IVF full form?

All you need to know about IVF

In vitro fertilization (IVF), is the most common and effective type of assisted reproductive technology to help people become pregnant. IVF can help achieve pregnancy when other treatments have not worked.

This procedure involves fertilizing an egg outside the body, in a laboratory dish, and then implanting it in a person | s uterus.

IVF is the most common and effective type of assisted reproductive technology (ART). According to the Centers for Disease Control and Prevention (CDC), ART is the conception method for around 2.1%Trusted Source of babies born in the United States each year. There is also a higher chance of a multiple births with IVF.

This article covers the IVF procedure. It explains success rates, costs, screenings, and more.
Overview of IVF
Brown became the first baby born via IVF conception. Robert Edwards and Patrick Steptoe, who collaborated on the procedure, are considered the pioneers of IVFTrusted Source.

In a natural pregnancy, an egg develops and matures in the ovary. Ovulation is when the ovary releases that egg.

The sperm travel through the uterus and into the fallopian tube to find the egg and penetrate it, which leads to fertilization. The fertilized egg, or embryo, then attaches itself to the uterus wall and begins developing into a baby.

However, IVF may be an option for the following reasons:

a person is unable to get pregnant naturally
a person or couple is diagnosed with unexplained infertility
male factor infertititly or abnormal sperm parameters
a person | s fallopian tubes are blocked

The IVF process

According to the Human Fertilization and Embryology Authority in the U.K., one IVF treatment cycle can take between 3–6 weeks. However, a person may require more than one cycle depending on their risk factors and the success rate of the treatment.

Techniques may differ depending on the clinic. However, IVF usually involves the following steps:
1. Superovulation

Superovulation is also known as controlled ovarian hyperstimulation. Fertility medications contain either luteinizing hormone or follicle-stimulating hormone. These hormones make the ovaries produce more eggs than usual. Transvaginal ultrasound scans can monitor the growth and progress in the ovaries.

As an alternative, a person may use donated or frozen eggs.
2. Retrieving the eggs

Doctors use a minor surgical procedure known as “follicular aspiration” or “egg retrieval” to collect eggs.

Under ultrasound guidance, a thin needle is inserted through the vagina and into an ovary. The needle is attached to a suction device that removes the follicular fluids and the eggs. Doctors perform this process for each ovary.
3. Insemination, fertilization, and embryo culture

The collected eggs are placed together with sperm and kept in an environmentally controlled chamber. After a few hours, the sperm should enter the egg.

Sometimes the sperm is directly injected into the egg. This process is known as an intracytoplasmic sperm injection (ICSI). Frozen sperm, retrieved through testicular biopsy, may be used.

The fertilized egg divides and becomes an embryo. Once the embryos reach the blastocyst stage, many fertility centers offer preimplantation genetic testing (PGT). This technique screens an embryoTrusted Source for chromosomal abnormalities or aneuploidies.

The transfer uses one or two of the best embryos. A person then receives hormones and other medications to prepare the uterine lining for the embryo | s implantation.
Sometimes, the womb receives more than one embryo. It is important to discuss the number of transferred embryos with a doctor.

Most commonly, the doctor will only transfer a single embryo. The decision to transfer more than one embryo must consider several risk factors, and a person should discuss them with a doctor.

Around 3–5 days after fertilization, the transfer of the embryo begins by using a thin tube or catheter. It enters the uterus through the vagina. When the embryo sticks to the uterus lining, also known as implantation, a pregnancy has started, and embryo growth continues.
IVF success rates
, the CDC estimated that the percentage of intended egg retrievals that resulted in live birth deliveries was:

52.7% among people aged under 35 years
38% among people aged between 35–37 years
24.4% among people aged between 38–40 years
7.9% among people over the age of 40

These statistics vary depending on where the procedure takes place.
Other factors

Age is the most important risk factor that affects the success rate with IVF.

However, the likelihood of success can depend on other factors, including:

the cause of infertility
ovarian reserve test results
whether or not pregnancy or a live birth has occurred before
the strategy that will be used

IVF costs

The average cost of one IVF cycle in the U.S. varies between $10,000–15,000. However, some insurance providers cover infertility treatments such as IVF. Therefore, a person with health insurance may obtain IVF treatment at a lower cost.

