Covering all important things about IVF (IVF) programs

IVF orin fitro vertilization(IVF) can be an option for couples who have difficulty having a child. Although it may seem like a shortcut to get pregnant quickly, actually the IVF process is quite long and requires careful preparation. The following is a complete explanation of the IVF program that you need to know.

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IVF process

In vitro fertilization (IVF) is a form of infertility treatment to help people with fertility problems who have difficulty having children.

Quoted from the Mayo Clinic, in brief the IVF procedure is to combine eggs and sperm outside the body.

Then, the fertilized egg cell that is ready to be transferred to the woman's uterus.

Below are the relatively long steps of the IVF process, if you wish to do it.

1. Know the menstrual cycle

Before starting IVF or IVF, you must know how the menstrual cycle first.

You may also be advised to take the contraceptive pill before starting this program.

Taking contraceptive pills has been shown to increase the success of the IVF program.

Then, this pill is also believed to reduce the risk of hyperstimulation syndrome and ovarian cysts.

However, not all doctors usually recommend this.

In the fertile period before menstruation, the doctor will give GnRH antagonists (such asGanirelix) or GnRH agonists (such asLupron).

This drug is usually in the form of an injection drug. This medicine allows your doctor to have full control over your fertile or ovulation cycle when the IVF program is started.

2. Ovarian stimulation and monitoring

Generally, in a normal ovulation cycle every month, the ovaries will only produce one egg.

While undergoing this program, you will use a drug that is for 8-14 days to encourage the follicles in the ovaries to produce more eggs.

Ovarian stimulation in IVF or IVF is usually done with injectable drugs.

Later, you will also be taught how to inject the drug yourself at home.

How many injections and how long to use the drug will depend on the rules of treatment.

Usually you will be asked to inject 1-4 drugs daily for a week to ten days.

This stimulation aims to increase the number of eggs produced by the ovaries.

The more eggs you can take and fertilize, the better your chances of getting pregnant.

During this ovarian stimulation, the doctor will monitor the growth and development of the follicles by doing blood tests and ultrasound every few days.

Your doctor will look at your estrogen levels, especially E2 or estradiol.

This test is done to make sure your ovaries are "sleeping", as this is the desired effect of the GnRH antagonist injection.

Monitoring is very important to determine how many doses of your medication. Does it need to be increased or even lowered.

If your follicles are already large, about 16-18 mm in size, they may need to be monitored daily.

3.Maturation of oocytes (eggs in the ovary)

Before being taken, the eggs in IVF must develop and grow accordingly. To trigger the maturation of the oocyte, an injection is requiredhuman chorionic gonadotropin (hCG).

Usually, an hCG injection is given when four or more follicles are about 18-20 mm in size and your estradiol level is over 2000 pg / ml.

This hormone injection is done once and must be done at the right time. If done too early, the eggs might not be cooked enough.

If done too long, the eggs will be too old and will not bear fruit properly.

So, the use of ultrasound is needed to see when is the right time to do the injection.

4. Taking eggs

The collection of eggs in the IVF process is carried out approximately 34-36 hours after you receive the hCG injection.

Before taking eggs, you will be anesthetized so you don't feel pain. The method most often used for this process is transvaginal ultrasound.

Transvaginal ultrasound is done to guide the doctor in the egg collection. A probe will be inserted into the vagina to identify the follicle.

There is one oocyte (egg) per one follicle which is taken from the ovary.

The number of follicles removed can vary between individuals. These oocytes will then be taken to the embryology laboratory for fertilization.

After the process from the fourth stage of IVF is complete, you will be asked to rest briefly for several hours.

If you have signs of ovarian hyperstimulation syndrome, such as:

• Bloating
• Nausea
• Diarrhea
• Gaining weight
• Mild pain or discomfort in the stomach

You should immediately report these signs to your doctor. Ovarian hyperstimulation syndrome can occur in 10% of women who undergo IVF.

This condition is a side effect of using fertility drugs during IVF.

5. Sperm retrieval

The next process is taking sperm to fertilize an egg.

Previously, sperm cells will be requested by giving a semen sample to a doctor or medical professional.

Generally, the semen is produced through the process of masturbation.

Sperm cells can also be obtained from other methods, for example through surgical procedures to obtain sperm directly from the testes.

When brought into the laboratory, sperm will be collected and separated from your partner's semen.

6. Fertilization of eggs

The next step in the IVF process is fertilization of the egg.

Previously, the eggs or follicles that have been taken from the vaginal follicles will be chosen which is the best.

The sperm is then separated from other things in the semen and the best seeds are also selected.

About 10,000 sperm will then be placed with the eggs in a special container.

This container will then be incubated in the laboratory. Within 12-24 hours, it is hoped that fertilization has occurred between the sperm and the egg.

In men who have low sperm quality, sperm may need to be injected directly into a mature egg.

This is called intra-cytoplasmic sperm injection (ICSI).

7. Transfer of the fertilized egg (embryo) into the uterus

After the eggs are fertilized, the eggs will be stored for 3-5 days in a special place before being transferred to the woman's uterus.

The transfer of the fertilized egg (embryo) is usually done on the fifth day after fertilization.

