HealthPregnancyExpert Talk: Dr Tomar On Everything You Need To Know About IVF...

Expert Talk: Dr Tomar On Everything You Need To Know About IVF In India

As a treatment for infertility and genetic problems, many couples find themselves considering In-Vitro Fertilisation (IVF) if they haven’t had success with Intra-Uterine Insemination (IUI) or getting pregnant naturally. This assisted pregnancy treatment can be emotionally, physically and financially challenging, but it also has the highest success rate for couples who aren’t able to conceive. And while younger women may still have the option to try fertility drugs and IUI as the primary resolve, IVF is the most obvious option for those attempting a late pregnancy (women above 40).

Now, if you’ve seen the Kareena Kapoor and Akshay Kumar starrer movie Good Newwz, you may feel a little more comfortable and informed about IVF as a fertility treatment. The light-hearted Bollywood flick was the first to bring this topic into mainstream cinema, which is a game-changer considering most Indian couples who get IVF feel uncomfortable acknowledging the assisted pregnancy due to societal pressure.

So for all those moms-in-waiting, we’ve roped in Dr Sushma Tomar, Infertility Specialist & Endoscopic Surgeon, Fortis Hospital, Mumbai. She’s here to normalise and answer everything you need to know about IVF treatments in India.

1. What Is In-Vitro Fertilisation? How Does The Treatment Work?

Picture Credit: Times Of India

“In a nutshell, IVF is ‘Assisted Reproductive Technology’ (ART). In-Vitro Fertilisation (IVF) is the process wherein the egg and sperm are fertilised outside the body. This is needed as a treatment for some infertile couples who cannot conceive naturally. The process needs lots of counselling about the procedure, success rate, expenditure, and complications. If couples are ready and prepared for it, we then do some tests of both the husband and the wife; according to the reports, an IVF treatment cycle is planned. For every patient, the line of management is different. The whole process takes about 2 months right from starting the medication, stimulation, egg retrieval, transfer of egg, and finally getting the end result to see if you’ve succeeded.”

2. Who Is A Good Candidate For In-Vitro Fertilisation?

“Different factors come into play when determining whether the couple is a good fit for IVF. In India, it is often presumed that the woman is the cause of infertility. However, IVF and most fertility tests and treatments clearly put the onus of being able to conceive on both partners. For example, for IVF here are some things to consider when assessing if the couple is a good candidate:

  • A couple has been having trouble getting pregnant because the woman has Polycystic Ovary Disease (PCOD/PCOS) or advanced Endometriosis.
  • Absence or very low sperm count in the husband
  • Advanced age of either/both the wife and the husband, because hormone levels drop as you get older
  • History of multiple miscarriages because of genetics
  • Previous history of genital tuberculosis that may have damaged the Fallopian tubes”

3. What Is The Success Rate Of IVF & How Does It Compare With IUI?

“Intra-Uterine Insemination (IUI) involves placing sperm inside a woman’s uterus to make her pregnant. The idea is to increase the number of healthy sperm that reach the Fallopian tubes and increase the chances of fertilisation. 

IVF, on the other hand, is done outside the body. The egg and the sperm are fertilised in a highly advanced lab under the most favourable conditions to improve the success rate and not leave fertilisation to chance in our body. The embryos are then transferred back into the uterus after three days. If they are of good quality, they will grow and implantation will take place. This highly moderated environment is what improves your chances of a successful pregnancy with IVF.

It is well-known that IVF has a ‘much better’ success rate than IUI. It is about 40%-45% per cycle (compared to 5%-20% per cycle in IUI). 

A lot of factors matter though. The success rates for both depend on the quality of the husband’s sperm, the patient’s age, hormonal levels, uterine receptivity, previous history of tuberculosis and endometriosis, and many other variables. 

As you grow older, the success rate reduces, so instead of seeking multiple different opinions from different doctors year after year, IVF should be done in time.” 

4. Does An IVF Pregnancy Come With Higher Risks?

“Usually, most IVF pregnancies are and should be treated as high-risk pregnancies. This is because successful implantation is not the ultimate goal; it is to carry the pregnancy to term successfully. 

With IVF, the miscarriage rates are higher than if you were to conceive a child naturally. Sometimes multiple pregnancies may occur, which is not necessarily the desired outcome for some couples with financial constraints. Also, multiple pregnancies may not all make it to term necessarily either. Additionally, low birth weight, ectopic pregnancy, and birth defects are common with IVF-assisted reproductive technology. 

But the truth is, despite the risks, couples looking to have a child still consider this option because of its success rate when all other fertility treatments fail. You have to decide if the risks are something you’re willing to take.”

5. Are There Any Recommended Lifestyle Changes To Prepare The Body For IVF?

“Yes, lifestyle changes are often recommended to get your body to the most optimum level possible, for treatment endurance and success. These may include:

  • If you are overweight, the doctor will advise you to lose weight with diet and exercise using an expert so that your nutrition is not compromised.
  • If you have any infection like Tuberculosis, TORCH, or Vaginitis, it should be treated beforehand. 
  • Diabetes or hypertension should be treated beforehand as well. 
  • If the couple is consuming alcohol or smoking, it should be stopped immediately. 
  • Your food should be nutrient-rich to improve your fertility.
  • Caffeine and certain drugs should be avoided when you are planning for pregnancy, your doctor will guide you with an exhaustive list.”

6. How Soon After An IVF Cycle Can You Take A Pregnancy Test To Confirm The Results?

“The pregnancy test should be done 14 days after the embryo transfer. You can always take a home pregnancy test but you should get it confirmed with a blood test as well. At the lab, the HCG (Human Chorionic Gonadotropin) hormone is tested in the blood. If it comes positive, it should be repeated after two days to confirm whether it’s doubling or not. Sometimes you may see a positive result in a home pregnancy test but the lab result may differ or the doubling may not happen.”

7. What Is The Average Cost Of A Single Cycle Of IVF?

“The cost of an IVF cycle is variable. It’s determined case-by-case based on the additional treatments and medications required to make both partners good candidates for the procedure.  Also, customisation of each cycle is done according to the patient’s needs. 

An average cycle can cost you between Rs 1.5 lakh to Rs 2 lakh in India.

The truth is, in the quest for having a child, there’s no shame in relying on modern medicine and science to conceive. It’s not how you have a baby that makes you a parent; it’s the selflessness of wanting to have a child and being willing to dedicate your life to this unborn human being that makes you a parent (in waiting, until you become one). “

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