IVF is one of the most popular procedures available to assist couples that are finding it difficult to have a baby. The technique involves removing an egg from a woman’s ovaries and fertilising it with sperm in a laboratory. The embryo is then transferred back into the womb to grow and develop. Trouble conceiving and fertility procedures can be emotionally and physically draining, so it is useful to familiarise yourself with the available options before you commit to treatment.
So you want IVF
The National Institute for Health and Care Excellence (NICE) recommends that IVF be offered to women under the age of 43 who have been regularly trying to conceive for two years. The criteria may vary—or be stricter—depending on different clinical commissioning groups (CCGs) around the country. IVF treatment can also be performed at a private clinic.
Ultimately, local CCGs make the final decision about who can undergo NHS-funded IVF. IVF availability can depend on whether a couple has had any previous children, and whether they are a healthy weight and non-smokers. According to NICE, women under the age of 40 should be offered three cycles of IVF on the NHS. Some CCGs may only provide one cycle, and some may only offer funded treatment for women under the age of 35.
The price for private treatment can also vary, with one cycle of IVF costing around £5,000. Discussing exactly what this price includes is important, as there may be additional costs for medicines, consultations and tests. Pursuing IVF abroad is another option, but it can be a risk. Clinics in other countries may not be as regulated as those in the UK.
Success rates
Success rates of IVF are dependent on the cause of infertility and the age of the woman involved. According to the NHS, the percentage of treatments that resulted in a live birth between 2014 and 2016 were:
- 29 percent for women under 35
- 23 percent for women aged 35 to 37
- 15 percent for women aged 38 to 39
- Nine percent for women aged 40 to 42
- Three percent for women aged 43 to 44
- Two percent for women aged over 44
The possibility of success decreases as the number of unsuccessful IVF cycles rises, but there are a few lifestyle improvements that may increase the chances. Being a healthy weight, reducing alcohol consumption to no more than one unit per day and stopping smoking can all increase the effectiveness of IVF. Caffeine consumption has also been linked to lower success rates.
Advantages
An improved chance of pregnancy is the biggest advantage of undergoing IVF. It can bypass problems with a woman’s fallopian tubes and especially helps couples with a male infertility problem. IVF also confirms that fertilisation takes place and an embryo is created. If this isn’t possible, it may provide the couple with some answers as to why they couldn’t conceive naturally. In most cases, IVF is very safe. It can also help same-sex couples that wish to have a child and be used to screen embryos for inherited diseases and abnormalities.
Disadvantages
The main risk with IVF is that success in getting pregnant is not a guarantee, and it can be expensive. In these cases, counselling should be provided, as an unsuccessful pregnancy can cause stress and—even—depression. In addition to the above, side effects from hormone medication include hot flushes and headaches. Multiple births are a possibility and can be dangerous to the mother and babies; and the treatment also increases the risk of an ectopic pregnancy, where the embryo develops in the fallopian tube. Ovarian hyperstimulation syndrome (OHSS)—where too many eggs develop in the ovaries—can also be a severe result of IVF treatment.
A typical treatment
- The natural menstrual cycle is suppressed with medication for about 2 weeks.
- A fertility hormone called the follicle-stimulating hormone (FSH) is injected daily for about 10 to 12 days. This increases the number of eggs that the ovaries produce.
- Vaginal ultrasound scans monitor the ovaries and a final hormone injection is administered to help the eggs mature.
- Under sedation, the eggs are collected using a needle that is passed through the vagina and into each ovary. This only takes around 15 minutes. A hormone is then administered to prepare the lining of the womb to receive the embryo.
- The eggs are mixed with sperm in a laboratory and the embryos continue to grow for up to 6 days. The best 1 or 2 are transferred into the womb by a tube that is passed through the vagina.
- After 2 weeks, a pregnancy test can be carried out to see if the treatment has been successful.
Did you know?
More than 8 million IVF babies have been born since the world’s first test tube baby in 1978
Source: ESHRE monitoring
This article was originally published in Live to 100 with Dr Hilary Jones. Read the digital edition, here.