Getting pregnant can be one of the most exciting chapters in life — that is, if you want children in the first place. Even if you do, conceiving can be difficult. For some would-be parents, that’s where assisted reproductive technology, or fertility treatments that involve both eggs and embryos, comes in. In vitro fertilization (IVF), for example, is a more and more popular technique for having babies: A 2014 report from the Society for Assisted Reproductive Technology found that IVF led to the births of 1.5 percent of all babies born in the U.S. in 2012, an all-time high.
To get the lowdown on how it works, who can benefit from it, and more, Allure spoke with fertility doctors Zaher Merhi, the director of IVF Research and Technology at New Hope Fertility Center, and Joel Batzofin, founder of New York Fertility Services. Ahead, what you should know about this increasingly common treatment.
How does IVF work?
When a patient decides to get IVF, they begin by taking medication that helps stimulate the production of eggs. They’re monitored by a doctor with blood tests and ultrasounds to make sure they’re healthy during the process and that their eggs are maturing; eventually, the practitioner extracts the eggs through the vagina with a needle. Then, eggs and sperm are transferred to the same dish, where insemination hopefully occurs; if the semen sample in question has a low sperm count or the sperm are otherwise having a hard time doing their job, an embryologist can also directly inject an egg with a sperm cell. Batzofin says that at this point, depending on what the patients want, they may do something called “PGS,” or preimplantation genetic screening: “During this procedure, they do testing for healthy embryos to make sure they don’t have chromosomal abnormalities or genetic defects.” Then, the embryo is transferred into a uterus — that of the person who provided the egg, or someone else’s.
Who typically benefits from IVF?
Merhi tells Allure that any couple (or person) who has been unable to conceive after having unprotected vaginal intercourse for more than one year — that’s what it takes to qualify as infertile — would benefit from seeking medical advice. If that person is over the age of 35, unsuccessful trying for six months is an indication that it’s time to call in a doctor for guidance. And if someone has been diagnosed with cancer and needs to undergo treatment, it’s definitely a good idea to see a doctor to explore egg-freezing: “If a woman has any type of malignancy or cancer,” Merhi says, “chemotherapy can kill her eggs, so we can also freeze her eggs so that she can get IVF later on.”
Batzofin says in the 1970s, IVF was initially understood as an option for women with fallopian tubal disease. As the medical community began to better understand the situations in which it could be helpful, its use increased: “Indications grew to include treatment for men who have low sperm count, as well as people with endometriosis, infertility from autoimmune disease, as well as polycystic ovarian syndrome,” Batzofin says. He also explained it can be used when a couple wants to avoid passing on a sex-linked disease to their child: If they have a genetic disease in the family that only affects males, for example, they can choose to implant only female embryos. All this said, IVF generally isn’t the very first thing doctors recommend for people who don’t get pregnant right away. Fertility meds on their own and both intracervical and intrauterine insemination of sperm can also be helpful, depending on the person or couple.
How successful is IVF?
Both doctors agree that the success rates are highly dependent on the age of the patient giving the egg. While Batzofin says sperm quality and uterine quality also matter, egg quality — which generally begins to decline significantly when a person is 35 — matters the most. “Success is multifactorial,” he points out. “How did [patients] respond to the meds? That matters, as well as the expertise of the doctor in the lab. These factors are all important in success rates.” So while IVF’s success varies widely, one estimate puts it at 41 to 43 percent for people under 35, and 33 to 36 percent for people from ages 35 to 37.
As for how people can help the process along? “Patients can contribute to success by doing nothing — being relaxed and not stressing out about the treatment helps,” Merhi says. “A lot of the time, it makes it very hard psychologically when patiences are stressed out. As far as other things, the recommendation is just to avoid smoking, drinking alcohol, and be generally healthy.”
Are there any safety risks?
As with any medical procedure, there are a few safety risks. Batzofin says ovarian hyperstimulation is a potential risk with IVF: “Some women can be very sensitive to the [fertility] medications so their ovaries can swell up,” he explains, “but with competent hands and careful monitoring, the risks can be minimized.” As far as the actual egg retrieval, he says it carries risks of infection, bleeding, and injury to the surrounding structures, although these are rare. Merhi mentions the medications themselves have a few side effects, estimating that 10 to 20 percent of those who take them may have hot flashes and more may experience mood changes. The other side effects may include pain and bruising from the shots, though these aren’t long term. There’s also some research suggesting IVF may slightly increase the chance a baby will be born prematurely or underweight.
Okay, so how much does it cost?
IVF treatment is not one-size-fits-all — depending on what you need and where you’re getting treated, you’ll be paying a different amount. Batzofin says one of the biggest factors in price is geography, as medical costs (like many other costs) vary widely from, for example, New York City to Montana. City-based practices with higher business costs will likely charge more. But both Batzofin and Merhi estimate a single cycle can cost from $6,000 to $15,000.
IVF does cost a pretty penny, but “It’s an effective treatment, relatively safe in competent hands,” Batzofin says, adding that it’s led to the births of over a million babies to date. IVF is not a silver-bullet guarantee that you’ll get pregnant or be able to have a biological child, but it’s proven a sound option for many a parent — including some famous ones.
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