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How To Ensure The Success Of IVF?

By Shamila Rafat
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IVF is fairly expensive. As per data available from 2014, IVF costs were somewhere between USD 600 to USD 1,000 per cycle in India [1] . With such high costs involved, IVF is indeed not for everyone. Costs are the primary deterrent for many childless couples that explore IVF. For practical reasons, it is in the interest of all concerned to ensure the success of the first cycle itself, so that the procedure does not have to be repeated at a later date.

With a wide variation in success rate - clinics reporting success rates either as high as 46% or as low as 10% [2] - there has nonetheless been a significant increase in the success rates over the years [3] .

IVF
IVF : All you need to know about, जानें क्या है आइवीएफ ट्रीटमेंट | Boldsky

Steps To Ensure Success Of IVF In The First Attempt

1. Preparation - Prepare your body and mind for IVF. The success rate of the procedure depends a lot on the overall physical as well as emotional health of the mother-to-be.

2. Take notes - Often, the doctor clearly lays down the dos and don'ts to follow both before and after the procedure. While there are a specific number of embryos that a clinic aims to transfer, the number of embryos cannot be increased to ensure the success of the procedure, as this could lead to complications.

3. Detoxification - The first step before you go in for IVF is detoxification as it is important to increase the success rate of IVF. This detoxification program should always be conducted under the supervision of a specialist.

4. Diet - Follow a healthy diet at least 3 months or 100 days prior to the IVF. Follow the diet recommended by your doctor, ensuring that your reproductive organs get a sufficient amount of blood and nutrients. Similarly, your partner should also make the necessary changes in his diet to boost the quality of sperms.

5. Give up alcohol, smoking and caffeinated beverages - The success of the IVF procedure can be adversely affected by the consumption of alcohol, smoking or intake of caffeinated beverages. [4]

6. Acupuncture - By reducing stress levels and boosting the supply of blood to the uterus, acupuncture has been seen to somewhat increase the success rate of IVF. While the success rate increased by up to 20% when acupuncture was used, it should be done at least 3 to 4 months prior to IVF. You should never try acupuncture without asking your doctor. Reflexology, yoga and/or massage therapy can also be opted for, but always after consulting your doctor.

7. Make love - With heightened stress levels and trepidation about IVF, making love can calm you down with the release of feel-good chemicals following an orgasm.

8. Vitamins and minerals - For successful implantation of the embryo in your womb after an IVF cycle, your body requires the following vitamins A, C, B, E, minerals like zinc, selenium, magnesium and iron, folic acid, coenzyme Q10 and essential fatty acids. Your doctor can either prepare a diet plan or prescribe supplements for the same.

9. For men - For the sperm to be of good quality, the man should not indulge in any activities that heat up the testicles, thereby killing the sperm. Hot baths, cycling, steam baths and jacuzzi are not advisable for a man who will be supplying the sperm for IVF. Also, the man must try to be stress-free, drink sufficient water to keep himself hydrated and take requisite vitamins and minerals as well. For men, taking vitamins A, B6, B12, C, E, minerals like selenium, zinc and manganese, antioxidants and amino acids is important to increase the chances of success of IVF.

10. Exercise - Regular exercise helps in reducing stress levels and maintaining BMI. If your BMI is more than 20-23, you should postpone IVF till the time that your BMI is back within the healthy bracket.

11. Be relaxed - On the day of IVF, you must take adequate rest and indulge in soups or broths to bring down your cortisol levels. A stress hormone, heightened levels of cortisol can adversely affect the chances of success of IVF.

12. Trust your doctor - While an IVF cycle usually takes 3 days for completion, a doctor will ask you to rest for another 2-3 days after the procedure. The doctor might also instruct you on some other steps to follow. Do take note of all instructions and follow your doctor to increase the chances of your pregnancy

Keeping in mind the above-mentioned points will significantly increase the success of IVF, in all probability, not requiring another cycle of the same.

Important Things To Note

There are certain things to be kept in mind when you opt for IVF. These are as follows:

1. Medication - The process of IVF begins with medications that are administered to stimulate ovaries. Stimulation of ovaries steps up the production of eggs, in addition to helping in the production of many mature eggs and follicles.

