Isha Ambani Piramal, a businesswoman and the daughter of Reliance Industries chairman Mukesh Ambani, made the decision to demystify and normalise in-vitro fertilisation (IVF), a process in which the sperm and egg are united in a lab setting, by claiming to have undergone the treatment herself. Furthermore, the Reliance Foundation chair Nita Ambani, her mother, followed the same path. The truth is that there are a lot of misconceptions around IVF that must be dispelled.
The most frequent misconception I’ve heard is that since embryos are frozen, abnormal birth defects may result. The most crucial elements for a healthy birth, according to Dr. Anjali Malpani—one of the pioneers of IVF in India and one of the first to perform egg retrieval in 1998—are patient education and access to the correct clinic and physician.
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When do you Recommend IVF?
IVF is recommended for couples facing infertility due to low sperm count, blocked fallopian tubes, endometriosis or any other medical condition. IVF should be done only after assessing the medical condition and tests of the intending parents.
How simple is the process?
It is quite simple. Fertility medications are used to stimulate your ovaries to produce multiple mature eggs. Then a minimally invasive procedure is performed to collect them and the sperm from the donor. Once the eggs are fertilised and become embryos, we monitor for several days as they grow and divide. Once a healthy count is ready, one or more healthy embryos are carefully inserted into your uterus through a thin catheter. If implantation occurs, the embryo attaches to the lining of your uterus and pregnancy begins.
Are fertility injections painful?
Now we use technologically advanced thin needles, which are not painful at all. In fact, all our patients take these injections at home. They are that safe and fuss-free.
Does a woman have to suspend her normal activity during the procedure?
Not at all. Home injections have even cut down their trips to the clinic. The injection is first given on Day 2 of your period cycle. On Day 7 of your cycle, we do sonography and blood tests for monitoring. On day 10, if eggs are ready, we give the trigger injection of pregnancy hormones. We retrieve the eggs 36 hours after the trigger injection. So everything gets done in 10 to 12 days. After retrieval, the woman can go back to work. After implantation, we recommend a two-day rest.
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Any side effects of hormone injections?
There are no side effects of hormone injection and that has been proven by medical research. Many fear cancer in later years. But that doesn’t happen.
What about risks?
Women with PCOD (polycystic ovarian disease) may have hyperstimulation syndrome, which is an exaggerated response to hormones. She may overproduce eggs, more than 20, and a huge amount of estrogen-rich fluid that spills into her abdominal cavity. Usually women require hospitalisation to drain this fluid out. But now there’s a special technique during egg collection with a double lumen needle, which allows us to flush each follicle meticulously and ensure no more than 15 eggs are produced.
Other risks are multiple pregnancies (eg, twins or triplets), or ectopic pregnancy, where the embryo implants itself outside the uterus and inside a fallopian tube and has to be terminated.
What’s the success rate and how many cycles can a woman undergo?
For women less than 35, the success rate is 45 per cent. There is no physical harm in trying out IVF cycles as long as you can afford to do them emotionally and financially. Remember, each cycle can cost Rs 2-3 lakh.
Why do IVF cycles fail and what to do then?
Failure happens because of poor egg quality, sperm-related issues, faulty embryo development, implantation failure, hormonal imbalances, uterine abnormalities and underlying health conditions such as endometriosis or polycystic ovary syndrome (PCOS). Additional IVF cycles can be done with donor eggs or embryos.
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How can a woman improve her chances of success with IVF?
Just follow your doctor’s recommendations, maintain a healthy lifestyle, including a balanced diet and regular exercise, avoid smoking and excessive alcohol consumption and manage stress levels. Take folic acid about two months before.
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