What is the success rate of IUI/IVF? Is it 100%

The success rate of IUI varies from centre to centre. In properly selected cases it varies between 18-25%. If one doesn’t conceive then there is a cumulative rise in pregnancy rate in the next cycle. If the couple doesn’t conceive in 3-4 cycles of IUI it is time to move on. The success of IVF varies on many factors including age of female partner, duration of infertility; cause of infertility, ovarian volume various hormonal parameters. If all factors are within normal limits and age of women is ? 35years then the chance of success is as high as 45-55%. Beyond the age of 35 years there is a drop in fertility even in IVF.

Will I have twins or triplets?

The rate of having twins and triplets in normal conception is 1 in 80 and 1 in 1600. In ICSI/IVF the average number of embryos transferred by Indian doctors is 3 in young and 4 in elderly to get a satisfactory fertility outcome. Because of this there is a higher incidence of twins and triplets. 70-80% of IVF conceptions will still be singleton. There is 10-15% chance of twins and 1-2% chance of triplets.

What are the factors which will decrease my fertility?

The most important factor decreasing fertility is age. The biological clock of the female is ticking. She is most fertile between ages of 20-29 years. There is a marginal decrease in fertility till the age of 35 yrs. Another 1-2% decrease between ages 35 to 37 yrs. Beyond 37 yrs. there is steep decline in fertility and every month is crucial. Beyond the age of 40 the fertility potential drops to 5 % and there is increasing chance of miscarriages.

Anxiety and stress are part and parcel of today’s life. They have impact on all aspects of our life from diabetes to blood pressure. It also plays an important role in fertility. It does not allow the hormones to act adequately and the requirement of fertility medications is increased and the response to the fertility medication is not up to the mark.

A de-stressed attitude is essential for adequate response. Many couples have gone for a vacation and then returned pregnant naturally.

Smoking and alcohol should no longer be considered as status symbols. They are responsible for decrease in the quality of eggs and sperms. The male partner should also be asked to give up smoking when his wife is pregnant.

Does the rate of congenital anomalies increase with IVF?

There are various stories that IVF increases the rate of congenital malformations. Various studies have been conducted. A 1-2% increase in abnormalities has been reported in ICSI patients.

Is the treatment painful?

There is a misconception that the IVF treatment is painful. It is not so. There are only a few injection pricks that need to be taken which is not painful. The egg retrieval is done under general anesthesia and so is absolutely painless.

Is bed rest essential after embryo transfer?

Earlier the concept was to advice the female partner to be on bed rest for 3 months following the embryo transfer. It is probably because of the relation of the cost of the treatment. Recent studies have demonstrated that bed rest is not required. The lady can leave the clinic in 15 min. following the embryo transfer. She can resume her routine activities. She only needs to avoid strenuous exercise.

How many times can I do an IVF cycle before I give up?

In properly selected cases as discussed earlier there is a cumulative rise in pregnancy rate with each cycle. However if on does not conceive in 6 cycles of IVF in the same centre there is no more cumulative rise and the chance of success decreases. Usually most fertility centres review the cases after 2 failed cycles of IVF.

What is the difference between IUI and IVF?

In IUI the lady is stimulated with tablets or minimal doses of injections or both with the idea of development of 1-2 follicles in one or both the ovaries. The follicles are allowed to rupture with injections and following that the husbands processed semen sample is introduced into the uterus through the vagina. For this procedure to be successful the fallopian tubes should be normal. The fertilization of the egg with the sperm takes place in the tube. In IVF the oocyte is retrieved & sperm is injected into the egg (ICSI) in the laboratory. The embryo formed is then transferred in to the patient.

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