What Should We Consider Before Starting IVF Treatment?

An IVF patient discussing an ultrasound result with her doctor

In vitro fertilisation (IVF) is a series of procedures that are used to treat fertility problems and enable a couple to conceive. It is an effective form of assisted reproduction with high success rates.

Infertility issues can exist in both males and females. From fallopian tube blockage to low sperm count, many of these problems can be overcome by opting for IVF treatment. However, because IVF treatments are more invasive and costly, they are not often the first choice. Where other fertility treatments have failed, then it is often recommended.

How IVF Works

IVF treatment begins with ovarian stimulation to encourage a higher production of eggs in the ovaries. Normally, one egg is produced per cycle. By administering hormonal injections to the woman, the ovaries can be stimulated to produce multiple eggs. Thereafter, another medication is taken to make the eggs mature without being released from the follicles. Egg retrieval is later undertaken when the eggs are mature. An ultrasound is used to guide a hollow needle to the follicles from which the eggs are aspirated or sucked out. Aspiration can be done in the doctor’s office with the woman being sedated.

At the same time, the man will be instructed to provide a sperm sample. In the lab, the eggs are incubated in a culture medium. Once healthy eggs and sperm have been identified, they are mixed to allow fertilisation to occur. Eggs that are successfully fertilised become pre-embryos. Genetic testing may be undertaken where there may be concerns about chromosomal disorders.

One or more pre-embryos are then transferred into the uterus of the woman, with the expectation that at least one will successfully implant. You will need to consult with your doctor to decide on how many pre-embryos to transfer. If more than one, there is the possibility of conceiving multiples such, as twins or triplets. Successful IVF treatment is when the woman finally becomes pregnant.

With the promise of a child on the horizon, many couples are happy to go through the stress of IVF treatments. Here are some key issues to consider when deciding if this is the right path for you to take to parenthood.

1. Your health matters

The healthier you are, the better your chances of successful IVF treatment. Given the stress and financial strain this treatment can mean, being in the best health condition will help. To achieve this, you will have to make a considerable effort to stop any unhealthy habits. This may require serious lifestyle changes such as maintaining a healthy weight and cutting out alcohol and tobacco products. If you suffer from any chronic conditions, like Crohn’s disease, diabetes or high blood pressure, you will need to consult with your specialist on the steps you need to take to stabilise and control the condition.

2. It takes time

From the moment you first step into the doctor’s office for a consultation, undergo the necessary tests and begin hormone treatments, it can take several weeks before you complete the first cycle of IVF treatment. It is a slow process with multiple stages that all contribute to your chances of a successful pregnancy. There will be repeated visits to the doctor’s office and labs. Patience will be key as you may not even be successful the first time you try. Many couples have to undergo multiple rounds of treatment before successfully conceiving.

3. Success rates may not apply

It is common for patients to select a fertility clinic based on their IVF success rates. But these success rates may not apply to your particular case. Every couple that suffers from infertility will have their own set of circumstances causing the problem. Factors such as age, weight and reproductive history can play a significant role in influencing IVF success. You should not assume that your situation is the same as those that successfully treated their problem with IVF. Consult your doctor to figure out if IVF is truly the best treatment option for you and what kind of success rate you can realistically expect.

4. Do not be guided by price

It is said that cheap is expensive. Getting a great deal on your IVF treatment may not be a bad thing, but the quality of care you are getting should be the most important consideration. The clinic you choose should have fertility specialists that are properly trained and experienced in all the required medical procedures such as ovarian stimulation, egg retrieval and embryo transfer. They should also have a well-equipped lab that can undertake whatever testing and procedures that are required.

Look into what financial arrangements are available, including to what extent your expenses may be covered by insurance. You may also want to consider travelling overseas for this treatment as you may find there are some countries with a high standard of healthcare that comes at a more affordable cost.

5. There will be discomfort

Certain aspects of this treatment can lead to physical discomfort and sometimes pain. This mostly affects the woman. Even if hormone shots are well tolerated, there could be side effects like cramps and breast tenderness that may make the experience uncomfortable. Later procedures like egg retrieval and embryo transfer are also invasive and could require sedation. However, despite all these challenges, it is important to remember what the ultimate prize is, a healthy baby.

6. Multiples and unused embryos

When embryo transfer is being done, the doctor will most likely select one or two embryos for the procedure. This is even when many embryos have been grown. Multiple births are often desirable but can be a health risk hence this limit that most doctors adhere to. Do consult with your doctor on this issue and be aware that if you have two embryos transferred, there is the possibility of having twins.

Also, consider what should be done with your unused embryos. Many clinics can freeze and store embryos, eggs, and sperm indefinitely. This can be helpful as you wait on the outcome of your IVF treatment. If the woman does not fall pregnant, you can opt for another round of embryo transfer from the stored embryos. If you no longer need the embryos, you may opt to have them disposed of, donated for medical research, or given to an infertile couple.

Picture of Dr. Tanut Jerachotechueantaveechai

Dr. Tanut Jerachotechueantaveechai

Medical Director, Bangkok Central Clinic IVF & Wellness Dr. Tanut Jerachotechueantaveechai is a specialist in Obstetrics, Gynecology, and Reproductive Medicine, having graduated with first-class honors from Siriraj Hospital in 2010. Dr. Tanut has experience working at Maharaj Nakorn Chiang Mai, Lanna, Chiang Mai Ram, and Phyathai Sriracha hospitals. He previously served as a Medical Director at First Fertility PGS Center Bangkok, and was a special reproductive technology lecturer at Mahidol University. He provides a tailor-made treatment approach, working closely with couples to support their family-planning goals, and achieved an average success rate of 72.5% in 2019. He continuously updates his medical knowledge through international workshops and congresses across Asia-Pacific, Europe, and Australia.