How to make Test Tube Baby the right way? IVF treatment needs expertise and the right set up.

I recently interviewed Dr.Jayalakshmi Suraj and while talking to her a few things emerged. Listen to the podcast or watch the video and for more information don’t forget to read the post.

Dr.Jayalakshmi Suraj Medical Director and IVF coordinator, of Dreamflower IVF center talks in detail about what couples should know about healthy lifestyle practices when they are planning an IVF treatment. While talking to her a few things emerged.

Questions the Doctor answered

What is the average success rate of successful live births at the Dreamflower clinic?

What are the steps you take to help couples prevent IVF failure?

What can the couple do by themselves, to improve the emotional bonding while going through a tough process like IVF?

Where can the listeners connect with you for more information Doctor?

Children are definitely God’s blessings. Some people want children, and some are not yet in that space, and some definitely don’t want to. One of my friends delayed planning a baby for ten years. Then they tried the conventional way. It didn’t happen. Her Obstetrician,  checked them out found them, healthy and advised them to try some more. The baby still didn’t arrive. They went for IVF for 2 years, and my poor friend was a wreck. But she was yet to have a baby.

Now my friend and her hubby probably had something called an Idopathic variety of infertility. That’s when both partners are okay anatomically, physiologically, and still somethings not clicking. They finally did have two children, but that’s part of another story. But today, I will tell you about what you need to know if you are planning IVF.

Quick Fact: Only 25% of intercourse in healthy adults, even when timed, result in pregnancy. So implantation needs work. But what about IVF or in-vitro fertilization? How successful is it?

What is IVF treatment or In vitro fertilization ?

In simplest terms: When the union of the female egg and male sperm happens inside a petri dish in the laboratory,  under controlled circumstances, to increase the chance of creating a live embryo its called in-vitro fertilization or IVF. The embryo is frozen for future use or transferred into the uterus of the mother to be.

What is Test tube baby?

When an embryo is created inside a petri dish .test tube through IVF its  called a test tube baby.

The egg, sperm, the embryo can be yours and your partners or donated, depending on the medical profile of each couple.

In some cases, drugs to enhance fertility and intra-uterine  seminal injection may help, and IVF may not be needed. Every couple is unique, and your doctor will help you understand what will help you most.

What is Recurrent implantation failure?

Recurrent implantation failure is defined as the failure to achieve a clinical pregnancy, following the transfer of a minimum of four good-quality embryos in a minimum of three fresh or frozen cycles of a woman less than 40 years.

Quick fact: Higher the age of the mother, higher is the risk of Implantation failure

If you are thinking about IVF or having RIF, be aware of the tests needed and lifestyle changes you must make. Emotional preparedness will help you on this journey. Both partners must be positive about the process, and conflict should be resolved before starting. The women’s body is flooded with hormones during the process, spousal support is essential.

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What can be done for a successful IVF and prevent RIF?

Doctor at the IVF center may suggest

• A detailed blood workup including hormonal assays, Antiphospholipid syndrome screening
• Ultrasonography
• Hysteroscopy
• Endometrial Receptivity Assay(ESA)
• Platelet-rich plasma(PRP)

Depending on the couple, the success rate of IVF-ICSI can further be improved by egg donation, sperm donation, embryo donation, or surrogacy. You can visit a center like Dreamflower IVF clinic who are trying to bring joy in north Malabar with their work.

Listen to the services they offer. (Podcast embedded)

What you can ask the doctor:

Ask them about the team of doctors who will be treating you. Experience and qualification both are important.

1. Ask for data about successful live births following IVF.
2. Successful live births in couples with  RIF.
3. How they approach cases of RIF, and what can you do to increase the chances of having a baby.

9 Positive Lifestyle changes which will help make IVF successful

1. Obesity is linked to increased miscarriage rates and other complications of pregnancy.
2. Stop smoking, alcohol, and drug abuse.  This is recommended for both partners.  Caffeine intake should also be limited.
3. Don’t stress it.  Stress causes the release of the stress hormone cortisol, which is terrible for you in all sorts of ways.  If you confirm doing it, the good work is undone. If you stress about becoming pregnant, that’s a significant barrier to becoming pregnant. Relax, talk to your partner.  Enjoy cuddles and being emotionally intimate.  The love in a relationship makes the baby-making fun.
4. Stay active, fit with a healthy average.  Underweight or overweight both can cause significant problems. Walking is a good exercise.
5. If you have a thyroid problem, diabetes mellitus gets checked and correct that before planning conception.
6. The truth is both the egg and sperm quality go downhill as women and men grow older.  Time waits for no one.  Quality and quantity both may be affected.
7. The timing: Know about your ovulation time.  From five days before ovulation till the date it happens, it is the most fertile period.  That’s about 10-14 days before your next period.
8. Staying positive will help as it floods your body with endorphins.
9. If you are sad about miscarriages and RIF: Please be kind to yourself

