Myth 1. IVF is only for those over 35 years old.
In what cases is it worth talking about the need for an IVF procedure before the age of 35?
The frequency of pregnancy directly depends on the age of the woman and is 2 times higher in women at 25 than at 35, per one menstrual cycle, and steadily decreases with increasing age. For example, the chances of getting pregnant after age 42 are about 10%. These indicators also apply to conception with the help of any assisted reproductive technologies (ART): IVF, injection of sperm into the oocyte cytoplasm (ICSI), cryopreservation of germ cells, artificial insemination with husband’s or donor’s sperm, etc. In general, the younger the woman, the better the quality of her eggs.
There are absolute indications for IVF – this is, firstly, the absence of the fallopian tubes or their complete obstruction. On the part of the man – the presence of single spermatozoa in the ejaculate, when the IVF-ICSI procedure is indicated. Accordingly, the younger the woman who has absolute indications for IVF, the higher the likelihood of getting pregnant as a result of this procedure on the first attempt.
Another thing is that for some reason a young woman postpones the birth of a child. In this case, it would be wise to take care of IVF with subsequent cryopreservation of excellent quality embryos, for their transfer to the uterine cavity in the future, when life circumstances will favor the birth of a child.
Myth 2. IVF is the only way out for infertility.
What are the factors affecting female, male infertility? What is it connected with? Should I go for IVF immediately after the diagnosis? What additional examinations are needed?
Sometimes IVF is really the only way out for infertility, when there are absolute indications for this procedure. The World Health Organization identifies 23 female and 18 male factors leading to infertility. For example, this may be due to disruption of the endocrine system, with the consequences of previous inflammatory diseases of the genital organs, with congenital anomalies in the development of the genital area. There are many conditions in which the ability to conceive is drastically reduced, such as anemia or, for example, extreme vitamin D deficiency. Of course, when the cause of infertility is established and there are indications for this procedure, the sooner it is performed, the higher the likelihood of pregnancy. The Order of the Ministry of Health No. 107-n dated August 30, 2012 lists all standard examination procedures that are carried out to select patients who need the use of assisted reproductive technologies.
Myth 3. IVF always leads to multiple pregnancies.
What determines how many embryos will take root?
Multiple pregnancy is a complication of ART. Sometimes, this, frankly, is a very desirable “complication” for a married couple. All international associations of reproductive specialists do not recommend transferring more than two embryos into the uterine cavity in one treatment cycle. And only in some cases, when poor quality embryos are obtained as a result of repeated attempts, the number of transferred embryos can be increased to increase the likelihood of conception.
If embryos are transferred at the blastocyst stage (fifth day of embryonic development) and if they are of good quality, then it is ideal to transfer one embryo, then multiple pregnancy is excluded in principle.
We all need to remember well that multiple pregnancy is associated with an increased risk of miscarriage, dissociated development of fetuses and many other undesirable conditions associated with excessive stress on the woman’s body.
The number of embryos that can be implanted after being transferred to the uterus directly depends on their quality and the quality of the endometrium (uterine lining), as well as other indicators that the attending physician takes into account.
If these factors are ideal and there is a favorable interaction between the cells of the embryo and the cells of the endometrium, then the implantation of the embryo will occur with great probability. This happens in the so-called “implantation window” – the time when the endometrium is in its full readiness to “shelter” the embryo and become its “home” for the next 9 months.
Myth 4. Childbirth after IVF is always carried out by caesarean section.
In what cases can a woman give birth herself?
Caesarean section as a method of surgical delivery also has its absolute and relative indications. Absolute indications do not arise from which method the child was conceived – IVF or naturally. For example, a discrepancy between the size of the fetus and the size of the pelvis of a pregnant woman or, for example, the transverse position of the fetus in the uterine cavity are indications for a caesarean section. It doesn’t really matter how the pregnancy came about.
The decision on the need for a caesarean section is made by the obstetrician if there are four or more relative indications for it or one absolute one.
Let’s say the first pregnancy in a woman over 35 years old, which occurred as a result of IVF, and some concomitant pathology that she had before pregnancy – the decision will be made, perhaps in favor of a caesarean section, but if there is the possibility of childbirth through the natural birth canal , then the woman will be asked to give birth herself.