That is, when the embryo is already in the blastocyte phase or a small cavity is formed.

The embryo in the blastocyst phase is able to attach well to the woman's uterus.

A few days before the embryo transfer in IVF, you will be given a hormone drug progesterone to help prepare the uterine wall.

During embryo transfer, a thin tube or catheter filled with embryonic fluid will be inserted into your cervix.

The number of embryos transferred depends on the quality of the embryos. Usually only 2-5 embryos are transferred.

Then, you will be asked to remain lying down for a few hours.

If there are still good quality embryos left, the freezing process can be done. These embryos can be used later if the IVF process has not been successful.

What happens after IVF?

After undergoing a series of IVF or IVF processes, you can carry out your usual activities.

However, at that time, the ovaries may still be enlarged in size.

It would be better if you can avoid activities that are too excessive so that things that are not desirable happen.

After undergoing the IVF process, there are several side effects that need to be known, including:

• The vagina bleeds right after the procedure
• Breast pain due to high levels of the hormone estrogen
• The stomach feels slightly bloated or cramped
• Constipation or constipation

If you experience pain after an embryo transfer procedure, contact your doctor immediately to evaluate any complications you may have.

Will I definitely get pregnant after IVF?

Based on data from PERFITRI REGISTRY in 2017, the average chance or success rate for IVF is 29%. The sooner you start, the better.

If you and your partner started the IVF program under the age of 35, the chance of success can be up to 40%.

A younger age means that the body is still able to produce eggs and sperm cells that are healthier and of better quality

Generally, you have to wait two weeks to find out whether you are successful or not.

At this time, it's best to do activities as usual and avoid stress about the success of this pregnancy planning.

After two weeks of this IVF program have passed, do a pregnancy test for a few days.

If you are positive for pregnancy, don't forget to check your pregnancy with your doctor.

However, IVF or IVF programs are not always immediately successful. There is a risk of failure in this stage of the process.

Therefore, you still have to prepare yourself for this possibility while living it.

Some things that can make IVF fail:

• Lack of embryo quality, i.e. sperm and egg.
• Poor ovarian response, producing few or no eggs.
• Failed implantation.
• The growth of the uterine lining is not optimal.

Tips for increasing the success of IVF

There are various factors that make IVF programs successful, including:

1. Planting more than one embryo

According to researchers from the Medical Research Council at Bristol and the University of Glasgow, planting two embryos is better than one embryo.

It aims to increase the chances of pregnancy from IVF, especially in women of older age.

Several studies have shown that women who are over 40 years old and implant two embryos, have a higher chance of getting pregnant.

2. Live a healthy lifestyle

The mandatory thing that needs to be done so that IVF is successful is to eat foods that can increase the chance of pregnancy.

Expand foods that contain anti-oxidants, protein, low glycemic, healthy, and varied.

If previously you and your partner were active smokers who also consumed alcohol, it is advisable to stop it.

Don't forget to exercise to maintain an ideal body weight so that it can increase the success of the IVF program.

3. Maintain your intake of vitamins and supplements

Not only from food, ensure that fertility vitamins are still met to increase the success of IVF or IVF.

Some foods that contain vitamin D include fish that contain good fats (salmon, tuna, mackerel, and sardines), eggs, and red meat.

If needed, you can also get vitamin D intake from supplements or multivitamins recommended by your doctor.

There are also other supplements such as follistatin which are believed to make the uterine wall stronger and better for the future fetus.

A study shows that women who take DHEA (Dehydroepiandrosterone) supplements have a higher chance of success in IVF.

This supplement can increase hormone levels in the body.

Most importantly, follow the advice and recommendations of your obstetrician during the IVF program so that the goals are achieved.

4. Avoid stress and too tired

A study published in 2014 in Human Reproduction suggested a link between high levels of stress and infertility.

Although not directly related, managing stress can help increase the success of IVF.

Then, also avoid excessive physical activity because it can inhibit the release of eggs and change the menstrual cycle as a whole.

Certain types of physical activity can also affect the development of the uterine lining. This condition causes the uterus to be not thickened optimally.

The risks that can occur in the IVF process

Basically, IVF involves little discomfort or pain.

However, it is more subjective, depending on the patient's physical condition and pain tolerance.

Before undergoing IVF or IVF, you also need to know some of the risks of pregnancy complications that can occur:

1.Ovarian hyperstimulation syndrome (OHSS)

Ovarian conditions that produce more eggs than normal. About 2% of women who undergo IVF have this syndrome.

It usually occurs as a side effect of the fertilizers given during the IVF process.

2. Multiple births

IVF is indeed quite a lot to produce twins. Approximately 17% of cases of multiple pregnancies are from the IVF program.

However, multiple pregnancies are not the main "goal" desired from the IVF program.

This is because the effect is very high risk of premature labor and various other complications.

3.Ectopic pregnancy (pregnancy outside the womb)

This complication of an ectopic pregnancy occurs when a fertilized egg attaches to a place other than the uterus.

Ectopic pregnancies often occur in the fallopian tubes, abdominal cavity, or on the cervix.

The main features of an ectopic pregnancy are severe abdominal pain on one side, a cloudy or dark discharge, and light blood spots.