Author: drjeyanirmala@gmail.com

IVF is an advanced fertility treatment which has a worldwide success rate between 30–70%. Although it is a well-established process, each step is complex and carries chances of failure. Several patients undergo 2–3 cycles before achieving success. Dr. Ramya Ramalingam, Chief Fertility Specialist, Jeevan Mithra Fertility and Women Care Centre, Arumbakkam, Chennai, shares some guidelines to improve chances of success.

APPROACH IVF TREATMENT AT THE RIGHT AGE

The woman’s age is especially important for IVF success. As every woman is different, the biological clock must be assessed with tests like Ovarian Reserve Assessment, to see if she can wait and try naturally or proceed to IVF.

CHOOSE THE RIGHT FERTILITY CENTRE FOR A FAVOURABLE OUTCOME

Considering the numerous fertility centres with various claims, choosing the right centre can be confusing. In addition to checking the centre’s success rates and team of specialists, also consider their live birth rate and success rate in critical cases, which reflect the embryology lab’s success. Also enquire on surplus embryo freezing facilities and seek first hand feedback and reviews.

ENSURE COMPLETE PRE-IVF EVALUATION

Women must undergo a general check-up, appropriate blood tests and vaginal and breast examinations to detect underlying conditions which may impact IVF success. A properly done trans vaginal ultrasound scan can reveal critical information to improve outcome. Fibroids, hydrosalpinx, endometrial polyps and low antral follicular count must be identified and treated before proceeding further.

Men must undergo semen analysis. The couple must maintain sugar control and ideal weight. Medication for pre-existing conditions must be changed to pregnancy-safe medicines under specialist guidance.

DECIDE ON PROPER TREATMENT PROTOCOL

IVF treatment offers various injection protocols. The best suited one must be decided ahead. Several techniques are also available to evaluate sperm and finalise on the right treatment. Further, the fertilisation procedure after egg collection must be planned beforehand. It can involve IVF, ICSI or other advanced fertility treatments like PICSI, IMSI and Microfluidic ICSI.

PROCEEDING WITH TREATMENT

There must be no compromise on the choice of hormone injection as it directly impacts the quality of egg, therefore resulting in superior grade embryo and IVF success rate. Recombinant injections are recommended. 10–15 eggs are ideal, so some can be used for the 1st cycle and others can be frozen for future pregnancy. Proper follicular and hormonal monitoring is critical to ensure adequate number and quality of eggs.

TIMING OF EGG COLLECTION

Egg collection is ideally planned 35–36 hours after trigger injections, failing which there is a chance for follicular rupture and low or no egg production. Once the egg collection is done, fertilisation is done according to the predetermined plan in the IVF laboratory.

Blastocysts which are embryos developed 5 days post fertilization have better implantation rate compared to day 3 embryos. Blastocyst transfer is especially recommended for those with previous IVF failures. Embryo growth and grading is important for IVF success and are determined by lab conditions.

EMBRYO TRANSFER

The number of embryos transferred is decided by the fertility specialist, while considering the woman’s age and embryo quality. Luteal support injections can be substituted with oral and vaginal medicines with the same effect, to make the process painless.

The woman must sleep well, avoid stress and protect herself from infection. She must eat freshly prepared, easily digestible food, without much oil and spice and follow medication as prescribed by the doctor.

TAILOR-MADE INDIVIDUALISED IVF PROTOCOL

Jeevan Mithra Fertility offers advanced ART techniques, for couples to achieve biological parenthood using their own gametes even at an advanced age. The centre boasts of a high success rate even in complicated cases with multiple failures.

In case of failure, couples should not lose hope and instead seek assistance from an experienced fertility specialist for troubleshooting and undergo further advanced tests and procedures, to improve success in repeat cycles. Jeevan Mithra Fertility has online consultation services for couples battling IVF failure.