IVF, Here's What You Should Know

IVF is a procedure performed to assist the process of pregnancy. Pthis procedure can be one solution for couples who experiencedisturbancefertility to have children.

Pregnancy begins when a mature egg is fertilized by a sperm in the fallopian tube. If the fertilized egg attaches to the uterine wall, normally the fetus will begin to grow in the uterus and will be born 9 months later.

However, due to certain conditions, the process does not run normally. This can be caused by disorders of the female pelvic organs or fertility problems in men. In these conditions, IVF procedures can be performed to help pregnant women patients.

IVF is a program to help patients get pregnant, by combining eggs and sperm outside the body. After fusion, the fertilized egg (embryo) will be placed back in the uterus.

IndicationTest-tube baby

IVF procedures are used to achieve pregnancy for patients with fertility problems. But usually, before the IVF procedure is chosen, the doctor will first suggest other methods, such as giving fertility drugs and artificial insemination.

In addition to getting pregnant, IVF procedures can also be carried out to prevent genetic disorders suffered by parents from passing on to the fetus.

This procedure can also be performed on female patients who will undergo treatment, such as radiotherapy and chemotherapy. Through IVF, patients can store healthy eggs before undergoing the treatment.

IVF is usually recommended in female patients over the age of 40 who have impaired fertility or in patients with the following conditions:

  • There is blockage or damage to the fallopian tubes (fallopian tubes)
  • History of surgical removal or sterilization of the fallopian tubes (tubal ligation)
  • Ovulation disorders that cause a shortage of eggs
  • Endometriosis, which is a condition when uterine lining tissue grows outside the uterus
  • Myoma, which is a benign tumor in the uterine wall that can interfere with the attachment of the embryo to the uterine wall
  • Disorders of sperm function, shape, and production, such as abnormalities in the shape and size of sperm (teratospermia), poor sperm motility (asthenospermia), or lack of sperm production (oligospermia)
  • Other unknown reasons for infertility

IVF Warning

Couples can do IVF if both parties are physically and mentally ready. Couples will go through many medical processes and sometimes not succeed in one action (cycle).

It is important to know, increasing age of women can reduce the chances of successful IVF program and the risk of causing chromosomal abnormalities in the fetus.

Excess weight and unhealthy lifestyles, such as smoking and consuming alcoholic beverages, are also at risk of lowering the chances of IVF success.

BeforeTest-tube baby

Before undergoing the IVF procedure, there are a series of tests that will be carried out by the doctor, namely:

  • Ovarian reserve testing

    This examination aims to determine the number and quality of egg cells by measuring levels of follicle-stimulating hormone (FSH), anti-mullerian hormone (AMH), and the hormone estrogen at the beginning of the menstrual cycle. If needed, the doctor will also perform a pelvic ultrasound.

  • Infectious disease check

    Doctors will examine or screen patients and their partners if there are infectious diseases, such as HIV.

  • Inspection Wall womb

    This examination is done by injecting a special fluid into the uterus through the cervix, followed by ultrasound to get a picture of the uterine cavity (sonohysterography). This examination can also be done by inserting a flexible tube with a camera into the uterus through the vagina (hysteroscopy).

  • Embryo transfer experiment imitation

    This procedure aims to see the thickness of the uterine cavity and find the most suitable technique when working on IVF.

  • Sperm test

    This test is performed to determine the quantity and quality of the patient's sperm.

Procedure Test-tube baby

The IVF procedure consists of 5 stages, namely ovulation induction, egg retrieval, sperm retrieval, fertilization, and embryo transfer. Here is the explanation:

1. InductionoVulation

Ovulation induction is the administration of synthetic hormones and drugs, such as:

  • Follicle-stimulating hormone (FSH), luteinizing hormone (LH), or a combination of both to stimulate the ovaries (ovaries)
  • Human chorionic gonadotropin (hCG), generally given 8–14 days after an ovarian stimulant injection, to help the egg maturation process when the egg is ready to be collected
  • Premature ovulation suppressant, to prevent the egg from releasing too quickly from the ovary
  • Progesterone hormone supplements are given on the day of egg retrieval, to prepare the uterine wall to become a place for attachment of the embryo

Ovulation induction generally takes 1-2 weeks before an egg can be collected. During this process, the patient will also undergo a transvaginal ultrasound to make sure the eggs are growing, as well as blood tests to make sure the hormones estrogen and progesterone are at the right levels.

