Understanding IVF

Understanding IVF

In vitro fertilization (IVF) is a medical procedure that has changed the lives of millions of people who wish to start a family. Since its inception in 1978, IVF has advanced by leaps and bounds, bringing hope to those who face difficulties in conceiving.

That is why understanding its basic concepts is essential for those considering this assisted reproductive option. Understanding IVF involves knowing the different stages of the process, from ovarian stimulation to embryo transfer, as well as its advantages, challenges and alternatives.

What is in vitro fertilization?

IVF is an assisted reproductive treatment that helps people conceive a child when they face difficulties conceiving naturally. Understanding the basics of IVF is important to know what to expect from the procedure.

During this process, eggs are removed from the ovaries and fertilized with sperm in a laboratory. Once fertilized, the embryos are cultured for a few days before being transferred to the uterus to initiate pregnancy.

The process includes a number of stages:

• Ovarian stimulation: medications are administered to stimulate the ovaries and obtain several mature eggs.
• Egg retrieval: Eggs are retrieved once they are mature using a minimally invasive procedure called follicular aspiration.
• Laboratory fertilization: Here eggs are combined with sperm in a laboratory dish to create embryos. In some cases, intracytoplasmic sperm injection (ICSI) is used to introduce a single sperm directly into each egg.
• Embryo culture: Embryos are developed in the laboratory for 2 to 5 days.
• Embryo transfer: The best embryos are selected and placed in the uterus using a catheter.
• Pregnancy test: After a period of 10 to 14 days, a pregnancy test is performed to confirm if the procedure has been successful.

Why is IVF performed?

IVF is used to help couples and individuals who face difficulties conceiving naturally.

This treatment may be necessary due to various medical conditions. A common issue that may require IVF is damage, blockage, or absence of the fallopian tubes. When these structures are affected, eggs cannot travel from the ovaries to the uterus, making fertilization difficult. Another condition that may necessitate IVF is endometriosis, a disease where the tissue lining the uterus grows outside of it, potentially interfering with conception.

Male infertility can also be a reason to resort to IVF. This may be due to problems with the quantity or quality of sperm, making it challenging to fertilize the egg. In some cases, couples may face unexplained infertility, where no specific cause is found for their difficulty in conceiving. In these situations, IVF can be a viable option to attempt pregnancy.

Advanced maternal age is another reason why women may consider IVF. Women aged 35 or older may find it more difficult to conceive due to a decrease in the quality and quantity of their eggs. Lastly, premature ovarian failure, where the ovaries stop functioning before the age of 40, can be a significant cause of infertility that could be addressed through IVF.

History and evolution of IVF

In vitro fertilization has come a long way since its inception to become one of the leading assisted reproductive options worldwide.

Understanding IVF and its historical development helps to appreciate not only the technical advances, but also the social changes it has fostered.

Early days

The first attempts at IVF date back to the early 1970s. A group of researchers in the United Kingdom, led by Robert Edwards and Patrick Steptoe, began experimenting with fertilizing eggs outside the human body.

After several attempts and improvements in the technique, the world witnessed a milestone in 1978: the birth of Louise Brown, the first baby conceived by IVF.

This event, in addition to being a scientific triumph, signaled a change in public perception of the possibilities of medical science.

Evolution and improvements

Since the birth of Louise Brown, IVF has undergone numerous advances that have refined the procedure and increased its success rates.

One of the most significant developments has been the introduction of intracytoplasmic sperm injection (ICSI) in 1992. This makes it possible to fertilize an egg with a single sperm, which helped overcome severe cases of male infertility.

Another important innovation has been preimplantation genetic diagnosis (PGD), which allows embryos to be genetically analyzed before implantation. This ensures that only healthy embryos are selected for transfer.

These complementary techniques have improved the chances of pregnancy, while helping to prevent the transmission of genetic diseases.

Comparison of IVF with Other Assisted Reproductive Techniques

There are other assisted reproductive techniques besides in vitro fertilization (IVF). Each has its own characteristics.

Artificial Insemination (IUI)

This technique involves directly introducing sperm into the uterus during ovulation to increase the chances of pregnancy. The procedure involves careful monitoring of the menstrual cycle and, in some cases, the use of medications to stimulate ovulation.

Compared to IVF, AI is less invasive and more economical. It also requires less medical preparation. However, its success rate decreases, especially for women over 35 years old. Additionally, it is a low-efficacy option for couples with severe fertility problems.

Frozen Embryo Transfer (FET)

This is a variant of traditional IVF that involves using embryos frozen during a previous cycle. The process includes thawing the embryos and transferring them to the uterus. It allows for multiple attempts at pregnancy with a single ovarian stimulation cycle.

FET is useful for those who need to undergo medical treatments such as chemotherapy and plan to conceive once their health improves. However, this treatment is not exclusive to these cases; it is also beneficial for those who wish to postpone motherhood, for example.

The difference with traditional IVF is that in IVF, fresh embryos are transferred to the uterus, whereas in FET, previously frozen embryos are used.

Other Techniques

Other reproductive techniques include surrogacy, where a woman (the surrogate) carries and gives birth to a baby for another person or couple. There is also egg or sperm donation, where donor eggs or sperm are used instead of the couple's to create embryos.