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How To Make IVF Successful The First Time

How To Make IVF Successful The First Time

What is IVF treatment?

In vitro fertilization (IVF) is one type of the Assisted Reproductive Technology (ART) refering to a complex procedure designed to overcome infertility and produce a live birth as a direct result of the intervention.

In an IVF cycle, in approximately a two-week interval of time the ovaries are stimulated with a combination of fertility medications, oocyte(s) are retrieved from ovarian follicles, and these oocytes are fertilized in the laboratory ("in vitro") with sperm. The fertilized eggs develop into embryos in the IVF laboratory. The resultant one or two of the embryos are transferred into woman's uterus, where it is hoped that one will implant and produce a pregnancy.

Why the success rate in IVF treatment is so important?

IVF treatment is a very difficult process with emotional ups and downs and coping with this situation can often be difficult. This period is particularly difficult if the couple has been trying to conceive for a long time, if the treatment is not covered by insurance, or if the couple has other medical, family or business and financial problems.

What is the success rate of IVF treatment?

IVF has a reasonable rate of success in most cases. A complete cycle includes all fresh and frozen-thawed embryo transfers resulting from one egg collection.

Overall, the average success rate of IVF procedure is 35-40% and approximately 30 percent of IVF cycles will end in a live birth, and the cumulative chances of success are higher when more than one cycle of IVF is done. The cumulative live birth rate in women under age 35 is 50%. However, for women ages 42 and older, 3.9% of the egg transfers resulted in a birth. 

Which factors IVF success depend on?

The chances of giving birth to a healthy baby after using IVF depend on various factors, including the woman's age, cause of infertility, and treatment approach, ovarian reserve, sperm quality, response to ovarian stimulation, where you're having the procedure done, whether eggs are frozen or fresh, whether eggs are donated or are your own.

1-Response to ovarian stimulation

Approximately 10 percent of cycles are discontinued before egg collection. A cycle may be cancelled if there is poor or excessive ovarian response. The cancelation rate increases with increasing the woman’s age.

Poor response: A poor responder woman is a woman in whom her ovaries require large doses of medication for stimulation but produce less than an optimal number of oocytes. The woman might have a poor ovarian response:

  • After going through an IVF cycle or,
  • She might be expected poor responder based on her older age and a pre-cycle abnormal test of ovarian reserve.

High or excessive response: Individuals with a high response to ovarian stimulation produce large numbers of mature oocytes and/or high estradiol levels. Modification of the stimulation protocol is important to avoid ovarian hyperstimulation syndrome (OHSS).

2- Impact of endometrial receptivity on pregnancy rate

Although controlled ovarian stimulation increases the number of oocytes obtained, it also appears to inhibit endometrial receptivity to some degree. The most likely reason for diminished endometrial receptivity is the premature increase in progesterone that occurs with all forms of ovarian stimulation. The magnitude of the effect on endometrial receptivity is not clear, and embryo quality also likely plays a role.

3- Embryo quallity

Transfer of embryos that are good quality is associated with higher pregnancy rates compared with less quality embryos. However, not all embryos survive the development process.

4- Women age

Younger women are more likely to get pregnant and give birth to a healthy baby using their own eggs during IVF treatment.

5- Reproductive history

Women who have given birth before are more likely to become pregnant with IVF treatment than women who have never given birth. Women who have not been pregnant with more than one IVF treatment cycles have a lower chance of success.

6- Cause of infertility

Women who have severe endometriosis are less likely to be able to get pregnant with IVF treatment than are women who have unexplained infertility.

7- Lifestyle factors

Smoking reduces the success of IVF by 50%. Women who smoke have fewer eggs retrieved during IVF and may miscarry more often. Obesity, alcohol, recreational drugs, excess caffeine, and the use of certain medications can also reduce your chances of getting pregnant and having a baby.

How To Make IVF Successful The First Time?

When IVF treatment is decided to conceive, the couples need to prepare their physical and emotional health that can affect the success rate of the procedure. Your doctor will suggest the things you should do and things you should avoid.

The factors that you can change that make IVF treatment successful the first time are: https://ivftreatmentistanbul.com/blog/tips-for-couples-for-a-successful-ivf-treatment 

1- Weight (BMI)

Body mass index (BMI) is calculated by dividing weight in kilograms by height in meters squared (m2). BMI between 18.5-24.9 is considered in normal limits. The values lower than 18.5 is underweight and over 24.9 is overweight.

