24 Nov 2021
One of the top questions couples that undergo fertility treatments ask is how long will it take. They live in hopes of soon being able to carry their newborn healthy baby in their arms. Trying to get pregnant and create the family you dreamed of can be incredibly stressful, physically, emotionally and financially. Hence the desire to know how long the process will take to produce results.
The path to parenthood however holds no guarantees and can come with multiple stages and challenges. Here we will outline the steps to in vitro fertilisation (IVF) and give estimates where possible.
IVF is a type of fertility treatment that allows for the fertilisation of a woman’s egg in a lab setting before the embryo is transferred to her uterus where implantation can occur. If successful, the woman’s conception will be confirmed with a pregnancy test and will hopefully lead to the desired delivery. The process leading up to this stage can have begun weeks or months before.
In many countries, it is recommended to consult with a specialist after a year of trying to conceive without success. You can get a referral to a fertility clinic in Bangkok from your family doctor or gynaecologist. If the woman is over 35 years of age, this consultation may be sought sooner. This is because, unlike men, women have a much shorter period during which they can get pregnant. The older they are, the earlier intervention should be sought. During the consultation, the doctor will review the couple’s medical history. A full workup, including lab tests and scans, will likely be ordered to facilitate a proper diagnosis of the challenge.
An inability to get pregnant can stem from various reasons including problems with ovulation, low sperm count, or even complications from conditions like diabetes and cancer treatment. It could be the result of either or both partners physical condition. Diagnosis of the couple’s fertility can often be done within a week. Depending on the diagnosis, the doctor will discuss with you if IVF treatment is the best option. Some conditions may also require individual treatment before IVF that can include taking medication and/or undergoing surgical procedures. The doctor may even recommend weight loss in some cases, which can end up lengthening the timeline.
The process begins by suppressing the woman’s natural menstrual cycle. This is often done using birth control that is prescribed to be taken for 2 to 4 weeks. Though it can seem counterintuitive to what you are trying to achieve, this suppression can help to boost egg production when ovarian stimulation is later done. It can also provide better control and timing of egg production and retrieval.
After completing the course of birth control, the woman will then be administered fertility medications. Follicle-stimulating hormones (FSH) are what will encourage the production of eggs in the follicles. While this is being done, the woman will undergo repeated blood tests and ultrasounds to monitor this production and determine when to administer other medication that will cause the eggs to mature. On average (age 20 – 35 years), 10-20 eggs may be produced.
Fertility stimulation can take up to 2 weeks. Triggering of final maturation can be done within 2 days with egg retrieval being scheduled to be done immediately after. Egg retrieval is a single-day procedure. Sperm collection from the male partner is typically done on the same day. Although in some situations where sperm count is a concern, the collection could have been done earlier and frozen. The sperm is washed and spun to retrieve the healthiest that will be used during fertilisation. The woman will also be thereafter administered hormone drugs to help stimulate the development of the womb lining in readiness for implantation of the embryo.
This is done in a lab setting. The eggs and sperm will be mixed. In some cases, each egg may need to be injected with pre-selected sperm in a procedure known as intra-cytoplasmic sperm injection (ICSI). The fertilised eggs are then left to develop for up to 3-6 days in the lab. This is to allow the embryo’s cells to multiply. A few cells are extracted after this development for genetic screening to be conducted. This extraction does not harm the embryo. The screening helps to identify which embryos are healthy and if applicable, what their genders are.
Once there are viable embryos to be transferred, the woman returns to have them placed in her uterus. This is done using a catheter passed through the cervix. Depending on circumstances, the woman will have either one or two embryos transferred. Leftover embryos can be frozen for later use. After this transfer, the woman will need to wait about 2 weeks before having a pregnancy test done to confirm if the treatment has been successful. Once pregnancy is verified, patient care can then shift to your obstetrician or gynaecologist.
When you consider the series of procedures involved when undergoing IVF treatment you can see that it can be difficult to accurately predict how long it will take to get pregnant. There could be problems in the recovery of suitably mature eggs or healthy sperm. There could also be problems getting viable embryos that could force the couple to start the process over. Even after embryo transfer, it is possible for implantation to fail. If the couple had healthy leftover embryos that were frozen, they may not have to start again from the beginning. If they did not have any frozen embryos, they may need to do so.
The length of IVF treatment can vary greatly from couple to couple depending on their health condition, ability to produce enough healthy eggs and sperm, successful fertilisation, and implantation. All these factors mean your treatment may last anywhere between a few weeks to even several years. As IVF treatments can be quite invasive and costly, you need to consult carefully with your specialist. Based on their diagnosis, they should be able to give you a clearer timeline and your odds of success.