Fertility preservation
Women who are planning motherhood at a later stage can freeze eggs before the age of 35, when their quality is highest.
The same is also recommended for upcoming cancer treatment or surgeries affecting the ovaries.
The eggs can be stored for years and used later for IVF when the woman decides to become a mother.
After embryo transfer
After the transfer, the woman can lead a normal life - move around, work and bathe. Avoidance of heavy exercise and sexual contact is recommended until the pregnancy test.
If severe pain, swelling or shortness of breath occurs, a doctor should be sought to rule out ovarian hyperstimulation syndrome.
How often can IVF be done?
If the first attempt is unsuccessful, the treatment can be repeated after 1-2 menstrual cycles.
There is no strict limit to the number of attempts - it is important to analyse the reasons for failure and change the protocol if necessary.
In vitro without medication (IVM)
In some patients who cannot take hormones, the so-called. IVM - In Vitro Maturation.
This is a method in which immature eggs are extracted and matured in a laboratory.
It is suitable for women with polycystic ovaries or at risk of hyperstimulation, albeit with a lower success rate.
Recovery and tracking
Two weeks after the transfer, a pregnancy blood test is done. If the result is positive, after about 10 days, the first ultrasound is performed to confirm the gestational sac.
Pregnancies that occur through IVF are tracked in the same way as natural pregnancies.
Conclusion
In vitro fertilization is a reliable and safe method that enables thousands of couples to become parents.
While the process requires patience and discipline, modern technology greatly increases the chances of success.
Proper preparation, a healthy lifestyle and trust in an experienced team of specialists are the keys to the most important outcome - a new life.
