Success of IVF

Contents

    In vitro fertilization (IVF) is a reproductive technology that helps achieve pregnancy in cases of certain infertility conditions. IVF is performed by fertilizing an egg cell with a sperm outside the body, in a Petri dish containing a nutrient medium.

    The resulting embryo is kept in specialized laboratory conditions for 3-5 days, with the same temperature, carbon dioxide, and oxygen levels as the uterine cavity. The embryo is then transferred to the uterus.

    The success of IVF can be determined as early as 10-14 days after the embryo transfer procedure. A standard pregnancy test can be used to detect the level of human chorionic gonadotropin.

    Factors Influencing the Success of IVF

    The success of fertilization and implantation (attachment of the embryo to the uterine wall) depends on several factors. One key factor is the woman’s age. The older the woman, the lower the probability of achieving pregnancy through IVF. This is because the woman’s body undergoes changes with age that affect fertility:

    • Aging of the ovaries and a decrease in ovarian reserve – the overall number of follicles from which eggs can develop. Ovarian reserve can be accurately determined during the planning stage of IVF through anti-Mullerian hormone (AMH). AMH is considered the most reliable marker of ovarian reserve.
    • Reduced ability of the uterine lining to support implantation and successful embryo development.
    • Increased incidence of endometriosis and uterine fibroids. These conditions decrease the likelihood of achieving pregnancy.
    • Blockage of the fallopian tubes due to previous inflammatory and infectious diseases of the pelvic organs.

    Excessive or insufficient weight can reduce the success of IVF, as both factors negatively affect fertility. Another important risk factor is smoking, as tobacco consumption negatively affects the quality of egg cells, reducing the chances of successful fertilization.

    Various hormonal disorders can lead to miscarriages and pregnancy loss. These include thyroid diseases, polycystic ovary syndrome, and pathologies associated with elevated levels of insulin and prolactin.

    The quality of sperm also affects the success of IVF. Factors such as sperm count, motility, and morphological characteristics are important. These parameters can be assessed through a semen analysis (spermogram).

    Success of in vitro fertilization (IVF)

    The average success rate of in vitro fertilization (IVF) is around 40%, but this rate varies across different age groups.

    under 30

    35-37

    38-40

    41-43

    over 45

    Among patients under 30 years old, the success rate of IVF procedures reaches 65-70%. As age increases, this rate significantly decreases. For women under 40, the likelihood of IVF success is around 38-40%, while for those over 45, it is approximately 10-12%.

    Pregnancy can occur in the first IVF cycle in about 50% of cases. The remaining 50% of women may require 2-3 attempts to achieve pregnancy.

    The success of IVF is also influenced by the number of fertilizable eggs and embryos transferred into the uterine cavity.

    Using donor gametes – 46-47% Combined (IVF with ICSI) – 23-32% Frozen embryo transfer cycle – 23-25% Natural cycle – 8-11%

    How many eggs are retrieved for IVF?

    Typically, 10-20 eggs are retrieved for IVF. This number is necessary to increase the chances of a successful procedure. It is because only two-thirds of the retrieved eggs will be mature enough and suitable for fertilization. Additionally, not all embryos will be viable.

    To obtain an adequate number of eggs during the preparation stage of the IVF cycle, ovarian stimulation is conducted using hormonal medications. The choice of drugs, the method of administration, and the duration of the course are determined individually by the doctor. The stimulation period usually lasts from 2 to 4 weeks.

    In most cases, ovarian stimulation proceeds without complications. However, some side effects may occur due to the hormonal medications taken by the woman, such as:

    • Headaches and dizziness
    • Abdominal pain in the area of the ovaries
    • Swelling, a sense of fullness, and breast tenderness

    These symptoms typically resolve on their own after the completion of the stimulation course.

    How many eggs are fertilized for IVF?

    All eligible eggs obtained from the woman are fertilized for IVF. Typically, this ranges from 6 to 15 eggs. However, not all eggs develop into embryos. In some cases, fertilization does not occur or happens incorrectly. Evaluation is conducted on the following day after the fertilization procedure. There are several parameters that the doctor can use to determine successful fertilization and embryo development.

    On the third and fifth day, evaluation is performed using a specific scale. It helps classify embryos as high-quality, medium-quality, or low-quality. However, this evaluation method does not guarantee 100% certainty that a high-quality embryo will successfully implant and result in pregnancy. Conversely, lower-quality embryos may successfully implant, leading to pregnancy and the birth of a healthy baby.

    One, two, or three embryos are transferred into the uterus. The reproductive specialist determines the number based on the woman's medical history. In most cases, 1-2 embryos are chosen. If the woman has previously experienced unsuccessful IVF attempts or if lower-quality embryos were obtained during fertilization, three embryos can be transferred.

    Increasing the number of embryos increases the likelihood of pregnancy, but it also carries certain risks. For instance, in the case of a multiple pregnancy, there is an increased likelihood of complications during gestation and childbirth.

    How to increase the chances of IVF success

    Several modern technologies and procedures can help increase the effectiveness of IVF and improve the chances of success:

    1. ICSI (Intracytoplasmic Sperm Injection) involves selecting the highest-quality sperm from the semen sample and injecting it directly into the cytoplasm of the egg. This increases the likelihood of successful fertilization and the formation of a high-quality embryo. The IMSI (Intracytoplasmic Morphologically Selected Sperm Injection) technology is used to identify suitable sperm using a specialized microscope with over 6300 times magnification.
    2. Timelapse technology involves capturing images at regular intervals during the development of the embryo. It helps in accurately assessing the quality of the embryo and selecting the best one for transfer into the uterus.
    3. PGD (Preimplantation Genetic Diagnosis) and NGS (Next-Generation Sequencing) are genetic tests performed on embryos to detect chromosomal and genetic disorders. They also assist in assessing the quality and viability of embryos.
    4. Laser Assisted Hatching involves thinning the outer shell of the embryo using a laser to facilitate the embryo's successful attachment to the uterine lining.
    5. Intracytoplasmic injection of mononucleated cells (ICSI-M) prior to embryo transfer. This procedure increases the chances of successful implantation.

    To increase the likelihood of successful IVF, it is important for women to follow the appropriate post-procedure behavior. In the first few days after the embryo transfer, it is crucial to avoid stress and maintain a balanced routine of work and rest. Lifting heavy objects and engaging in strenuous physical activities should be avoided. Sexual intercourse should be abstained from for 10-14 days following the procedure.

    Even with thorough preparation and adherence to all doctor's recommendations, successful pregnancy after IVF is not guaranteed. In some cases, pregnancy may not occur, or miscarriages may happen. However, the failure of IVF does not mean that you cannot become a parent. Surrogacy can be an option to explore in such cases.