In Vitro Fertilization (IVF) also known as IVF is a series of procedures used to treat fertility problems and other genetic problems to help you get pregnant. IVF is the most effective method of assisted reproductive technology available today, but your chances of getting a pregnancy through IVF depend on several factors, including your age and the cause of infertility you or your partner is experiencing. There are several steps you can take to prepare yourself for this procedure, both physically and mentally for a higher success rate. For women, a healthy, nutritious and protein-rich diet is important to maximize egg production, while mentally you may need to prepare yourself for regular injections and fertility testing.
Step
Part 1 of 3: Understanding the Process
Step 1. Understand the process of receiving IVF
Before deciding to undergo IVF treatment, you should understand the process involved in IVF so that you and your partner can better prepare, if you do do IVF with partner support. IVF includes five main steps: ovulation induction, egg retrieval, sperm retrieval, fertilization, and embryo transfer. One IVF cycle takes about two weeks and you may have to go through more than one IVF cycle to get pregnant. The process of receiving IVF includes three phases:
- Phase 1: You will receive fertility injections to increase follicle production and stop ovulation. You will have to visit your doctor several times for blood tests and a vaginal ultrasound (USG).
- Phase 2: After the eggs are cooked, a small operation will be performed to retrieve them. The embryologist will prepare the eggs and place them in a petri dish. Sperm are then introduced by injecting one sperm into each egg.
- Phase 3: After the egg is fertilized, the egg will continue to divide until day 3 or 5, when the embryo is transferred. If needed, you can have the embryo examined for defects such as cystic fibrosis, muscular dystrophy, and Down syndrome. You then decide how many embryos you want to transfer to the uterus, and whether you want the remaining embryos to be frozen.
- Please keep in mind that the chances of getting pregnant through the IVF method are unpredictable because each couple has a number of factors, such as age and reproductive health, that can affect the success of treatment. Your doctor can give you an estimate of the likelihood of getting pregnant, based on your background and medical history. However, until recently IVF was considered the most viable fertility treatment available and was known to have a high success rate.
Step 2. Know the risks that come with IVF
IVF is an expensive procedure and can take up a lot of personal time. IVF can also be stressful and stressful, especially if you and your partner are having trouble conceiving and have to go through several IVF cycles before conceiving. Stress and anxiety can be a big risk during the IVF process. Some of the medical risks that can be experienced when using the IVF method include:
- Multiple births: IVF increases the risk of multiple births if more than one embryo is implanted in the uterus. If you are carrying twins, you may have a higher risk of early delivery.
- Premature birth and low birth weight babies.
- Ovarian hyperstimulation syndrome: This occurs when the ovaries are swollen and painful. This syndrome can occur due to injection of fertility drugs. You may experience symptoms such as abdominal pain, bloating, nausea, vomiting and diarrhea. If you are pregnant, these symptoms may continue for several weeks.
- Miscarriage: Although the miscarriage rate for women who conceive via IVF is roughly the same as for women who conceive naturally, this risk increases as the mother ages. Using frozen embryos during IVF is also known to slightly increase the risk of miscarriage.
- Complications during the egg retrieval procedure: The doctor will use a needle aspiration to remove the eggs and this procedure can cause bleeding, infection, or damage to the stomach, bladder, or blood vessels.
- Ectopic pregnancy: This occurs when the implantation of a fertilized egg occurs outside the uterus, usually in a fallopian tube. About 2 to 5 percent of women who use IVF will have an ectopic pregnancy.
- Birth defects: There is evidence that the rate of birth defects in IVF pregnancies is slightly higher than in spontaneous pregnancies, but the exact mechanism for this is not clear.
Step 3. Discuss with your doctor about the costs involved for the IVF procedure
By far, IVF is known to be one of the most expensive fertility treatments available. For a basic IVF cycle you have to provide around IDR 40 million to IDR 70 million. Most insurances will cover the cost of diagnostic tests, such as ultrasound or hysterosalpingography, but many do not cover the IVF treatment itself. To make sure contact your insurance agent. The cost you have to pay depends on your personal needs, as well as the standard fees at the clinic or hospital you choose. Price quotes for IVF treatment may include:
- Fertility drugs
- Early fertility test
- Ultrasound and monitoring
- Blood Test
- You may also need additional treatments such as ICSI – injecting sperm directly into the egg – which can cost around Rp. 12 million, or PGD – genetic examination of the embryo – which costs around Rp. 30 million or more. If you decide to freeze embryos, you may have to spend quite a bit of money for initial freezing and storage.
- Your doctor should be able to give you an idea of the costs for your IVF treatment, and offer alternative sources of funding if you can't afford it. Some clinics in the United States even offer a refund program if you pay for the one-pack fee (which can be in the $200-$300 range) and the clinic will refund a portion if you don't get pregnant after three to four cycles. However, you should clarify with the clinic what a positive result counts as leaving the clinic pregnant does not guarantee you will have children. You may experience a miscarriage or complications, and lose your chance to get a refund.
- Some insurers also offer to cover part of the cost of IVF treatment or fertility diagnostic procedures. Contact your insurance agent to find out what IVF costs are covered. You may need to turn to a clinic designated by your insurance company for financial support.