Coverage will be dependent on the health insurance provider and the state that the person lives. Currently, 17 states in the U.S. require insurance providers to either cover or offer coverage for infertility treatment by law.
Due date calculator for IVF

A person can calculate an estimate of their due date by using a due date calculator.

Many websites, such as Flo Health, provide a calculator to estimate a person | s due date using information such as the embryo transfer date and the type of transfer they underwent. The calculators include:

Day 3 embryo transfer
Day 5 embryo transfer
IVF with own eggs
IVF with fresh donor eggs cycle
Fresh donor embryos cycle

Screenings

Screening and testing are available to determine the sex of the embryo and to identify if there any genetic abnormalities.

Primarily, preimplantation genetic testing (PGT) was a procedure used by doctors to detect genetic disorders in the embryo | s DNA. These could result in a birth abnormality or developmental issue.

In addition, doctors now also conduct this method to identify the sex of the embryo before implantation during IVF. Doctors can analyze which chromosomal make up the embryo processes to determine if the embryo will be male or female.

A 2018 study notes that over 72%Trusted Source of contacted ART clinics offer preimplantation testing.
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IVF vs. IUI

Intrauterine insemination (IUI), also called artificial insemination, is a technique where the uterine cavity receives sperm directly from a catheter. This technique reduces the time and distance required for the sperm to travel to the egg and fertilize it.

This process is different from IVF, where the eggs and sperm are placed together outside of the body in a controlled environment.

IUI is normally used to treat mild male factor infertility and couples with unexplained infertility. A person undergoing IUI may also receive medication to stimulate ovulation. A doctor will inject the sperm into the uterus during the ovulation period.

IUI is a simple procedure that normally takes between 5–10 minutes compared to IVF. IUI is also cheaper than IVF. IUI, on average, costs between $300–1,000 without insurance.

However, IUI is also less successful than IVF.

Once the sperm is injected by doctors into the uterine, the body | s natural processes will take over. In IVF, doctors can monitor whether an egg has been fertilized and select the best embryo(s).

Success rates for IUI are generally around a third of that for IVF.

Additionally, IUI may not be a suitable fertility treatment in the following circumstances where a person:

has blocked fallopian tubes
has severe endometriosis
is in their late 30s or over 40
has low-quality eggs
has a low number of eggs

This treatment is also not suitable if the reason for infertility treatment is severe male factor infertility.
Insemination vs. ICSI

ICSITrusted Source is a technique that injects a single sperm into an egg for fertilization.

ICSI is a common treatment for couples experiencing male factor infertility. It may also improve the chance of fertilization in people with a previously unsuccessful IVF cycle. It is also for cycles that plan to use preimplantation genetic testing.

The American College of Obstetricians and Gynecologists associate ICSI with a slightly higher risk of birth defects, including:

Angelman syndrome
Beckwith-Wiedemann syndrome
autism spectrum disorder
intellectual disability

Side effects of IVF

Many people will experience little to no side effects during IVF. However, some people may experience side effects. These may includeTrusted Source:

fatigue
abdominal pain
sore breasts
irritability
nausea
headaches

These symptoms tend to occur during the ovarian stimulation phase of IVF. A small percentage of people may also experience the following side effects:

shortness of breath
dehydration
vomiting or abdominal pain that requires hospital admission

Some people may also experience mood fluctuationsTrusted Source.
Is it painful?

The IVF process is usually not painful, although a person may experience mild discomfort at some stages.

As IVF involves the injection of fertility medication, there may be mild bruising and pain at the injection site. A person may also experience abdominal cramping that may be painful.

The egg retrieval process is normally not painful because pain medication is given before the procedure.

Embryo transfer is also not usually painful.
Risks with IVF

Some risks are associated with IVF, including the following:
Side effects of medication

Some people may have reactions to the medications given during treatment.

The possible side effects of IVF drugs include:

nausea and vomiting
difficulty breathing
irritability
hot flashes
enlargement of the ovaries
difficulty sleeping
abdominal pain

Ovarian hyperstimulation syndrome (OHSS)

Rarely, the medications used to stimulate ovaries to produce eggs can cause OHSS. This happens when there is an overresponse to the medications being used and the hormone levels become very elevated.

