Things you should know before starting your IVF Treatment
Fact 1 : Pre treatment with vitamins and supplements before starting IVF Cycle.
It takes about 12 weeks for an immature oocyte to cross various stages of maturity within human body and become competent for fertilization. Many vitamins, antioxidants and minerals play an important role in the entire process of oogenesis (development of eggs).
CoQ10 (Co Enzyme Q10) has been proven to have an important role in development of healthy oocytes / eggs, especially for women above 35 yrs of age or with diminished ovarian reserve.
Your doctor may prescribe you two to three months of the supplement prior to your IVF cycle based on your general health and age.
Same concept applies to males with reduced sperm counts in whom ICSI is planned or azoospermia where TESA or Micro TESE is to be performed. Antioxidants and micronutrients like Levo-carnitine, Coenzyme Q10, Zinc, Lycopene and Astaxanthin are usually given for 4-6 weeks before collection of semen sample or surgical sperm retrieval. They may not increase the total sperm count or motility but definitely improve fertilisation rates.
Fact 2: The effect of timing of IVF injections and drugs that are used in IVF cycle affects the IVF cycle result.
During an IVF stimulation, doctors are trying to control the quantity of few hormones like LH, FSH and E2 that dictate maturation of follicles within the ovary and its release on maturity.
The interrelationship of these hormones is very complicated and needs meticulous management through external medication and injections.
Make sure you understand the instructions about the storage details of the IVF injection and timing of administration thoroughly before you start the IVF cycle.
IVF injections need to be administered either intramuscularly or subcutaneously. Intramuscular injections are best administered by trained nurses who know how to mix the salt well and administer without much discomfort.
You may want to go through the following blog to understand more about IVF injections.
Some tips for proper administration of IVF Injections:
- Always maintain proper temperature of injections when you step for administering them by carrying injections between ice packs.
- Be sure to arrange a nurse or clinic for administration of injections daily on same time, even on Sunday and holidays. Administration of injections should be done within a one hour window.
- Set up a repeating alarm on your mobile phone so that you never miss an injection.
- If you happen to miss out on any IVF injection, immediately administer them as soon as you realize your mistake. Inform clinic about the mishap.
- In case of any doubt, contact IVF nurse and clinic to clarify your doubts.
- Store injections on the upper shelves of the refrigerator and never on the door, so that proper temperature is maintained.
- Make sure that the nurse who is administering you the injection is administering the entire dose and not leaving anything in the vial. Every drop counts.
Fact 3: The treatment steps of IVF cycle can be broken over and spaced over months to accommodate personal or professional obligations.
One common mistake that many couples unknowingly make is to delay IVF treatment thinking that they are not ready for a baby yet. Undergoing an IVF cycle does not mean that you will be jumping into parenthood right away.
IVF cycle can be broken into Egg harvesting, Embryo Formation and Embryo Transfer.
Age has an adverse effect on oocyte quality and quantity for females, hence it makes sense to undergo IVF cycle sooner than later. However, if the couple thinks that they have some personal and professional commitment due to which they would wish to delay pregnancy, they can choose to keep the embryos cryopreserved for months to years. Once they are ready, they can undergo Embryo Transfer at their comfort at a later time.
However, since every embryo transfer may not result in pregnancy, couples should delay embryo transfer only if they form at the least 2 to 3 good quality Blastocysts ensuring two to three Embryo Transfer attempts in future.
Fact 4: One is all you need ! Even a single good quality blastocyst works.
Do not fall for trap of multiple embryos to increase success rate of IVF cycle unless there are pressing reasons.
Many clinics transfer two to three embryos wanting to increase the success rate of the IVF cycle. This however at times leads to twin or triplet pregnancy, unnecessarily complicating the pregnancy outcome. Couples should know that the chances of preterm delivery increases with twin pregnancy.
Not only does it increase the complication, but it also increases the chances that the babies would have to be kept in neonatal ICU for a few days.
Single Blastocyst transfer gives good success rate if the quality of Blastocyst is good. Make sure you get to choose a Blastocyst Transfer over a Day 3 embryo whenever possible.!
Fact 5: Failure is not Permanent.
If you fail to produce good quality embryos in one cycle, does not mean that you may fail in the next cycle.
Every oocyte in your body is different than the other. Just because there were no good quality embryos in one IVF cycle, does not mean that the fate of your next IVF cycle will be the same.
IVF specialist handling your case and the Embryologist who has cultured your embryos usually discuss every case to figure out the reason for failure to produce good quality embryos. Typically, they discuss what can be tried differently in the next cycle which may include change in IVF stimulation protocol, addition of dietary supplements and antioxidants, change in culture strategy etc.
At times if all of these have already been tried, the same things are repeated again with meticulous precision and most of the times we see better embryos. For patients who consistently fail to produce good quality embryos, gamete replacement through donor program could be considered.
Benjamin Franklin
“If you are failing to prepare, you are preparing to fail.”
The same holds true for IVF treatment. An IVF cycle takes emotional, financial and physical preparation. If done with the right set of expectations and proper preparation, most IVF cycles eventually result in a successful pregnancy.
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