Pregnancy rate is found to be lower in underweight and overweight women undergoing IVF treatment compared to those with normal body weight. Obese women are more likely to have IVF cycle cancellation, lower pregnancy, and lower live birth rates. Overweight is associated with polycystic ovary syndrome (PCOS) which can lead to difficulties with IVF-ICSI treatment.

Overweight men are likely to be lower fertility related to some factors such as hormonal problems, erection problems and other health conditions linked to obesity. Loosing weight might increase total sperm count and quality. As sperm production takes about three months, weight loss is suggested at least three months before IVF treatment.

A healthy diet and exercise plan with your partner will increase your chances of getting pregnant and having a healthy baby. https://ivftreatmentistanbul.com/blog/diet-for-ivf 

2- Sperm health

Maturation of a sperm stem cell in the testis to become a last stage fertilizing sperm takes about 3 months. Men can help to boost their sperm numbers and as well could improve the quality and this can have a beneficial impact on IVF outcome.

Factors those improve sperm quality:

  • Maintaining a healthy weight,
  • Use of multivitamins,
  • Staying physically active,
  • Eating a well-balanced diet,
  • Be started on vitamins and antioxidants.

Factors those decrease sperm quality:

  • Heavy drinking and cigarette smoking can lead to reduced testosterone production, impotence and can decrease sperm count/quality.
  • Increased scrotal temperature: scrotum exposure to warm objects, such as a laptop, saunas and hot tubs might hamper sperm production and sperm quality,
  • Using boxers over briefs,
  • Long period sitting.

3- Vitamins

Micronutrient supplements (especially antioxidant therapy) and vitamins such as zinc, copper, and selenium, as well as vitamin B, folate can affect the eggs and sperm quality and improve the fertile environment of the body and pregnancy rates. it is better to start the supplementing three to six months before to conceive.

4- Smoking

Smoking have a negative influence on fertility outcome. Smoking is related to a decreased likelihood of both IVF success and live birth following IVF treatment.

Men who smoke cigarettes are more likely to have low sperm counts and low sperm motility. Smoking increases DNA fragmentation. DNA damaged sperm may lead to problems with fertilization, embryo development, embryo implantation, and increased miscarriage rates. There is a risk of increased pregnancy loss with paternal smoking, which is most likely due to spermatozoal DNA damage.

Female smoking has an adverse effect on ovarian reserve. Nicotine ages the ovaries earlier than the expected time and causes eggs resistant to fertilization, the oocytes exposed to smoking in the past have decreased fertilization rates. Smoking also increases your risk for a miscarriage and can cause birth defects. Women who smoke need two times more IVF cycles to have a healthy baby.

Heavy drinking can lead to reduced testosterone production, and decreased sperm production. It is adviced to stop smoking and alcohool at least three months before starting IVF treatment.

5- Exercise

Moderate exercise (15-60 minutes) can reduce the risk of infertility, and improve sperm quality. Extreme exercise can cause infertility.

6- Fertility-enhancing foods

The food that is eaten affects the health of the eggs and sperm. Women can decrease infertility risk due to ovulation disorders by 80% with healthy dietary changes. It has been shown that fertility is improved with a diet centred around vegetables, fruits, plant-based proteins, whole grains, fish, monounsaturated fats, healthy fats like olive oil and nuts (mediterranean diet).

Factors that might reduce IVF success the first time must be corrected before starting the treatment:

  • The treatment of sexually transmitted diseases, pelvic inflammatory diseases, infectious diseases in both partners, and abnormal PAP smear before starting IVF is of vast importance.
  • Uterine polyps, fibroids, intrauterine adhesions, congenital uterine malformations, such as a bicornuate uterus, a T-shaped uterus, or a uterine septum must be corrected by either hysteroscopy, laparoscopy or open surgery.
  • Adenomyosis -Endometriosis in the womb. The presence of ultrasound diagnosed adenomyosis was associated with a significant reduction in successful implantation of good quality embryos in patients undergoing IVF treatment. Adenomyosis can be treated either with surgery or drugs before starting IVF treatment.
  • Hydrosalpinx in tubes is associated with poor IVF outcome. A preventive salpingectomy (removal of the fallopian tubes by surgery) can be recommended for patients with hydrosalpinges enlarged enough to be visible on ultrasound and in particular for those affected bilaterally.
  • Thyroid diseases, diabetes mellitus must be treated and TSH and blood sugar be regulated with drugs before starting IVF treatment.
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Prof. Dr. Nilgün TurhanIVF TREATMENT ISTANBULProf. Dr. Nilgün Turhan
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