People with OHSS have a large number of growing follicles and high estrogen levels. This leads to fluid leaking into the abdomen, which may cause bloating, nausea, and swelling of the abdomen.

With severe OHSS, the following symptoms are possible:

blood clots
shortness of breath
dehydration
vomiting

Pregnancy loss

The leading causeTrusted Source of pregnancy loss, whether in IVF or natural conception, is an abnormal number of chromosomes, known as chromosomal aneuploidy.

An embryo is tested with PGT to look for aneuploidy.
Multiple births

When the uterus recieves more than one embryo in the transfer, there is a higher chance of having twins, triplets, or more babies.

Pregnancies with more than one fetus can result in:

preterm birth or low birth weight
double the mother | s risk of developing diabetes
significant increase in the mother | s blood pressure

The doctor may recommend that there should only be a single embryo transfer in people who have a heightened chance of having twins.



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Heavy lifting, shift work may negatively impact women's fertility

Women who have physically demanding jobs may experience decreased fertility, finds new research by Harvard T.H. Chan School of Public Health. Working schedules that fall outside normal daytime office hours may also lower a woman | s ability to conceive.
Regularly lifting heavy loads at work may have an adverse affect on women | s fertility.

Lidia Mínguez-Alarcón, a research fellow in the Department of Environmental Health at T.H. Chan School of Public Health in Boston, MA, was the lead author of the research, and worked alongside Audrey Gaskins, research associate in the Department of Nutrition, among other researchers. The study was published in Occupational and Environmental Medicine.

“Our study suggests that women who are planning pregnancy should be cognizant of the potential negative impacts that non-day shift and heavy lifting could have on their reproductive health,” says Mínguez-Alarcón.

Previous studies have found a relationship between factors that relate to occupation and fertility. These factors were described to have an effect on outcomes including how long women took to become pregnant and whether they could carry the pregnancy until their due date.

However, those studies did not measure biomarkers of fertility such as ovarian function and levels of reproductive hormones. The researchers say that the new study is one of the first to assess whether workplace factors affect a woman | s biological capacity to have a baby.
Effect of occupational factors on women | s fertility assessed

The new research focused on women who required treatment for fertility problems. This allowed the investigators to measure biomarkers of fertility that could not be measured in women who were attempting to conceive naturally.

Mínguez-Alarcón and colleagues examined indicators of “ovarian reserve” in 473 women who sought infertility treatment at Massachusetts General Hospital. Ovarian reserve is the amount of remaining eggs and level of follicle stimulating hormone (FSH) that rises as a woman ages and represents declining fertility.

Additionally, the team observed “ovarian response” in 313 of the women who had completed at least one cycle of IVF. Ovarian response is the number of mature eggs that are capable of developing into healthy embryos.

The women were asked questions about the physical demands and working schedules of their jobs and the researchers analyzed associations between these factors and biomarkers of ovarian reserve and ovarian response. Questions were also asked about physical and sedentary activities that occurred during the women | s leisure time.

Four out of 10 women indicated that they had to lift heavy objects regularly as a part of their job. Approximately 1 in 4 of the women answered that their jobs were moderately to very physically demanding. Around 91 percent of the women worked regular daytime office hours.

The women were part of the ongoing EARTH study that explores how environmental and dietary factors affect fertility. The participants had an average age of 35 years and an average BMI of 23.
Lifting heavy loads linked with lower egg reserve, fewer mature eggs

Findings showed that regularly lifting heavy objects had no effect on FSH levels. However, compared with women who rarely lifted heavy loads, women with physically demanding jobs had a lower reserve of eggs.

On average, women who worked shifts had fewer mature eggs than women who worked regular hours. Furthermore, women who worked shifts in the evening and during the night had even fewer mature eggs. The researchers suggest that evening and night shifts affect mature egg count due to the disruption of the internal body clock.

Among women going through IVF cycles, the women who had a physically demanding job had an 8.8 percent lower egg reserve and 14.1 percent fewer mature eggs than women whose jobs did not require heavy lifting.

The differences in ovarian reserve and ovarian response in women with and without physically demanding occupations were even greater among women whose job required them to work shift patterns in the evening, at night, or rotating shifts.

