What are the risks of IVF? What are the disadvantages of IVF when it grows up?

Although IVF can help couples who cannot conceive naturally to achieve their wish, the risks and costs of IVF are great, and the process is also painful. So what are the risks of IVF? What are the disadvantages of IVF when it grows up? Let's learn about it together~

"Testing for a baby" is risky and requires adequate preparation

"People are becoming more and more accepting of IVF, but from clinical experience, many patients are very ignorant of the technology and do not know that it has risks. Some patients think that it is okay to have children at an older age, as they can have IVF anyway, but they do not know that IVF is not something that can be produced by spending money." Lin Yun said that the technology of IVF is constantly improving, and the success rate of a single attempt is about 50%. If the attempt is repeated, the success rate will be further increased, but despite this, there are still cases of failure. According to statistics, among the patients who underwent IVF at the Reproductive Medicine Center of Guangdong Provincial People's Hospital, about one-third of them failed in repeated implantation.

Lin Yun said that the reasons for repeated failures include: poor physical condition, old age, taking medication for endometriosis, and being very nervous. "If you want to increase the success rate of the baby test, you must do it as early as possible. The reproductive function of women over 35 years old is getting worse year by year. You must also have a correct mentality during the baby test. Excessive nervousness will increase the risk of miscarriage."

Even infertile women whose physical conditions permit still bear considerable risks during the IVF process and need to be fully prepared in advance. The risks are mainly reflected in the following aspects:

First, the risk of ectopic pregnancy increases. The probability of ectopic pregnancy caused by IVF technology is 2.6 times that of natural pregnancy.

Second, multiple pregnancies increase the risk of fertility. In order to ensure conception, patients over 35 years old who undergo a baby test can place three embryos at a time, and those under 35 years old can place two at a time. For this reason, up to 30% of those who undergo a baby test will give birth to twins. However, the National Reproductive Committee solemnly stated that multiple pregnancies are actually a complication. Lin Yun introduced that if the mother is pregnant with a single fetus, the burden will increase by 30% to 40% compared to usual, and if she is pregnant with twins, the burden will increase by 60% to 80%. Such a "burden" is not something that all pregnant women can bear.

Third, some pregnant women who undergo IVF technology will be allergic to drugs. This is because after too much ovulation induction, "ovarian hyperstimulation syndrome" will occur, especially in those who have polycystic ovary syndrome. These pregnant women need to receive albumin treatment while doing IVF.

1. Modern artificial assisted reproductive technology - test tube babies, deprives sperm of the opportunity to compete and may pass on the Y chromosome with microdeletions, which can easily cause miscarriage, stillbirth, congenital malformations and other defects.

2. If a woman's body is not suitable for pregnancy, such as endocrine disorders, corpus luteum insufficiency, or a history of miscarriage, even if the IVF procedure is successful, miscarriage may still occur.

3. Ethical issues may arise. The irregularities in underground sperm banks have increased the ethical issues of artificial insemination. Some institutions do not strictly control sperm, and the source of sperm is unknown. The quality of the fetus cannot be guaranteed.

4. Increased risk of multiple pregnancy: Pregnant women with multiple pregnancy have many complications, high incidence of premature birth and perinatal mortality, and belong to the high-risk pregnancy range. Therefore, both doctors and patients hope to have a single pregnancy, or at most twin pregnancy.

5. High cost-effectiveness, that is, the cost of obtaining each offspring is high: one artificial insemination costs 20,000 to 30,000 RMB, and the pregnancy rate is 15%. If it is repeated multiple times, the pregnancy rate can be increased to about 37%, or even higher;

6. It has a great impact on women's physiology. Stimulating ovulation leads to low ovarian response, which is prone to premature ovarian failure, amenorrhea in young women before the age of 40, and ovarian insensitivity syndrome. Ovarian hyperstimulation syndrome: blood concentration, decreased blood volume, oliguria, ascites, pleural effusion, electrolyte imbalance, hypercoagulable state, liver and kidney damage, thrombosis, adult respiratory distress syndrome, and even death. The incidence rate is 0.6%-14%. 7. Test-tube babies created through artificial insemination are three times more likely to suffer from cerebral palsy at birth than babies born through natural insemination.

Preliminary inspection preparation

Various examinations are conducted on both husband and wife to determine whether they are suitable for IVF and to serve as the basis for subsequent medication plans.

