IVF is a medical procedure for conception in which a woman’s egg is fertilized with partner’s sperm outside in the lab and the resulting embryo is transferred to the woman’s uterus.
Though it’s one of the advanced fertility treatments, worldwide success rates of ivf ranges from 30-50%. The success of IVF primarily depends upon age of women, cause of infertility ,Sperm quality , oocyte quality and uterine receptivity.
Although IVF is a well-established process, each step is complex and carries with it a chance of failure. So, couples may require multiple cycles to achieve a pregnancy.
Here is a guide to help a couple to sail through the journey of ivf smoothly and improve the chance of being successful at the earliest.
1) Lifestyle changes- Maintaining a healthy weight ,quitting smoking, avoiding excess alcohol, well balanced diet and exercise.
2)Reducing stress- Several reports suggest improvement of pregnancy outcomes with the use of acupuncture and other stress relieving techniques, like enrolling in mind-body programs, stress reduction, and resilience training workshops.
3)Couples should take their multi-vitamin and mineral supplement which contains vitamins D, A, C, E and B complex, zinc, magnesium, selenium, iron and Co-enzyme Q10 .
4)Supplements should be continued to improve egg and sperm quality if your doctor suggests. These may need to be taken for at least 3 months prior to IVF.
5)IVF protocols - Individualised protocols for ovarian stimulation should be used for each patient rather than blanket therapy.
6)Associated gynaecological illness like fibroids, endometrial polyps, endometriosis, adenomyosis, hydrosalpinx should be dealt with before going for embryo transfer in IVF.
7)Sperm DNA damage testing (DFI) -
Routine semen parameters like sperm concentration, motility and morphology may not be sufficient to predict pregnancy outcome. ICSI-intracytoplasmic sperm injection can also improve IVF outcome in such cases when sperm analysis is otherwise normal.
DNA damaged sperm can impair fertilization, embryo development, implantation and can also cause miscarriages. Treatment with antioxidants and varicocelectomy can decrease DFI.
Sperm sorting techniques like MACS and microfluidics can help to sort out best sperm for ICSI.
8)TESA-Testicular sperms have less DNA damage and better DNA integrity. Sperms can be easily aspirated with small needle without much damage and used in ICSI.
9)Blastocyst transfer- embryos that has been grown up to 5 days post fertilization are called blastocysts and they have a better implantation rate compared to day 3 embryos. Only 1/3 of all embryos are capable of growing to this stage.
10)Assisted hatching: when embryo is unable to escape its shell, the Embryologist facilitates the hatching process by laser so that embryo can come out and implant.
11)Embryo glue- Specially developed solution that contain a substance called hyaluron can be used. It has implantation enhancing effect
12)Preimplantation Genetic Testing (PGT)-This is a procedure for genetic testing of IVF embryos by a biopsy prior to transfer and help us to select healthy and chromosomally normal embryo. This improves chances of conception and avoids abortion and birth defects. With this test you can also eliminate the risk of passing genetic disease to your baby.
13)ERA: Endometrial receptivity analysis is a genetic test that evaluates the uterine endometrial lining. It analyses the optimal timing of embryo transfer to promote successful implantation. This is also called Personalised embryo transfer.
Your Fertility Specialist would be the best one to judge what would work the best for you. In case of a failure the couple should not lose hope and instead discuss the causes for failure and go for further advanced tests and procedures for improving success in repeat cycles.