Using Drugs in IVF, Yes or No…?

So the last blog mentioned briefly upon how an egg can be fertilised outside of the human body.  But it’s a lot more complicated than this to achieve.  Only 30% of women that undergo IVF actually get pregnant. It is surprising how many couples actually try to get pregnant through IVF considering the physical and mental difficulties that can be experienced, not to mention time, as well as lots of money if privately done.

With so many new options of IVF, things can sometimes get confusing but it is definitely worth researching all areas, to find out the right treatment for the individual.  In this blog I am going to go over the use of drugs in IVF, and when they are needed, and who will benefit from them.

Natural Cycle IVF

Natural cycle IVF is when he woman’s cycle is monitored closely, allowing the removal of an ovum at the correct time of month.  This egg can then be fertilised and placed into the uterus, establishing implantation of the blastocyst, and allowing the embryo to develop into a foetus and so on. This method differs from IVF, as no hormone drugs are given prior to egg collection.  There are many reasons for not using fertility drugs, ranging from health reasons, some cancer patients may be at risk from ovarian hyper-stimulation that can be dangerous, whilst others may have religious reasons, or do not want to have excess embryos destroyed as a result of their treatment [1]. The chances of having a successful birth are lower than that of stimulated IVF, as you are relying on the body to correctly behave as it should, which is not always consistent! This said though, the risks associated with a natural cycle IVF treatment are much lower, and no risk of twins or triplets!natural cycle baby

IVF using drugs

3075injection

These drugs are given to allow several eggs to be produced at the same time from the ovary.  IVF treatments carried out with drugs given usually have a higher success rate, due to a higher number of eggs available for collection and fertilisation.   This method is called Mild IVF and produces about 2-7 eggs that can be used to create embryos for implantation. The women that opt for the natural IVF are usually concerned about the side effects of these ovarian stimulating drugs due to health conditions, or want their pregnancy to be as natural as possible without drug intervention.

What drugs are given?

Fertility drugs- These help trigger egg production (ovulation induction).  Gonadotrophin-releasing hormone (GnRH) analogues are given by injection or tablet from.  They are pituitary agonists that prevent the normal cycle from occurring.

Hormone injections- These are injected daily for 12 days and help stimulate multiple egg production from the ovaries.  Gonadotrophin hormones such as follicle stimulating hormone (FSH) and luteinising hormone (LH) are used.  Hormone levels in the blood are monitored, allowing the IVF clinic to detect the best time to harvest the mature eggs.  Human chorionic Gonadotrophin (hCG) stimulates the release of the eggs and is naturally made in the developing placenta of the embryo in early development.

What next?

For the female:  After the eggs have matured and are ready for collection an anesthetic is given and eggs removed from the ovaries using a hollow needle that is attached to a probe that enables ultrasound scanning. The eggs are located on the follicles using the probe.

For the male:  The sperm is collected from a fresh sample provided by the man.  These can then be frozen, to be used at a later date, or used as fresh sperm in the IVF process.  Once collected, the sperm is washed and best sperm chosen for use.  It is not normal practice for men to be given fertility drugs during a normal course of IVF.

Drugs for embryo transfer

To prepare the uterus for the implantation of the blastocyst, progesterone is give to the woman.  This thickens the uterus lining, allowing a successful implantation.

Using a catheter, 1-2 embryos are placed within the uterus to prevent multiple pregnancies of more than twins, but enough to hopefully get a successful cycle of IVF.

So it all depends on the patient really, making the decision whether to use drugs or not, and whether this choice is the best for you, in regards for your health, beliefs, and the best possibility of getting pregnant.

References/extra reading

[1] http://www.hfea.gov.uk/natural-cycle-ivf.html

Alternatives to ovarian hyperstimulation. Natural cycle IVF, available at: http://books.google.co.uk/books?hl=en&lr=&id=l-TdGJX2zEMC&oi=fnd&pg=PA173&dq=natural+cycle+ivf&ots=8L16QOTGrw&sig=1Z0s_EoKK_AhDBT7NKY_XAA7olU#v=onepage&q=natural%20cycle%20ivf&f=false

Efficacy of natural cycle IVF: a review of the literature, available at: http://humupd.oxfordjournals.org/content/8/2/129.short

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