Decreased fertility was particularly significant among overweight and obese women who lifted heavy loads at work, compared with women of the same weight and lean women who did not do heavy lifting as part of their occupation.

“Our study is the first to show that occupational heavy lifting and non-day shifts may be adversely affecting egg production and quality, rather than accelerating ovarian aging. Future work, however, is needed to determine whether egg production and quality can be improved, and if so, how quickly, if these work exposures are avoided.”

Audrey Gaskins

As the study is observational, no conclusions can be drawn about cause and effect. The team was also unable to assess the impact of other influential factors, such as working long hours and changing between day and night shifts.

Learn how licorice may reduce fertility in women.

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What to know about egg freezing

What to expect
Who would benefit?
Costs and side effects
Outlook

Women today are choosing to have children later in life than ever before. Egg freezing can enable a woman to delay pregnancy until a later stage.

Medical professionals refer to the procedure as oocyte cryopreservation.

In 1980, the average woman in the United States had her first baby at the age of 22 yearsTrusted Source. By 2000, that age had risen to almost 25 years, and, in 2014, the average woman waited until 26 years oldTrusted Source to have her first child.

In the United States, 2.3 percentTrusted Source of all births are to women aged 40 to 44 years.

Society and patterns in childbirth may be changing. However, the biological realities of fertility remain the same.

Most women enter menopause in their late 40s or early 50s. In the years before menopause, a woman | s fertility declines. Conceiving a child is not as easy in later years as it is for a younger woman.

Women who are considering freezing their eggs should be aware that successful pregnancies are less commonTrusted Source with frozen eggs than fresh eggs. However, the use of frozen eggs can offer hope of conceiving in the future.

In this article, we explore the procedure, costs, and benefits of egg freezing.
What to expect
Egg freezing can help preserve fertility later on in life.

As a woman grows older, the quality of her eggs tends to decline.

The eggs may contain more chromosomal abnormalities, and women will no longer ovulate after menopause. This means that her ovaries will cease to release eggs.

If a woman wants a child but is not able or ready to conceive at the present time, a dedicated facility can freeze her eggs for use at a later date.
Preparation

Before the egg-freezing process begins, a doctor will take a comprehensive medical history with a focus on fertility, assess the regularity of the menstrual cycle, and perform a range of blood tests to assess hormone levels.

A woman | s ovaries usually release one egg per month. When fewer eggs are available for freezing, the chances of a successful pregnancy are lower.

In order to maximize the number of available eggs, a woman will undergo hormone treatment to stimulate the production of more eggs. This treatment normally requires a woman to inject herself with hormones at home between one and three times a day.

Most women will also take birth control pills for at least a month before receiving the hormone injections. This suppresses the natural cycle and increases the effectiveness of the hormones.

The number and type of hormones vary. Treatment will normally include:

around 2 weeks of injections with follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which encourage the ovaries to produce more eggs
an injection of gonadotropin-releasing hormone (GnRH) about halfway through the cycle, which prevents ovulation from taking place too early in the cycle
an injection of human chorionic gonadotropin (hCG) to trigger ovulation

A doctor will perform regular blood tests to monitor the effects of hormone treatments. The woman will also have at least one ultrasound to detect ovulation and to assess egg development.

Procedure

The doctor inserts a needle into the ovarian follicles to retrieve the eggs after they ripen.

The doctor will normally use ultrasound to guide the procedure. However, if the eggs are not visible during ultrasound imaging, the doctor may perform abdominal surgery to remove them.

With this more invasive approach, the doctor makes a small incision in the abdomen under sedation and pain medication and inserts a needle to extract the egg.

Once the doctor has retrieved the egg, freezing will need to take place as soon as possible. However, the eggs are full of water, which can become damaging ice crystals if freezing occurs immediately.

To prevent this, the doctor injects a special solution into the eggs before freezing them.

In the future, when the woman is ready to use her eggs, she will undergo in vitro fertilization (IVF).

With IVF, a fertility specialist fertilizes the egg in a lab, using sperm from either the woman | s partner or from a donor.

If the procedure works, the egg and sperm develop into an embryo that undergoes implantation in the woman | s uterus a few days later. Most fertility clinics try to grow several embryos at once to increase the chances of a successful pregnancy.
Who would benefit?
Some cancer treatments might reduce or end fertility. Egg freezing can help preserve the ability to have a child beyond these treatments.