There is also an immunologic basis behind infertility. This means your immune system can help or hinder the process.  Creating an environment to activate the reward system can help.  Stop thinking about baby-making and focus on having fun.  Enjoy activities together or with friends to encourage positive interactions.  This helps boost up the immune system without medication or invasive procedures and can be done at home or anywhere you are comfortable.  Creative hobbies, travel, visit a park, nature walk, meeting friends, can help boost positivity.  This can be tailored to your hobbies and habits and could be a significant first step.

What are the causes of Repeated Implantation Failure?

Its a complex mix of anatomical, endocrine, immunological, hematological, and endocrinological and genetic causes.

First, you have to find out what is causing the problem?

The uterus needs to be assessed. Inadequate uterine receptivity causes an average of two-thirds of implantation failures. The embryo itself is responsible for only one-third of these failures [1].

The two main factors in this are

1 )Maternal  factors

• Uterine anatomic abnormalities are:
• Other Common Maternal factors:
• Septate uterus
• bicornuate uterus
• Uterine fibroids, especially submucous type
• Endometrial polyps
• Intrauterine adhesions
• Hydrosalpinx.

This is a complex area. But uterus distorting lesions which can prevent implantation may need to be treated in case of RIF.

• Thrombophilia
• Connective tissue disorders
• Non-receptive endometrium(uterus lining not sticky enough to hold on to the baby)
• Immunological factors

2)Embryological factors are :

Genetic abnormalities or other elements of the embryo that reduces its ability to get attached and develop in utero. When miscarriages happen in the first trimester, this is more likely to be a  chromosomal anomaly making the embryo nonviable.

Embryo abnormality occurs due to either paternal sperm factors, or egg, and also its ability to being fertilized regularly and cleave. The abnormal karyotype of the embryo is a significant reason for implantation of failure as well as miscarriage.

About Preimplantation Genetic diagnosis: Should you do it?

If you are facing RIF, you and your partner may be advised to undergo karyotype testing to rule out balanced chromosomal translocations, genetic counseling. But there is inadequate data to justify routine preimplantation genetic testing.

IVF is a complex topic and needs a detailed understanding of the physical, emotional, financial, and legal implications before going for it.

Conclusion:

Repeated implantation failure can occur due to many reasons related to the couple and Technology. From the age of mother to  timing of collection of eggs, quality and quantity of eggs collected, Quality of sperms, Chromosomal issues, Idiopathic causes.

But don’t be disheartened. A positive outlook helps in more ways than one.  Look for a center equipped to handle situations like yours. 

Before choosing a center, ask for data related to successful live births after IVF. Having access to such information may empower you to make a more informed decision.

Successful implantation is multifactorial. It depends on a tango between a working endometrium and a healthy embryo. Any abnormality in one or both these variables can cause repeated implantation failure. The condition should be assessed for its different causes and be treated accordingly. In all cases, a good doctor and a good set up can help you.

Make baby joyfully.

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References

Homer, H. A. (2019), Modern management of recurrent miscarriage. Aust N Z J Obstet Gynaecol, 59: 36-44. doi:10.1111/ajo.12920

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Recurrent pregnancy loss: A summary of international evidence-based guidelines and practice

Ying Hong Li   Anthony Marren 

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Nepomnaschy PA, et al. Cortisol levels and very early pregnancy loss in humans: Proc Natl Acad Sci U S A; 2006. p. 3938–42.

Bashiri, A., Halper, K.I. & Orvieto, R. Recurrent Implantation Failure-update overview on etiology, diagnosis, treatment and future directions.  Reprod Biol Endocrinol 16, 121 (2018) doi:10.1186/s12958-018-0414-2

https://www.ncbi.nlm.nih.gov/pubmed/24269084

Biomed Online.  2014 Jan;28(1):14-38. doi: 10.10

16/j.rbmo.2013.08.011. Epub 2013 Sep 14.

https://rbej.biomedcentral.com/articles/10.1186/s12958-018-0414-2

Recurrent implantation failure: definition and management.

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