When is IVF the only fertility treatment option?
In Vitro Fertilisation (IVF) is one of many advanced Assisted Reproductive Technology (ART) available today to help couples facing fertility challenges to achieve a pregnancy.
While there are other fertility treatments available other than IVF, there are certain infertility problems that can only be treated by IVF and its associated procedures.
This article very briefly explains IVF and highlights the circumstances in which IVF is the only treatment option. You can also watch a video by Dr Tony Rodriques from Medfem Fertility Clinic in Sandton, South Africa, about the topic here…
What is In Vitro Fertilisation (IVF)?
IVF treatment was originally developed for women with damaged or missing fallopian tubes and has been the standard treatment for infertility since 1983. Since then, millions of babies have been born worldwide as a result of IVF treatment. In fact, IVF treatment success rates are now comparable – and even superior – to those of nature.
In the simplest terms, IVF treatment is a process of assisted reproduction where the egg and sperm are fertilised outside of the body to form an embryo, which is then transferred to the uterus to hopefully implant and become a pregnancy.
However, IVF treatment is not a single event, but rather a series of procedures that are completed over five stages to complete a treatment cycle. These are:
Stage 1: Ovarian Stimulation and Monitoring
Stage 2: Egg Retrieval
Stage 3: Fertilisation and Embryo Development
Stage 4: Embryo Transfer
Stage 5: Luteal Phase Support
You can read more about IVF here…
When is IVF the only option?
There are certain medical conditions and circumstances in which IVF is the only viable treatment option. In medical terms, these circumstances are referred to as “absolute indications for IVF”. What this means is that to achieve a pregnancy in a couple, IVF is the only solution to the fertility challenges faced by the couple.
In short, these absolute indications for IVF include:
* Blocked fallopian tubes whether due to infection or sterilisation
* Resistant polycystic ovaries
* Receiving donor oocytes (egg donation)
* Preimplantation genetic diagnosis (PGD) and preimplantation genetic screening (PGS)
* Oocyte or embryo preservation whether for delayed fertility or cancer treatment
Each of these are discussed in more detail below.
Blocked fallopian tubes
Blocked or damaged fallopian tubes are common among the many possible causes of infertility. It could be the result of tubal disease or infection, or due to a previous sterilisation.
While blocked fallopian tubes can in certain situations be repaired with advanced microsurgery, better results are achieved by bypassing the fallopian tubes through in vitro fertilisation (IVF) treatment. As mentioned above, IVF treatment was originally developed exactly for this purpose: to help women with damaged or missing fallopian tubes to achieve a pregnancy.
The fallopian tubes allow the eggs to move through from the ovary to where the end of the tube meets the uterus. Here, the egg stays, waiting for sperm to reach and possibly fertilise it. Once fertilised, the egg will remain at the end of the fallopian tube for another 5 or 6 days before moving down into uterus.
If the end fallopian tube is blocked, it must be removed because it can fill with fluid that can jeopardise a pregnancy and cause the loss of an embryo.
You can read more about blocked fallopian tubes here…
Resistant polycystic ovaries
The most common reason for lack of ovulation or inadequate development of eggs in infertile women is polycystic ovarian syndrome or PCOS.
PCOS is a condition where eggs mature in the ovaries but are not released into the fallopian tubes – instead they remain in the ovaries and develop into cysts. This makes it impossible to successfully achieve a pregnancy naturally.
However, there are a range of treatments available, including oral medication and injectables. If these treatments don’t work, the condition is referred to as “resistant polycystic ovaries” and the only treatment option in this case is IVF, which bypasses the fallopian tubes.
Find out more about PCOS here…
Receiving donor oocytes (egg donation)
When couples face difficulties conceiving because of an egg factor, for example the female patient’s eggs cannot be used to create healthy embryos, an egg is obtained through an egg donation from another woman with healthy eggs. This egg is then used in the IVF process.
At Medfem Fertility, our egg donation program is confidential, safe and effective. We carefully screen each donor with a comprehensive health questionnaire, physical, psychological, genetic, and ultrasound examinations to ensure a safe pregnancy.
Egg donation in South Africa is anonymous – egg donor and recipient parents’ details are strictly confidential. Egg donation is managed with strict guidelines and protocol procedures contained in the Southern African Society of Reproductive Medicine and Gynecological Endoscopy Regulations (SASREG).
You can read more about egg donation here…
Surrogacy is an arrangement in which a woman carries and delivers a child for another couple or person.
Traditional surrogacy is when a woman (called a surrogate mother) carries and delivers a pregnancy conceived with her eggs through IVF for a couple. After the birth, the child goes home with the intended parents.
Gestational carrier surrogacy is when a woman (called a gestational carrier) becomes pregnant after an embryo – created from another woman’s eggs – is transferred into her uterus via IVF. In this case the gestational carrier is not genetically related to the child. After birth, she gives the child to the biological mother and/or father.
At Medfem Fertility Clinic, our fertility specialists have been helping couples have children through IVF and surrogacy for over a decade.
Read more about IVF and surrogacy here…
PGS or PGD Pre Genetic Screening or Pre Genetic Diagnosis
Studies have shown that as many as 50% of embryos are chromosomally abnormal. Fortunately, high-tech methods now allow us to perform embryo screening for genetic and chromosomal information.
These advanced techniques of genetic analysis make it possible to screen eggs and embryos for specific abnormalities. The most common embryo testing techniques are preimplantation genetic diagnosis (PGD) and preimplantation genetic screening (PGS).
This allows us to select high-grade embryos for transfer during IVF thus reducing the risk of pregnancy failure and improving the chances of having a healthy baby.
Oocyte or embryo preservation for delayed fertility or cancer treatment
It is a known fact that women experience a decline in reproductive capacity with increasing age as their egg number and quality diminishes, yet many would like to postpone childbearing. In addition, women undergoing cancer treatments may have to consider egg freezing and storage to preserve their fertility.
Egg freezing is a breakthrough technology that allows women to freeze and store their eggs until a pregnancy is desired, at which time the eggs are thawed, fertilised and transferred to the uterus as embryos through IVF.
In vitro fertilisation cycles and egg donation cycles often result in more embryos than are needed. Embryo freezing – also known as embryo cryopreservation or blastocyst vitrification – allows for the storage of unused embryos for an indefinite amount of time.
Medfem Fertility Clinic has extensive experience in embryo freezing. With modern freezing techniques and greater experience, results from the transfer of frozen/thawed embryos are now almost as good as those with fresh embryos, so a store of frozen embryos can significantly add to the likelihood of pregnancy.
If you would like to know more about the circumstances when IVF is the only treatment option, please contact us for a 30 – 60 minute initial consultation with one of our fertility specialists at Medfem Fertility Clinic in Sandton, Johannesburg. Simply click here or contact us on +27 (11) 463 2244 to book your initial consultation.
We look forward to meeting you!