Before you try IVF…

FOR decades, infertility has stood as a major obstacle to many couples who desperately desire to have children, but advancements in in-vitro fertilisation (IVF) treatments have given these disheartened couples a real hope of conceiving. But consultant obstetrician-gynaecologist at Seymour Park, Dr Michelle Bailey, said that while IVF treatment presents an optimistic picture, the success rates vary and other factors should also be considered for those considering IVF treatment.

“IVF treatment — the most successful form of fertility treatment — is a process in which a sperm joins an egg in a laboratory as opposed to in a woman’s body. IVF treatment presents success rates varying from 20 to 40 per cent, which is good since couples have a 25 per cent chance of conceiving each month. This treatment is generally recommended by doctors after they have exhausted all other possible hindrances to fertility,” Dr Bailey said.

Dr Bailey pointed out that regardless of your perceived knowledge of IVF treatment, it is always important to review the facts.

Below, she shares 10 points to consider when you are considering IVF treatments — chief among them, making sure you need IVF.

1. Make sure you need the treatment

See a fertility specialist before deciding on IVF, as not all cases of subfertility require IVF. For example, some cases of unexplained infertility and mild endometriosis can be treated with intrauterine insemination (IUI). However, for patients in their 40s, IVF is a better option.

2. Couples need to optimise their health before going for IVF

If there are any medical problems or if the woman is on any medications contraindicated in pregnancy, these should be switched to drugs approved for use in pregnancy. Couples should also be screened for viruses which may be transmitted to the baby and have up-to-date vaccinations. For example, if a woman is exposed to Rubella in pregnancy, the baby may have congenital problems as a result. Couples should also be physically fit to optimise their chances of success.

3. The failure rate of IVF will depend on the couple’s age

Couples need to be prepared to get counselling to cope with the stress and possible failure of IVF. In general, as couples get older, their success rate with IVF is less when compared to younger IVF couples. The success of IVF also depends on the cause of infertility. All IVF centres offer counselling to their patients, or you may access independent counselling before the procedure.

4. There is a small risk of the complication Ovarian Hyperstimulation Syndrome (OHSS)

OHSS affects three per cent of patients. If it is severe, it may require admission to hospital for approximately one to two weeks. Women who are at risk for OHSS are usually those with polycystic ovarian syndrome and those who, after stimulation, produce more than 20 eggs. OHSS is a condition where fluid collects in the abdomen, leading to swelling of the stomach and legs. In rare cases, fluid may collect around the lungs and cause shortness of breath. Nonetheless, it is important to point out that OHSS is a self-limiting condition and usually resolves in one to two weeks.

5. IVF treatment carries a higher risk of multiple births

This is, therefore, one area that needs to be discussed with your partner, relatives and the fertility specialist. If you are against having multiple births, then the option of transferring a single embryo instead of multiple ones should be entertained.

6. What will you do in the case of spare embryos?

If there are excess embryos, you will need to start thinking about what to do with these embryos. If your religion is against freezing embryos, egg freezing is an alternative.

7. You also need to think about what you will do with the remaining embryos

In most IVF centres couples are usually offered four options:

a) Freezing

b) Donating to research

c) Donating the embryos to a needy couple

d) Discarding the embryos under laboratory conditions.

8. Storage

For various reasons you may want to freeze your embryos, or even your eggs for purposes of future use. This could be for a variety of reasons including your age, or in the case where more than one egg was fertilised during the IVF treatment. If you decide to freeze your eggs at one of these clinics, you must consider the annual fee associated with the storage of embryos or eggs.

9. Consider eventualities such as relationship termination

You need to discuss with your partner, in the unlikely event that you are no longer a couple, what will happen to your frozen embryos. Will you be willing to give them to your partner? Will your partner be willing to give you the embryos? Or should they be discarded?

10. Are you engaging the services of a surrogate for IVF treatment?

If you are going to use a surrogate, you need to consider that the law in Jamaica states that whoever delivers the child is the mother, and thus you will have to adopt your biological child after the delivery.