Doctors can delay IVF if egg growth is low, too high, or if ovulation occurs prematurely. Then the doctor will repeat this process again by changing the dose of the hormone given.

2. Retrieval tegg

The egg retrieval process is carried out 34–36 hours after the last hormone injection and before ovulation. Prior to this procedure, the patient will be given an injection of sedative and painkillers to reduce the pain that occurs during the egg retrieval process.

The following are the stages in the egg retrieval process:

  • The egg will be removed from the uterus using a small needle, guided by a transvaginal ultrasound. If this is not possible, the doctor will make a keyhole-sized incision in the abdominal wall and insert a small needle with the help of an abdominal ultrasound.
  • Some of the eggs will be sucked through the needle for approximately 20 minutes. Mature eggs will be stored in an incubation containing a special liquid, to be fertilized by sperm. But keep in mind, the fertilization process is not always successful.

3. Retrieval sperma

To take a sperm sample, the doctor will ask the male patient to masturbate. Another way that can be done is to take a sperm sample directly from the testicle using a needle.

4. Fertilization

The fertilization process can be done in 2 ways, namely:

  • Insemination

    This process is done by mixing healthy sperm and eggs overnight to become an embryo.

  • Iintracytoplasmic sperm injection (ICSI)

    ICSI is performed by injecting one healthy sperm into each cell. ICSI is generally performed when sperm quality is poor or fertilization by insemination has failed. Keep in mind, not all embryos can survive after the fertilization process occurs.

5. Embryo Transfer

This last stage is carried out 3-5 days after the egg retrieval process, where the embryo has begun to develop. However, before the embryo is transferred into the uterus, the doctor will run tests to check for chromosomal abnormalities or certain infectious diseases.

The stages in the embryo transfer process are as follows:

  • Patients will be given a light anesthetic to relieve pain, although some patients may experience mild stomach cramps.
  • The doctor inserts a flexible tube (catheter) into the uterus through the vagina.
  • One or more embryos will be injected into the uterus through a catheter.

This process is considered successful if the embryo implants in the uterine wall within 6–10 days after the embryo is transferred.

After Test-tube baby

Some things that must be considered after undergoing the IVF process are:

  • Patients who have undergone IVF procedures can return to their activities. However, avoid strenuous activity because it can trigger discomfort in the uterus.
  • After the embryo transfer, clear fluid or blood may come out of the vagina. Patients may also experience constipation, stomach cramps, and flatulence. In addition, the patient's breasts may feel softer due to high levels of the hormone estrogen.
  • Doctors will prescribe synthetic progesterone hormone in the form of injections or pills, to be used for 8-10 days after embryo transfer. This drug is useful for supporting the growth and development of the embryo in the uterus.
  • Immediately see a doctor if you have fever, pelvic pain, heavy bleeding from the vagina, or there is blood in the urine. Your doctor will perform tests to detect infection, ovarian hyperstimulation syndrome, or ovarian torsion.
  • Around 12–14 days after embryo transfer, the patient is advised to come to a hospital or clinic for a pregnancy check-up.
  • In case of pregnancy, the doctor will recommend the use of synthetic hormones continued until 8-12 weeks. The doctor will also advise the patient to undergo routine pregnancy check-ups.
  • If the IVF result is negative, the doctor will ask the patient to stop using the hormone progesterone. Patients will usually experience menstruation in 1 week. But if not, check with a doctor.

IVF Risk

The following are some of the risks that may occur as a result of IVF procedures:

  • Pregnant with twins, if more than one embryo is implanted into the uterus
  • Premature birth and low birth weight
  • Ovarian hyperstimulation syndrome, due to injections of fertility drugs, such as human chorionic gonadotropin (hCG)
  • Stress, which may be caused by wasted time, energy, and money
  • Ectopic pregnancy or pregnancy outside the uterus, such as in the fallopian tube
  • Birth defects or defects
  • Miscarriage