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Fertility Treatment For Women With PCOS – In Vitro Fertilization
In vitro fertilization (IVF) is not usually the first-line treatment for women with PCOS, but some will need IVF treatment to help them conceive. If this is you, don’t feel like a failure or be afraid of it. The success rate for IVF with this treatment is the greatest compared to the previous fertility treatments of Clomiphene, and FSH ovulation induction.
Common reasons why you should go the IVF route are:
- No pregnancy success with any other fertility treatments – ie Clomid, Metformin, Ovulation induction, or Ovulation induction and intrauterine insemination.
- When previous simpler fertility treatments have caused an exaggerated reaction of the ovary, causing 3 or more follicles to grow, you have an increased risk of a multiple pregnancy if they all fertilize.
- If there are other fertility reasons that lead to the need for IVF treatment; such as male factor problems with low sperm counts and poor swimmers, blockage of the fallopian tube, or endometriosis in the pelvis
- Another common reason is increasing female age: for all women, the chance of pregnancy decreases as we age, and if you are around 37 years of age or older, your fertility specialist may encourage you to consider IVF earlier than 6- 12 months to spend other treatment that may not work and then you get a year older.
This next section will give you an understanding of the management and care during; an IVF cycle, how you might feel, the risks, and what your chances of pregnancy might be.
IVF treatment process The treatment process of IVF basically involves taking your eggs (also called ovum/oocytes) from your ovaries and combining them with your partner’s sperm in the laboratory. So instead of sperm and egg fertilization in the fallopian tube, it occurs in the laboratory of a fertility clinic.
In normal human physiology, one mature egg is grown to maturity each month and then ovulated. But in IVF we don’t want just one egg, we want at least three or more eggs, to give you a higher chance of developing embryos.
The Treatment IVF Timeline: The start of your IVF treatment
Your fertility specialist and clinic will give you injections of fertility hormone that will stimulate your eggs in your ovary and grow. Your ovarian response will be monitored by the clinic nurses and doctors with blood tests and pelvic ultrasound. If your follicles have the appropriate growth size (18 – 22 mm), the decision is made to remove the eggs from your ovaries.
By the way, these hormone injections are the same FSH – follicle stimulating hormone that is used in the ovulation induction fertility treatment. Again, don’t be afraid of these FSH injections, they are simple and you will be shown how to use them by the staff.
The IVF egg retrieval
Your eggs are removed from the stimulated follicles in your ovary through a twenty to thirty minute procedure. You may be sedated for this or have it under local anesthesia or general anesthesia. Afterwards, you may feel some crampy menstrual pain that may last a day. The eggs are then placed with the sperm in the laboratory for fertilization. The fertilized eggs are then divided and developed into embryos
The IVF embryo transfer
The embryo transfer is a simple procedure; it takes about ten to fifteen minutes. It’s very similar to having a pap smear – with the speculum going into your vagina to visualize the cervix. The best quality looking embryo is chosen on that day to go back into your uterus through a small plastic tube. It is usually recommended for patients to grow the embryos for up to 5 days where they should then be more than 100 cells and have a higher chance of implantation. Also, on day 5 of embryo growth, you can then choose the best embryo to be transferred back.
Two weeks later you return to the clinic for the pregnancy test and it can often feel like a very long wait.
Many women say that this is actually the hardest part of the IVF treatment (the waiting time to see if the IVF treatment is successful).
IVF process: how you can feel
Continue each fertility treatment can be a roller-coaster ride, but more so with IVF, especially if it is more involved, more time-consuming, plus you expect higher pregnancy chances.
So of course expectations are often higher.
You may start excited and then end disappointed if pregnancy is not successful, especially if you have to repeat the treatment. So it’s important for you to have some kind of support around you, or practices in place to help you stay grounded and focused and still live and love life.
- Here are some other feelings you may have: Moody or sensitive feeling especially while on the injections
- Headaches, especially if you are prone to them
- Bloodiness in your abdomen as your ovaries grow. Your clothes may feel tight, especially after the eggs are removed in the first two weeks, many women feel that their belly is so big that people mistake them for being pregnant. This tends to happen when a lot of eggs are collected from the ovary…and I’m talking about twenty or more.
- Period like cramping pelvic pain after egg collection and sometimes in the next two weeks
- Your breasts will feel larger and may also be tender to the touch
IVF success: What are the chances of pregnancy with in vitro fertilization treatment?
IVF gives the highest chance of pregnancy for you compared to all other PCOS fertility treatments.
But it will depend on:
- Your age
- Your general health such as your weight and whether you have diabetes or insulin resistance.
- How well the laboratory handles your eggs, sperm and embryos in the IVF clinic where you are.
- The quality of your embryos.
- The number of embryos returned to your uterus
- Whether you have other fertility factors, such as having the condition called endometriosis, or male sperm problems that can affect chances
In general though you female agewhich correlates with the age of your eggs will be related to your chances of pregnancy and IVF success. The younger our age, the younger our eggs are and therefore the greater the chance of pregnancy. The older we are, the older our eggs are and the smaller the chance. of IVF success So you can see that for us women time is important in taking action for our fertility. Delay can lead to less results and regrets.
On average with one embryo returned, for women under 38 the chance of pregnancy is about 35 – 40%. For women between 38 and 40 years of age, the chance can vary between 25 – 35%. For women over 40 the chances are less than 20%.
What are the possible IVF side effects of IVF treatment?
IVF treatment has many of the same possible side effects as ovulation induction treatment with FSH. Some of the feelings may be worse because the dose of the FSH hormone is greater and therefore the ovaries are more stimulated and larger.
The risk of multiple pregnancy is another IVF side effect and will depend on the number of embryos transferred back to the uterus.
Myself and most fertility specialists would recommend transferring only 1 embryo. By inserting 2 embryos, the chance of twins is in the order of 20%.
Many couples tell me that they would like to complete their family by having twins. And although it sounds like a nice outcome, the reality is that many IVF babies from multiple pregnancies deliver earlier than the due date, and because of their prematurity can unfortunately end up with a bad outcome by developing the brain damage called Cerebral Palsy.
But generally if you need IVF, don’t be afraid. Many women with PCOS undergo in vitro fertilization treatment and have a baby. Of all the possible fertility treatments, it does give the highest chance of a pregnancy.
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