An in vitro baby, commonly referred to as a “test-tube baby”, is a baby conceived with the help of in vitro fertilization (IVF). IVF is one of the different types and most used assistive reproductive technology (ART).
An IVF procedure is done when an eligible couple fails to conceive naturally because of any fertility issue, whether it be in either partner or both, or for unexplained infertility. IVF treatment is also done when one or both partners carry genetic defects. In such cases, IVF helps evaluate the embryo for potential genetic defects before implantation in the womb, which is aimed to prevent miscarriages or genetic defects in the newborn.
There are several other options to treat infertility or increase the chances of conception, such as stimulating the release of eggs using drugs, surgery to clear any blockage in the tubes that carry sperm in males and fallopian tubes in females, intrauterine insemination (IUI), treating hormonal or psychological problems with drugs and counseling. IVF is usually considered after other treatments fail.
The other reasons for opting for an IVF procedure include:
- Older women who are trying to conceive may have a chance to choose healthy eggs
- Recurrent miscarriages, especially due to genetic disorders
- Women with irreparable, damaged or removed fallopian tubes
- Male infertility and low-quality sperm or the production of less amount of sperm
- Women with a low number of eggs or ovulation disorders
- Certain cases of endometriosis or uterine fibroids
What is IVF and how does it work?
In vitro fertilization (IVF) is a procedure where mature eggs from a female and sperm from a male are collected and stored in a laboratory under sterile conditions. The eggs are transferred to a shallow container called a petri dish and fertilized with the sperm. Once the eggs are fertilized, one to two embryos that are three to five days old are transferred into the uterus of the female.
Multiple embryos may be transferred depending on the age of the woman. This enhances the chance of implantation because the rate of implantation declines as women get older. IVF may offer higher chances of pregnancy because it allows a regulated interaction of eggs and sperm. Doctors can assess each embryo to see which ones are the most likely to result in a pregnancy.
What is the procedure for IVF?
In vitro fertilization (IVF) is a complex procedure, where one full cycle may take two to three weeks or longer. Before starting an IVF procedure, determining the status of reproductive hormones, quality of eggs (female) and semen (male) and functionality of the reproductive system of the woman are done.
The five basic steps of IVF are:
- Stimulating the process of ovulation with drugs for the release of multiple healthy eggs
- Egg and sperm collection
- Fertilization of eggs with sperm under aseptic conditions
- Development of embryo and genetic testing if required
- Transfer of embryo into the woman’s uterus
What are the risks of IVF?
The major risk associated with in vitro fertilization (IVF) is multiple births, which may lead to several complications, including:
- Pregnancy and labor complications
- Premature delivery
- Medical and developmental complications in the babies
Additionally, women undergoing IVF will be put on hormones for an extended period, which can cause physical and emotional stress, as well as potentially severe symptoms.
Human chorionic gonadotropin (HCG) hormone is administered to induce the maturation of eggs, but it may also cause the release of vascular endothelial growth factor (VEGF) from hyperstimulated ovaries. VEGF increases the permeability of the blood vessels due to fluid leaks from the vessels. Accumulation of fluid causes:
- Swelling of the abdomen (ascites)
- Shortness of breath secondary to fluid in the lungs (pleural effusion)
- Abnormal kidney function due to decrease in blood volume
- Pain due to swelling and twisting of ovaries (torsion).
The success rate of IVF is determined by a variety of factors, including reproductive history, maternal age, infertility reasons, other medical issues and lifestyle factors.
The first IVF baby was born in 1978, and an estimated eight million more have been born since then. In the United States, about 270,000 IVF rounds are performed each year, resulting in more than 74,000 kids being delivered each year.
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American Society for Reproductive Medicine. In Vitro Fertilization (IVF): What Are the Risks? https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/in-vitro-fertilization-ivf-what-are-the-risks/
Care New England Health System. In Vitro Fertilization (IVF). https://fertility.womenandinfants.org/treatment/ivf
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