IVF pregnancy is the aim of IVF treatments. IVF is a surgical-medical treatment aimed at getting pregnant by increasing the chance to generate good quality embryos either in your body or in an embryology laboratory. Getting an IVF pregnancy is considered hard to understand by most people who need this medical procedure to solve their infertility problems and unfortunately by some doctors. However, achieving a pregnancy by IVF is conceptually simple. IUI and in vitro fertilization and embryo transfer are both efficacious treatments to get pregnant in those cases of difficult or impossible conception attempted by regular sexual activity for 12-24 months.
Your gynecologist or andrologist have indicated IVF as the best treatment for you to get pregnant? Would you like to understand better the steps to achieve an IVF pregnancy? Gruppo Donnamed® will explain in simple words the IVF. Please take a breath and read this article by dedicating 10 minutes of concentrated effort!
The diagnosis of infertility
You should undergo some clinical examinations in order to ascertain a possible cause of infertility. Male infertility may be diagnosed by a simple test, the seminal fluid analysis also called spermiogram. This exam has to be done following an abstinence of 2-7 days and possibily far from any medical treatment. Collecting the seminal fluid by masturbation in a sterile container is the only procedure to be done by the proband. The seminal fluid analysis is particularly significant in those extreme cases in which the number and motility of male gametes (spermatozoa) is so compromised that the possibility of natural conception may be statistically excluded. Important to say: the spermiogram must be repeated at least 2-3 times in a 6 months time in order to be sure that the analysis identifies correctly the sterile male.
If the spermiogram is normal or mildly abnormal, the female partner diagnostic procedure is mandatory. Ovulation cannot be demonstrated by any diagnostic test, in particular the hormonal exams are not indicative of ovulation. Perhaps the best demonstration of ovulation is the regularity of the menstrual cycle, as most ovulating women have regular menses. Certainly, the only reliable ovulation test is having got pregnant by a beta-hCG test done by blood withdrawal. Any other procedure is unuseful to demonstrate ovulatory activity (i.e Persona or other hormonal assays).
The second test to be done in the female partner is the hysterosalpyngography. This procedure may be either radiologic or done by ultrasound (in this case it is called sono-hysterosalpyngography) and is aimed to demonstrating the patency of your fallopian tubes. The fallopian tubes (at least one) must be patent in order to achieve fertilization in your body. In cases of tubal occlusion on patency tests, the best think to do is laparoscopy, the gold standard to demonstrate tubal patency or occlusion.
However, if you are older than 35, Gruppo Donnamed® advices against tubal patency assays. In fact, if you are older than 35, IVF procedures aimed at getting pregnant in your body (i.e. in utero insemination) bear a remarkably low success rate. In those cases, it is better to proceed directly to in vitro fertilization and embryo transfer.
The first step to proceed to an IVF treatment is to get an infertility certification by a qualified doctor. He will be able to diagnose infertility and exclude any possibility to solve your fertility problems by a medical or surgical problem other than IVF. This is important to undestand. IVF pregnancy if the final solution of a complex diagnostic process aimed at excluding the possibility of increasing your fertility and getting pregnant by a natural treatment different from IVF.
Once ascertained a possibile cause of your infertility, the choice of the best treatment is the second step to get an IVF pregnancy. If the seminal fluid is not severely compromised, you are younger than 35 and at least one of your tubes is patent, you can proceed to IUI, a simple intrauterine insemination with a mild ovarian stimulation.
However if you are older than 35, your tubes are occluded and/or your partner is severely compromised, you should proceed to IVF-ET or ICSI. The last treatment is indicated just in case of extremely compromised seminal fluid. You must not undergo ICSI if there is no clear indication to this treatment, as the malformation rate (especially genito-urinary) and genetic problems in offsprings are higher in ICSI than in IVF. Also the twin rate is unacceptably higher in ICSI than in IVF-ET.
Once you get pregnant by either ICSI or IVF-ET, the IVF pregnancy may be normal if you bear a single baby in the uterus. Therefore it is important to transfer back the lowest number of embryos. This may be achieved by leaving the embryos grow to the blastocyst stage, i.e. 5 or 6 days in the laboratory. This technique allows to transfer one single embryo by maintaing the same pregnancy success rate that may achieved by transferring 2 or 3 embryos at day 2-3.
This article is not intended to substitute for informed medical advice. You should not use this information to diagnose or treat a health problem or condition. Always check with your doctor before changing your diet, altering your sleep habits, taking supplements, or starting a new fitness routine.
DOTT. ANGELO TOCCI
Angelo Tocci is a Obs & Gyn and Andrology. He is the Head at Gruppo Donnamed® in Rome Italy. He gained a lot of experience by working in reputed University Hospital in Italy, in UK (Queen Charlotte’s and Chelsea Hospital, Imperial College LONDON) and in France (Claude Bernard University Hospital, Lyon) He is member of the American Society for Reproductive Medicine, the European Society of Human Reproduction and Embryology and the European Academy of Andrology. He is presently treatment responsible of IVF treatment at the European Hospital private clinic in Rome Italy.