2. Activities to be avoided - During an on-going IVF cycle, strenuous activities that jerk your body are to be avoided. Such activities include driving, jogging, running or lifting anything quite heavy.

3. Pain and bulge - The skin around your waist might develop a bulge, making it difficult for you to wear your favourite jeans.

4. Sleeping position - To minimize the chances of developing swelling, sleeping on the left side or straight is advisable. As the process of extricating the eggs somewhat bruises the ovaries, bloods and/or fluids might flow a bit. Sleeping in an angle might cause these fluids to flow towards the diaphragm, thereby causing chest pain. Consult your doctor about the most ideal position for you to sleep in when you are undergoing IVF.

5. Hot flashes - Some women might also develop hot flashes during an IVF cycle. Also, IVF requires frequent trips to the clinic, for blood tests, injections, ultrasounds and even routine check-ups.

6. Side effects - Quite a common side effect of IVF is the chance of multiple pregnancies. In addition, some women might be unable to endure the mental, physical and emotional toll associated with hormonal medications and egg extraction.

7. Assisted reproduction techniques, such as IVF, are one of the primary reasons for multiple pregnancies. While for a childless couple desperate for a child, the idea of welcoming twins or triplets might hold special appeal, multiple pregnancies come with a host of problems. In addition to the health risk to the babies and their mother, the financial burden on the family can also be significant. Transference of more than one embryos during implantation in an IVF cycle is what leads to IVF twins. [5]

Always keep in mind that IVF is not an easy procedure. Along with being mentally strong enough for the challenging times ahead, you, as a mother-to-be, must also have the support of your family and friends to rally behind you and sustain you over your struggles with hot flashes, mood swings, pain and injections.

Are IVF Babies Healthy?

Despite the advancements made by technology, there is nonetheless some amount of stigma attached to babies born through IVF. In order to understand if IVF babies are healthy, we must look at the following:

1. Multiple embryo transfer - As not all embryos are expected to progress into full-term pregnancies, many clinics opt for transferring multiple embryos at a time to enhance the rate of success. This often leads to a woman conceiving twins or triplets which are usually born prematurely and have low birth weight. Nevertheless, this does not have any lasting ill effects on the children born through IVF, and they grow up to live as normal a life as their naturally conceived counterparts.

2. Neonatal issues - The only difference between a normally conceived child and an IVF baby is the mode of fertilization. Once the embryo has been implanted in the womb, the pregnancy progresses like a normal one. On birth, the child will have to meet the same growth parameters and checks. Thus, if opting for IVF, you must not be apprehensive about any neonatal issues as such.

3. Fertility issues - At times, it has been seen that children born of IVF are, in turn, unable to conceive naturally when they grow up. However, this can be due to some genetic predisposition rather than the effect of being born through IVF themselves.

4. Genetic disorder - Genetic traits, determined by epigenetics, have revealed that there is no correlation between epigenetics and IVF as such. In simple terminology, if a child is conceived through IVF, that does not put him at a greater risk for genetic disorders.

5. Mental retardation - Despite fears to the contrary, there is no known evidence to show that IVF increases the risk of mental retardation or autism in so-called test tube children.

6. Higher risk of cancer - Research was conducted at the Ben Gurion University of Israel to study the correlation between babies born of IVF and their chances of developing cancer later on. More than 2 Lakh children born of IVF and other assisted reproductive technologies (ART) were studied for malignancies.

The conclusion reached by the researchers was that children born through IVF are about 2.5 times more likely to later develop abnormal tissue growths or neoplasms. Some other population-based studies have found an increased risk of Hodgkin's lymphoma and leukaemia in children that were conceived through ART. [6]

While in terms of neonatal issues, genetic disorders and mental retardation, IVF babies were at the same threshold as their normally conceived peers; there has nonetheless been proven a heightened risk of cancer in children born by IVF and other ART.

Recent research had led to the finding that, among the women opting for IVF, women over 40 years of age were less likely to have babies with birth defects. With probably more favourable conditions biologically, IVF in women above 40 was seen to produce fewer babies with birth defects when compared to women who were younger in age. [7]

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How To Prevent A Miscarriage After Conception Through IVF?

