who needs ivf to conceive ?
– Published on 16 March 2024
When You Should Opt for an IVF Procedure?
In the journey towards parenthood, natural conception is the starting point for most couples. This process involves a series of biological events triggered by intercourse. For a woman with regular menstrual cycles, an egg is released from the ovary each month and travels to the Fallopian tubes, where it can live for about 12-24 hours.
If intercourse happens during this time, and the sperm meets the egg, natural conception occurs. However, when natural conception doesn’t lead to pregnancy, couples often consider alternative methods, like In Vitro Fertilization (IVF).
But when you should consider IVF? Well, there is no fix guideline to this. But, there are some points that you should consider. There are certain tests based on which you should make your decision. So let’s explore them one by one.
Ovarian Reserve Tests
When it comes to gauging a woman’s fertility, Ovarian Reserve Tests are invaluable. They provide a snapshot of the potential egg supply, helping to understand fertility health better. Let’s break down the two main components of this test:
1.Antral Follicle Counts (AFC)
- What It Is: AFC is a type of ultrasound test, typically performed internally.
- When It’s Done: The best time for this test is usually on the second or third day of the menstrual cycle.
- The Procedure: During the test, a healthcare provider counts the number of antral follicles in the ovaries. These are small follicles about 2-10 mm in diameter.
- Why It Matters: Antral follicles are a good indicator of the remaining egg supply. A higher count generally suggests a more robust ovarian reserve.
- Interpreting the Count: While the count can vary, generally, a count of less than 5-7 follicles indicates a potentially lower egg reserve.
2.Anti-Mullerian Hormone (AMH)
- Overview: AMH is a hormone secreted by cells in developing egg sacs (follicles).
- Testing Method: A blood test measures the level of AMH in a woman’s body.
- Significance: AMH levels are considered a reliable marker of a woman’s ovarian reserve.
- Understanding the Levels:
- Normal Range: The ‘normal’ range can vary, but generally, a level above 1.1 ng/mL is considered indicative of an adequate egg reserve.
- Low Levels: If AMH is below 1.1, it may suggest a reduced egg reserve. This doesn’t mean pregnancy is impossible, but it could mean fewer eggs are available for ovulation and IVF.
- High Levels: On the other hand, unusually high levels of AMH can be associated with conditions like Polycystic Ovary Syndrome (PCOS).
Why These Tests Matter
These tests are crucial for women who are considering pregnancy in the near future, especially those contemplating IVF. They provide valuable information about the quantity of eggs remaining, which can influence fertility treatment decisions.
It’s important to remember these tests don’t measure egg quality, and a lower count doesn’t rule out the possibility of natural or assisted pregnancy. These tests are usually part of a comprehensive fertility evaluation, which may include other tests and assessments.
Deciding When to Opt for IVF
In Vitro Fertilization (IVF) is a path many couples consider when facing challenges in natural conception. This advanced fertility treatment can be a game-changer in various situations:
Fallopian Tube Blockage
- The Challenge: Blocked Fallopian tubes prevent the egg and sperm from meeting, making natural conception very difficult, if not impossible.
- IVF as a Solution: In IVF, fertilization occurs outside the body, bypassing the need for the Fallopian tubes entirely. This makes it an ideal solution for women with this issue.
Uterine Fibroids
- Post-Surgery Consideration: Fibroids can interfere with the implantation of the embryo. Even after they are surgically removed, some women might still face difficulties in conceiving naturally.
- IVF Post-Treatment: IVF can be a viable option post-fibroid removal, especially if natural conception doesn’t occur within a reasonable timeframe after surgery.
Sperm Quality
- Sub-Par Sperm Parameters: A sperm count below 5 million, or poor motility (movement) or morphology (shape), can significantly decrease the likelihood of natural conception.
- IVF with ICSI: In such cases, IVF, often combined with Intracytoplasmic Sperm Injection (ICSI), where a single sperm is injected directly into an egg, can be an effective alternative.
Age Factor
- Diminishing Fertility with Age: Women above the age of 35 experience a natural decline in fertility, with a more pronounced drop after 40.
- Why IVF: IVF can be more effective for older women, particularly when using their own eggs, as it allows for multiple eggs to be stimulated and retrieved, increasing the chances of a viable pregnancy.
Additional Factors to Consider
- Unexplained Infertility: Sometimes, despite normal test results, couples are unable to conceive. IVF can be a viable option in these cases.
- Genetic Concerns: For couples with known genetic disorders, IVF with preimplantation genetic testing (PGT) can ensure the transfer of genetically healthy embryos.
Previous Unsuccessful Treatments: If other fertility treatments like medication or intrauterine insemination (IUI) haven’t been successful, IVF might be the next step.
Considering the Male Factor
It’s not just about women. Men’s fertility health matters too. If the sperm count is low (under 5 million), or if there’s a problem with sperm motility or morphology (below 4%), IVF can be the next best option.
A Word of Care
While IVF is a powerful tool in the fertility arsenal, it’s not a one-size-fits-all solution. The decision to proceed with IVF should be made after thorough consultation with fertility specialists, considering the unique circumstances of each couple. It’s also essential to have realistic expectations and understand that while IVF increases the chances of pregnancy, it doesn’t guarantee it.
We hope this guide has offered you a lot of information on the topic. Still, if you have any more doubts, do not hesitate to reach out. Our experts are always here to help. Feel free to give us a call.
By Dr Samidha Dalvi-Amale
IVF and Fertility specialist Medical Director- Pune IVF