Common examinations for women: hysterosalpingography, B-ultrasound monitoring of follicular development and endometrial conditions, blood hormone levels, blood type, liver and kidney function, infectious indicators, chromosome karyotype analysis, etc.

Common examinations for men: semen routine examination and sperm morphology, infectious indicators, chromosome karyotype analysis, etc.

Time: 2-3 months

Superovulation

After the preliminary preparations are completed, you can enter the formal IVF cycle. Taking the antagonist or short protocol as an example, the medication is usually started on the 2nd to 4th day of the menstrual period. The use of ovulation-stimulating drugs can give those small follicles that would otherwise be atretic a chance to develop, so that 8 to 12 mature eggs can be obtained in one menstrual cycle. We call this super ovulation.

Time: Continuous injections for 9-12 days

Night Needle

When the follicle develops to a certain size (usually 18-20mm in diameter), you can get an ovulation injection (usually HCG, injected around 9 pm) to promote further development and maturation of the egg. We call it the night injection, and the eggs will be retrieved 36 hours later.

Important things should be said three times: Night needles are very important, very important, very important!!!

The night injection determines the final maturity of the egg and the best time for egg retrieval. The injection must be given at the time specified by the doctor, and the difference should not exceed half an hour.

Time: Usually around the 14th day of menstruation, around 21:00 that night

Egg retrieval (Day 0, morning)

The day of egg retrieval is called Day 0, which means the beginning of embryonic development. However, the egg and sperm on this day have not yet combined and cannot be called an embryo, so it is Day 0.

Egg retrieval process: Under the guidance of B-ultrasound, a long thin needle is used to puncture the ovary through the vagina, puncture the follicle, and suck the egg in the follicle into the test tube and send it to the laboratory. This process is the only invasive part of the IVF treatment. General anesthesia can be selected to reduce pain.

Time: Around 8 o'clock in the morning 36 hours after the night injection. The whole egg retrieval process takes 5-15 minutes.

Sperm collection (Day 0, morning)

While the eggs are being collected, the husband is arranged to collect sperm in a special sperm collection room.

Sperm collection method: The most common method is for the husband to masturbate and collect semen. This method does not harm sperm vitality and is not easily contaminated.

In vitro fertilization (Day 0, afternoon)

On the morning of the day of egg retrieval, the embryologist in the laboratory optimized the husband's semen, and in the afternoon selected an appropriate amount of high-quality sperm, incubated them with the eggs, and completed the in vitro fertilization process.

Time: Afternoon of egg retrieval day

Embryo culture (Day 1-6)

On Day 1 (the second day after egg retrieval, which is the first day of embryo development, and so on), observe and record the egg fertilization. Then observe the embryonic division and development every day and record and score it.

On Day 3 (8-cell embryos) or Day 5-6 (blastocyst stage embryos), select appropriate embryos for transplantation or cryopreservation.

Time: 1-6 days after egg retrieval

Embryo transfer

Embryos with good developmental potential are selected and transplanted back into the uterus through a flexible tube under the guidance of B-ultrasound. This operation is non-invasive and painless, and the whole process only takes a few minutes.

Time: The day when embryo culture is completed

Embryo freezing

If the woman's condition is not suitable for embryo transfer (such as overstimulation or thin endometrium), or there are still remaining embryos after transfer, the embryos can be frozen and stored in a liquid nitrogen tank at minus 196 degrees Celsius, waiting for the right time to revive and transplant.

Time: The day when embryo culture is completed

This is the general process of IVF. Throughout the process, it is relatively simple for the man, who only needs to cooperate with the examination (blood draw, semen routine, etc.), complete the sperm retrieval on the day of egg retrieval, and only need to go to the hospital about 3 times in total; the woman needs to pay a lot. In addition to the above examinations, she needs to take injections and medication every day during the superovulation process, and often go to the hospital for follow-up B-ultrasound and other monitoring of follicle development. Egg retrieval is also an invasive surgery, which will cause varying degrees of discomfort. After embryo transfer, it is necessary to continue to take injections to preserve the fetus until the pregnancy is confirmed and the embryo develops well, and then the medication can be stopped. During the whole process, the woman needs to go to the hospital for follow-up more than 10 times, which has a great impact on her work and life.