Younger women have significantly higher success rates than older women when freezing eggs.

Women who wish to undergo egg freezing should do so as early as possible.

Most clinics work with women who are under 40 years old. Some clinics place restrictions on women who are 40–49 years of age. Few will allow women over the age of 45 years to freeze their eggs.

Frozen eggs do not definitely lead to a live birth. The chance of each frozen egg leading to a live birth is between 2 and 12 percentTrusted Source. A range of factors can affect a person | s chances of becoming pregnant, such as uterine health, age, and overall health.

The following are some reasons that women freeze their eggs:

Career and educational plans: Women who wish to pursue advanced degrees or demanding careers may freeze their eggs when they are young to ensure access to healthy eggs later on.

Some companies, such as Facebook and Apple, even fund egg-freezing for female employees who wish to delay childbirth for professional reasons.

Personal circumstances: Women who want to have a child with a partner but have not yet found one may freeze their eggs for future use. Women in same-sex relationships may also wish to have a baby further down the line.

Cancer: Chemotherapy and other cancer treatments typically interfere with and sometimes end fertility. Reproductive cancers might lead to the removal of a woman | s ovaries.

Egg freezing might help reduce the impact of some cancer treatments on fertility.

Infections, organ failure, and other health concerns: A wide range of health problems can harm egg quality and fertility, such as endometriosis, a condition that causes uterine tissue to grow outside of the womb.

Freezing eggs offers hope to women who are receiving treatment for a serious illness that may reduce fertility.
Costs and side effects

Freezing eggs can be expensive, and most insurance plans do not cover the procedure.

A single cycle can cost upwards of $10,000. Other costs include storage of the eggs and IVF, which could cost an additional $5,000. Egg storage is also indefinite – a woman may not need the egg for 10–15 years.

This means that ongoing egg storage costs will continue to build up.

Insurance is also unlikely to cover egg freezing for this reason. While the procedure can provide a personal, long-term solution to fertility problems, it is not active treatment and does not have an end date in sight.

Speak to your insurance provider about their policy on egg freezing.

After egg retrieval, some women may experience cramping, bloating, and spotting. Other unwanted side effects include:

weight gain
bloating
mood swings
headaches

The extra hormones can trigger these effects.

In rare cases, egg stimulation can lead to a condition known as ovarian hyperstimulation syndrome (HSS). The effects of HSS can include pain, nausea, and significant weight gain of over 10 pounds (lb) in 3–5 days. Very rarely, HSS might trigger blood clots in the legs and shortness of breath.

Long-term complications include a higher riskTrusted Source of ovarian cancer, according to this 2015 study.
Outlook
Up to 12 percent of frozen eggs develop into live births.

Data on pregnancies that result from egg freezing varies.

The American Society for Reproductive Medicine (ASRM) estimates that 2–12 percentTrusted Source of frozen eggs develop into a live pregnancy for women under 38 years of age.

This suggests that women may need to undergo multiple IVF cycles to become pregnant following egg freezing.

Factors that impact the success of egg freezing and thawing procedures include:

Age on freezing the eggs: Younger women tend to produce more eggs that are less likely to have anomalies.
Age at time of egg thawing and IVF: Younger women are more likely to have successful pregnancies.
Sperm quality: Healthy sperm is more likely to produce a healthy embryo and a successful pregnancy.
The clinic: The success rates of freezing and thawing eggs vary between clinics.
The number of eggs: Freezing a larger number of eggs offers more opportunities for successful IVF cycles.

How long will frozen eggs last?

Freezing an egg stops it from aging. A frozen egg that is several years old will typically have a better chance of fertilization than a fresh egg from an older woman.

Most studies on frozen eggs examined eggs that were a few months old. The length of time for which a specialist can freeze eggs remains unclear.

Most researchers suggest freezing eggs in the mid-to-late twenties for use after 30 years of age. Women who are considering IVF in the future should not delay any longer than necessary.

According to the University of Southern California | s fertility clinic, about 75 percent of eggs survive the thawing process.

Embryos are more likely to survive both freezing and thawing than eggs and more likely to result in a successful pregnancy.