IMPORTANCE OF IVF IN A COUPLE'S

JOURNEY TO PARENTHOOD

Understanding infertility Fertility issues can have a significant psychological and emotional effect on couples and individuals who are trying to conceive. Infertility refers to a failure of the male or female reproductive system defined to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse. Infertility affects millions of people of reproductive age worldwide and has an impact on not only families but also their communities. According to the report of Macrotrends, the fertility rate of 2021 declined by 0.09% as compared to last year and it continues to decline each year.

General causes

There are many factors that can lead to infertility including our lifestyle choices. Some general causes of infertility in both men and women include:

• Age

• Alcohol and tobacco consumption

• Hypertension

• Physical inactivity

• Obesity

• Hormonal issues

• Being underweight

• Tumor, cyst, infections, or other issues related to the reproductive system

• Diabetes

What is IVF?

In vitro fertilization is a type of assistant reproductive technology (ART) which helps the couple conceive. It is one of the most effective assistant reproductive technologies in which the mature eggs are collected from the ovaries and fertilized by sperm under laboratory conditions. It involves a combination of medical and surgical treatment to fertilize the egg outside the body first and then implant the resulting embryo into the uterus. IVF has today revolutionized the field of fertility where not only couples but even individuals can dream about becoming parents. The outcome of IVF treatment depends on a number of factors including the age and health of the patients.

When is it recommended?

One of the most common misconceptions around IVF is that it is only fertility treatment available for hopeful parents. However, it is important to understand that there are also other types of artificial reproductive technology depending upon the reason one is unable to conceive. IVF treatment is recommended when:

• Blockage or damage to the fallopian tubes

• Infertility problems in the male partner including low sperm count or sperm motility

• Chronic conditions including ovulation disorders, premature ovarian failure and uterine fibroids

• Genetic disorders

• Unexplained infertility

• Surgically removed fallopian tubes

How effective is it?

While it is important to remember that the success or failure of IVF depends on various factors including age and health of the patients, it is equally important to remember that it does not guarantee a pregnancy or live birth. Other factors including the reproductive history, maternal age, cause of infertility and lifestyle play a crucial role in determining whether a couple is capable of conceiving. The success rate of live birth IVF drops drastically with maternal age over 35 years (40% at 35 years of age and 4% over 40 years of age). As a result,

it is also important to know that for most people, multiple IVF cycles would be required for successful implantation.

Risk factors

While IVF is a source of hope to the people who are unable to conceive, it is also important to understand the risk factors that revolve around IVF:

• Bleeding, infections or any form of damage to the bowel and bladder during the egg retrieval process

• An increased risk of multiple pregnancies if multiple embryos are implanted

• The risk of miscarriage increases along with the maternal age

• Increased risk of ectopic pregnancies

• Psychological and financial risk to hopeful parents

Why good lab practice is important

Following good lab practices are considered to play a vital role in determining the success of the IVF treatment. The air quality is considered to be most important because the presence of harmful compounds including volatile organic compounds (VOCS) and other particulate substances are considered to be very harmful for the embryo. Apart from that, construction of these labs, lighting and temperature also plays an important role. Woodbased furniture release formaldehyde; PVC flooring materials, paints and carpets also release VOCS. Ammoniabased cleaning products and aerosol propellants such as butane or isobutane must be avoided at all costs. The IVF laboratories must use ethanol as a disinfectant to get rid of VOCS. Cosmetics, perfumes, colognes, and even aftershaves, are highly toxic to embryos in vitro. It is essential for IVF labs to set up air filtration systems to filter hydrocarbon pollutants, chemically active compounds and airborne pathogens.

Role of specialists

Specialists and embryologists play a very crucial role for a couple who are seeking IVF treatment as they are constant partners of the patients throughout their journey to parenthood. Since IVF specialists are the primary contact for patients seeking conception, it is their responsibility to handle and cater to not only the physical but also the psychological and emotional needs of patients. Every IVF cycle starts with a counselling session with a specialist who helps in establishing the expectations from the procedure. This procedure is then followed by several tests conducted in both men and women including blood tests to check for the symptoms of polycystic ovaries, diabetes, liver damage and sexually transmitted infections (STI). The test is also done to check the levels of hormones such as prolactin. Apart from that, imagebased scans such as ultrasound may also be used on women depending upon the case. For men, other tests are conducted to check the quality and quantity of sperms and conditions like premature ejaculation, retrograde ejaculation, and erectile dysfunction. All these procedures help in decoding the cause of infertility and assure that these health conditions are medically addressed before starting with the IVF cycle. The results of these tests suggest the next course of treatment that is decided by the IVF specialist.

In addition to the IVF specialists, embryologists also play a crucial role in an IVF cycle. Although they are not in direct contact with the patients, they are responsible for performing routine IVF procedures such as retrieval of eggs, sperm preparation, invitro fertilization of eggs and sperms in order to produce embryos, embryo selection, culturing embryos and embryo transfer. Apart from that, their work is not only confined to handling gametes and embryos, but they are also responsible for maintaining good IVF lab culture conditions including lab environment, maintenance and quality control of the instruments.