Step 4. Seek support from your spouse and/or close family
IVF is a process that requires you to receive eight to ten injections a day, undergo various tests, and visit the doctor many times. During IVF treatment, seek support from your partner and/or close family. It will take someone to learn to inject you with fertility hormones several times a day, and you may need help dealing with the side effects of these injections.
Side effects of IVF treatment include skin irritation at the injection site, flatulence, breast tenderness, headache, and nausea. You should also visit your doctor regularly during the IVF cycle to ensure progress. Don't be afraid to rely on your partner and/or close family for support during the IVF process, especially if you experience side effects from the injections
Step 5. Join an IVF support group
Many couples who go through the IVF process benefit from joining a support group. Do an internet search to find a fertility support group in your area that focuses on IVF. IVF can be a stressful process and you may find it helpful to connect with other people who are experiencing the same stress or anxiety so that you and your partner can address any issues you may be experiencing.
Part 2 of 3: Starting the IVF Process
Step 1. Have your doctor examine you for any fertilization problems
Before you start IVF, your doctor will perform several tests on you and your partner, if he or she will be the sperm donor, to determine each other's fertility levels.
- The doctor may perform an ovarian reversal test, which will determine the quantity and quality of the eggs. This test is done through a blood test that is done during the first few days of the menstrual cycle. The results of the test, plus an ultrasound of the ovaries, can help doctors determine how the ovaries will respond to fertility drugs.
- The doctor may also perform an examination of the uterine cavity, using sonohysteroscopy. In this examination, fluid is injected through the cervix into the uterus and an ultrasound is performed to create an image of the uterine cavity. The doctor may also use a hysteroscope, a thin, flexible, lighted telescope, and insert it through the vagina and cervix into the uterus to determine the condition of the uterine cavity.
- HSG is another common procedure. The doctor will inject dye through the cervix and take X-rays to see the shape of the uterine cavity and make sure the fallopian tubes are open.
Step 2. Ask your partner to have their fertility checked
The partner may have to undergo a semen analysis prior to any IVF treatment if he or she is the sperm donor. This examination will ensure that there are no fertility problems in the couple.
You and your partner will be screened to make sure there are no infectious diseases, including HIV, before IVF treatment can be started
Step 3. Take part in a trial IVF cycle (mock)
About a month before your first IVF treatment, your doctor may ask you to participate in a trial cycle. This will show that you and/or the donor are responding well to hormone therapy.
- During the trial cycle, the doctor will perform an ultrasound 10-12 days before the estrogen-boosted cycle. This will help the doctor determine the depth of your uterine cavity and determine the best technique for placing the embryo in the uterus. You may also need to start taking birth control pills to regulate your menstrual cycle so that you can align it with the donor's cycle, if you are using a donor.
- Your doctor may also give you liluberin (gonadotropin releasing hormone), which will block the surge of luteinizing hormone (LH) in your body. This will ensure that the lining of the uterus is ready for implantation of the embryo.
Part 3 of 3: Adjusting Your Routine and Diet
Step 1. Take omega 3 fish and folic acid supplements
Omega 3 fatty acids have been shown to improve embryo morphology during IVF treatment. In addition, folic acid given to pregnant women can improve the health of the fetus, and taking this supplement in preparation for IVF treatment can prepare the body for pregnancy.
Supplements are usually not regulated by BPOM. Therefore, choose a supplement that has been tested by a third party to ensure it does not contain contaminants and is recommended by a doctor. Your doctor can also suggest the correct dosage for each supplement
Step 2. Do light to moderate exercise every day
Women who are overweight or in poor physical condition can have a lower chance of getting pregnant during an IVF cycle. Doing light exercise such as walking or yoga every day can reduce the stress you may experience while preparing for IVF and regulate blood circulation. Mild to moderate exercise has been shown to have no negative impact on IVF treatment.
However, you should avoid strenuous activities and intense cardiovascular exercise such as running, jogging, or aerobics as these activities can reduce the chance of a live birth and the risk of miscarriage during IVF treatment
Step 3. Maintain a healthy sleep cycle
To get a high rate of fertility results, you should adopt good nutrition and healthy habits at least four to eight weeks before the first IVF cycle. In addition, you should also maintain a healthy sleep cycle, by getting at least eight to nine hours of sleep every night.
Try to sleep in a dark room as this increases melatonin production. Melatonin is a hormone that promotes healthy follicle development. Melatonin produced naturally through healthy sleep is more beneficial than taking melatonin supplements
Step 4. Eat high-quality, low-fat foods
Treat your body like you are preparing for pregnancy and maintain a low-fat, high-quality diet that is a good source of iron, potassium and magnesium. Follow a diet that contains lots of green vegetables, fruit, vegetables, calcium, and protein.
It's best not to start a strict diet, such as a low-calorie or low-carb diet. Instead, stick to a healthy diet so you can maintain a healthy weight and not jeopardize your ongoing IVF treatment
Step 5. Limit caffeine and alcohol intake
Just like any other pregnant woman, you should also limit your caffeine intake and not drink alcohol or smoke. This will ensure that your body is at its healthiest before you start IVF treatment.
Tips
- When consulting with an IVF specialist, make sure you ask for a realistic estimate of the chances of success of this treatment.
- There is no evidence that using frozen embryos will result in a higher pregnancy rate than performing a new IVF cycle.