Miscarriages in IVF procedures are probably as typical as in natural pregnancies. There are ways in which the risk of miscarriage in IVF can be significantly reduced.

1. Get a complete hormonal profile prior to IVF. This is essential as there is a direct relation between abnormal TSH levels and the risk of miscarriage.

2. Ensure that you get any uterine problems checked beforehand.

3. It is usual practice to give progesterone after an IVF cycle, irrespective of the fact that whether your own eggs are used or donated ones. Heightened levels of progesterone might lead to vomiting, and even cause miscarriage in certain cases.

4. Try to be as informed as possible about all facets of your IVF procedure. Inform your doctor as soon as any inconvenience is experienced. Always remember to err on the side of caution. Simply put, it is better to keep consulting your doctor over seemingly trifle concerns rather than regret later on.

5. Thick or clotting blood. If you have thicker blood than usual or face problems with blood clotting, get proper medical advice before beginning your IVF cycle. Thick blood or clotting can interfere with the proper circulation of blood to the baby in the womb.

6. Always take your medications on time. While taking medications even during a regular pregnancy is quite important, the importance gets magnified with IVF. Following your doctor's instructions and taking your medications is very important to prevent a miscarriage.

7. On routine visits to your doctor, make it a point to get your cervix checked to minimize the risk of miscarriage due to a weak cervical opening.

8. Be extra careful after your IVF cycle as infections can cause miscarriages. Toxoplasmosis, an infection attributed to cat faeces and unwashed vegetables, has been known to cause miscarriages. Always wash vegetables before consumption and avoid being in close proximity with cats.

The success rate of IVF in the first cycle itself depends on a lot of factors. While factors like the age that influence results cannot be modified, there are many lifestyle changes that can be made by both partners concerned. It is a proven fact that smoking and excess weight [8] negatively impact the success of IVF.

Various other factors like caffeine, level of activity, environmental pollutants and psychological stress are also suspected to adversely affect the success rate of IVF. However, certain steps such as, proper diet, exercise, detoxification can be taken to facilitate the successful progression of pregnancy to full-term.

View Article References
  1. [1] Teoh, P. J., & Maheshwari, A. (2014). Low-cost in vitro fertilization: current insights. International journal of women's health, 6, 817-827.
  2. [2] Dobson R. (2002). Data on IVF clinics show wide variation in success rate. BMJ (Clinical research ed.), 325(7362), 460
  3. [3] Wade, J. J., MacLachlan, V., & Kovacs, G. (2015). The success rate of IVF has significantly improved over the last decade. Australian and New Zealand Journal of Obstetrics and Gynaecology, 55(5), 473-476.
  4. [4] Phelps, J. Y., Levine, A. S., Hickman, T. N., Zacur, H. A., Wallach, E. E., & Hinton, E. L. (1998). Day 4 estradiol levels predict pregnancy success in women undergoing controlled ovarian hyperstimulation for IVF. Fertility and sterility, 69(6), 1015-1019.
  5. [5] Ismail, L., Mittal, M., & Kalu, E. (2012). IVF twins: buy one get one free?. J Fam Plann Reprod Health Care, 38(4), 252-257.
  6. [6] Reigstad, M. M., Larsen, I. K., Myklebust, T. Å., Robsahm, T. E., Oldereid, N. B., Brinton, L. A., & Storeng, R. (2016). Risk of Cancer in Children Conceived by Assisted Reproductive Technology. Pediatrics, 137(3)
  7. [7] Davies, M. J., Rumbold, A. R., Marino, J. L., Willson, K., Giles, L. C., Whitrow, M. J., ... & Moore, V. M. (2017). Maternal factors and the risk of birth defects after IVF and ICSI: a whole of population cohort study. BJOG: An International Journal of Obstetrics & Gynaecology, 124(10), 1537-1544.
  8. [8] Rossi, B. V., Bressler, L. H., Correia, K. F., Lipskind, S., Hornstein, M. D., & Missmer, S. A. (2016). Lifestyle and in vitro fertilization: what do patients believe?. Fertility research and practice, 2, 11.

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