Getting Pregnant with Invitro-Fertilization (IVF)

In vitro fertilization (IVF) is usually not the first-line treatment for woman with PCOS, but some will need to have IVF treatment to help conceive. If this is you, don’t feel like a failure or be frightened by it. The IVF success rate with this treatment is the greatest when compared with the previous fertility treatments of Clomiphene, and FSH ovulation induction.

Here are reasons why you may need IVF:

  1. No pregnancy success with all the other fertility treatments- that is Clomid, Metformin, Ovulation induction, or Ovulation Induction and intra-uterine insemination.
  2. When previous simpler fertility treatments have caused an exaggerated response of the ovary causing 3 or more follicles to grow giving you an increased risk of a multiple pregnancy if they all fertilize.
  3. When there are other fertility reasons leading to the need for IVF treatment; such as- male factor problems with low sperm numbers and poor swimmers, fallopian tube blockage, or endometriosis in the pelvis
  4. Another common reason is increasing Female age: In all women chances of pregnancy reduces as we get older, and if you are about 37 years of age or older then your fertility specialist may encourage you to consider IVF sooner rather than spend 6- 12 months having other treatment that may not work and then you will be a year older.

This next section will give you an understanding of the management and care during; an IVF cycle, how you might feel, the risks, and what your chances of pregnancy could be.

What happens during the IVF treatment process?

The treatment process of IVF basically involves taking your eggs (also called ovum/oocytes) from your ovaries and combining them with your partner’s sperm in the laboratory. So instead of sperm and egg fertilization taking place in the fallopian tube, it occurs in the laboratory at a fertility clinic.

In normal human physiology every month, one mature egg is grown to maturity then ovulated. But in IVF we do not want just one egg, we want at least three or more eggs in order to give you a higher chance of having embryos develop.

What happens at the beginning of your IVF treatment?

Your fertility specialist and clinic will give you fertility hormone injections that will stimulate and grow your eggs in your ovary. Your ovary response will be monitored by the clinic nurses and doctors with blood tests and pelvic ultrasounds. When your follicles are at the appropriate growth size (18 – 22mm), the decision is then made to retrieve the eggs from your ovaries.

By-the-way, these hormone injections are the same FSH – follicle stimulating hormone used in the ovulation induction fertility treatment. Again don’t be frightened by these FSH injections, they are simple and you will be shown at length by the staff how to use them.

The IVF egg retrieval

Your eggs are removed from the stimulated follicles in your ovary through a twenty to thirty minute procedure. You can be sedated for this or have it either under a local anesthetic or general anesthetic. Afterwards you may feel some crampy – type period pain that can last for a day. The eggs are then placed with the sperm in the laboratory for fertilization to take place. The fertilized eggs are then divide and developed onto embryos

IVF Embryo Transfer

The IVF embryo transfer

The IVF embryo transfer

The embryo transfer is a simple procedure; it takes about ten to fifteen minutes. It is very similar to having a pap smear – with the speculum going into your vagina to visualize the cervix. The best quality looking embryo is chosen on that day to go back into your uterus via a small plastic tube. I usually recommend to my patients to  have the embryos grown to 5 days where they should be over 100 cells by then and have a higher chance of implanting. Also, by day 5 of embryo growth you can then choose the best embryo to be transferred back.

Two weeks later you will go back into the clinic for the pregnancy test and it can often feel like a very long drawn out wait.
Many of my ladies say this is actually the hardest part of the IVF treatment (the waiting time to see if the IVF treatment has been successful).

IVF Process: How You May Feel?

Going through any fertility treatment can be a roller-coaster ride, but more so with IVF, especially when it is more involved, more time consuming, plus you expect higher pregnancy chances.

So of course expectations are often higher.

You may start out excited and then end up disappointed when pregnancy isn’t successful, especially if you have to do the treatment again. So it is important to for you to have some kind of support around you, or have practices in place to help you stay grounded and focused and still live and love life.

  • Here are some other feelings you may have: Moody or feeling irritable especially while on the injections
  • Nausea
  • Headaches, especially if your prone to them
  • Bloatedness in your tummy as your ovaries grow. Your clothes may feel tight, especially after the eggs are removed in the first two weeks many women feel their tummy is so large people will mistake them for being pregnant. This tends to occur when many eggs are collected from the ovary… and I’m talking about twenty or more.
  • Period like cramping pelvic pain after the egg collection and sometimes into the following two weeks
  • Your breasts will feel larger and may also be tender to touch

IVF Success: What are the chances of pregnancy with Invitro Fertilization Treatment?

IVF does give the highest chance of pregnancy for you when comparing all of the other PCOS fertility treatments.

But it will depend on;

  1. Your age
  2. Your general health such as your weight and whether you have diabetes or insulin resistance.
  3. How good the laboratory dealing with your eggs, sperm and embryos are in the IVF clinic you are with.
  4. The quality of your embryos.
  5. The number of embryos returned to your uterus
  6. Whether you may have other fertility factors such as having the condition called endometriosis, or male sperm problems which can impact on chances

In general though your female age, which correlates with the age of your eggs will be  related to your chances of pregnancy and IVF success. The younger our age the younger our eggs are and therefore the higher the chance of pregnancy. The older we are, then the older our eggs are and the smaller the chance. of IVF success So you can see that for us women, time is important when taking action for our fertility. Delay can lead to poorer outcome and regret.

On average if one embryo is transferred back:
– For women under 38 years of age, the chances of pregnancy are about 35 – 40%
– For women between 38 and 40 years the chances can vary between 25 – 35%.
– For women over 40 years chances are less than 20%.

What Are The Possible IVF Side Effects of IVF Treatment?

IVF treatment has much the same possible side effects as ovulation induction treatment with FSH. Some of the feelings may be worse because the dose of the FSH hormone is greater and therefore the ovaries will be more stimulated and larger.

Minor Headaches
Bruising, swelling, itchiness at injection site
Skin Rash at injection site
Mild abdominal swelling or discomfort
Mood swings
Some breast tenderness and pain
Crampy menstrual type pain
Major Pelvic Infection of 1% chance
OHSS Ovarian Hyperstimulation Syndrome
Blood clot

The risk of multiple pregnancy  is another IVF side effect and will depend on the number of embryos transferred back to the uterus.

Myself and most fertility specialists would recommend transferring only 1 embryo.
By adding 2 embryos, the chance of conceiving twins is about 20%.

Many couples tell me they would love to complete their family by having twins. And although it sounds like a nice outcome, the reality is many IVF babies from multiple pregnancies deliver earlier than the due date, and because of their prematurity can sadly end up with a poor outcome by developing the brain damage called Cerebral Palsy.

But overall if you need IVF don’t be afraid. Many of my ladies with PCOS do undergo invitro fertilisation treatment AND have a baby. Out of all the possible fertility treatments, IVF does give the highest chance of having a baby.

Good luck