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If you are unable to conceive in the natural way, for whatever reason, then In-Vitro Fertilization (IVF) may be the solution.
The first ever baby to be born of the technique, was Louise Brown, in 1978 in the UK. Since then, the treatment, now often combined with ICSI, has progressed enormously and helped countless childless couples to achieve their wish of parenthood. An estimated 2 million children have been born worldwide as a result of the technique. At the CRG alone over 15.000 children were born in the first 25 years of our existence.
IVF can be effective in achieving conception in the following infertility situations:
- gynaecological causes: closed fallopian tubes or absence of fallopian tubes; endometriosis; ovulation problems;
- andrological causes: if the man is less fertile (see sperm quality);
- immunological problems: if the man or woman produces antibodies against sperm cells (see Immunological investigations for women and men);
- unexplained fertility; after a number of years of trying to concieve, some couples are still unable to do so, without there being an apparent cause.
In all the above cases, IVF will provide a good chance of conception, where other treatments fail.
IVF and ICSI treatments take place for the large part without the need for hospitalization. It is neither necessary, nor possible for you to spend the night in hospital. Nevertheless, the forfeit 'Surgical Day Hospital' will be taken into account for certain procedures such as egg cell pick up. This is a form of hospitalization whereby you may leave the hospital on the same day as the procedure and is fully covered by your (belgian) health insurance. See also financial
The treatment in a nutshell
During IVF, fertilization does not take place in the fallopian tube as in nature, but rather in a dish in the laboratory. This is where the name of the treatment originates from (In-Vitro being Latin for in glass).
During a classical IVF, egg cells from the woman are placed together in a dish with sperm from the man. Here, the sperm fertilizes the eggs. The dish is then placed in an incubator which replicates the temperature and atmospheric conditions found in the fallopian tube.
ICSI involves the injection under laboratory conditions of a single sperm into each egg, which increases the chance of creating an embryo.
This advanced laboratory technique has been around since the
early nineties of the twentieth century. The CRG of UZ Brussel has
refined it to its definitive form in which it is applied with great
succes all over the world. For more information see In the lab
How does it actually work?
- The natural menstrual cycle is temporarily overridden with a medically induced cycle, during which the administration of hormones stimulate the ovaries to produce several follicles simultaneously.
- Just before ovulation, the follicles are punctured and drained with a fine needle, and the egg cells are collected. (Pick-up). The eggs are placed together in the lab with your partners sperm (or if applicable, that from a donor). This may even be one single sperm cell, which is injected directly in the egg. In this case we talk about ICSI. If all goes according to plan, a number of the eggs will fertilize.
- One or two of the resulting embryos will be replaced in the uterus (embryo transfer). Hopefully, one embryo will implant and go on to develop into a normal pregnancy.
- Surplus embryos can be frozen and used at a later date.
- If you are not pregnant following you embryo transfer, or if you are and you would want a second child later on, the frozen embryos can be thawed and used in a subsequent transfer. You will not need ovarian stimulation for this. To find out more, see course of treatment for FRET.
The new legislation on medically assisted reproduction, which came into effect in 2007, also states that in a subsequent IVF attempt a couple's stored embryos must be used before an attempt with fresh material can be undertaken. However, the chances of a successful transfer using frozen embryos is less than with fresh. They don't always survive the thawing process, not even the good quality ones. Only about 50% of frozen embryos are viable after thawing. It could therefore be possible, that even if you had a number of frozen embryos in storage, you will have to go through the whole treatment process again to be able to have another transfer.
Difficult but not painful
In-vitro fertilization is both an easy and a difficult treatment. Physically, it is relatively straightforward and uncomplicated. It involves a number of generally painless interventions which carry very little risk. Side effects are few (see next section) and certainly not dangerous. Furthermore, your treatment will not require you to stay a single night in hospital.
The psychological impact of the treatment however is much more severe. There are so many tests and examinations during the process, that you will have to organize your life around the treatment for a while and not the other way around. Stress factors such as wondering whether it is all going to be worth it can sometimes put enormous strain on a relationship.
The CRG tries to help everyone as much as we possibly can. Fulfilling your desire to have children and ensuring your comfort during your treatment are out priorities.
Possible side effects
Prevention of multiple pregnancies
It used to be that two to three embryos were placed into the uterus in order to maximize the chances of success. However this also increased the incidence of multiple pregnancy considerably. Thanks to medical progress, it is nowadays normally sufficient to replace only one embryo during transfer. This eliminates the risk of a multiple pregnancy and thus lessens the risk of complications arising for mother and child.
Apart from the psychological pressure of IVF treatment, there are a number of physical inconveniences which accompany the process, such as abdominal pain during the stimulation phase.
The formation of ovarian cysts could also be an issue which will need to be addressed. These cysts are usually functional and can produce hormones which would otherwise interfere with the effects of the medication you are taking. Therefore they will need to be removed. This simple procedure is explained in detail in the section puncture of ovarian cysts
Finally, there is always a risk of multiple pregnancy where more than one embryo is replaced in the uterus. See FAQ's
for more information.