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IN VITRO FERTILIZATION

Article  in  Journal of Biological and Scientific Opinion · December 2013

DOI: 10.7897/2321-6328.01425

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Review Article
IN VITRO FERTILIZATION
Abid M*, Rupali, Islam G, Gahlot K, Khan NA
School of Pharmaceutical Sciences IFTM University, Lodhipur Rajput, Moradabad, U.P., India

Abstract
*Correspondence In vitro fertilisation is now established technique for treating some forms of infertility, yet it
Abid M remains controversial due to its associated undesirable effect to mother as well as to child. The
School of Pharmaceutical Sciences IFTM University, aim of study is to aware the person who is going for IVF treatment about all the procedure,
Lodhipur Rajput, Moradabad, U.P., India current status in India including success rate, live birth rate and all the relevant negative effects
of the treatment to mother including fertility drugs used in the treatment and their side effects
on body, ectopic pregnancy, ovarian hyper stimulation syndrome, cervical cancer, increased
DOI: 10.7897/2321–6328.01425
risk of blood clot. IVF treatment has also a negative impact on child including heart problems,
neurological problems, birth defect etc.
Article Received on: 31/10/13
Keywords: In vitro fertilisation, ovarian hyper stimulating syndrome, fertility etc.
Accepted on: 30/11/13

INTRODUCTION Method
The World Health Organization (WHO) has defined sterility In this process after the natural ovulation the content from the
as an illness, if the respective couples have a desire for a woman`s fallopian tube or uterus are removed and mixed
child1. False perceptions are hindering access to new research with a viscous fluid consisting of secretion of accessory gland
on IVF2. IVF is a technique to solve the female infertility in with sperm and then the content is reinserting into the uterus.
the woman which is due to the suffering of fellopian tube or The IVF procedure is organized in five steps:
there is difficulty in fetilisation by in vivo process. IVF is a 1. Super ovulation: The woman is given fertility medications
major treatment in which an egg is fertilised by sperm outside in order to produce more than one egg per month as she
the body. This method is used when the other fertility usually does.
treatments have unsuccessful. In this process the woman’s 2. Egg Retrieval: Collection of eggs from follicle.
ovulation process is checked and the ova or egg is removed 3. Insemination: The sperm is mixed with the egg in a
from the woman`s ovary and then letting sperm fertilise them propitious environment or they inject the sperm directly
in a fluid medium in a laboratory. Then the fertilised egg that into the egg.
is known as zygote is relocated to the woman`s uterus. Louise 4. Embryo formation: After the egg is fertilized it becomes
Brown was born as a result of natural cycle IVF. Robert G. an embryo. After another 5 days the embryo's cells start
Edwards, the physiologist who developed the treatment, was dividing.
awarded the Nobel Prize in Physiology or Medicine in 20103. 5. Transferring the embryo in the woman's uterus: A tube
which contains the embryo is inserted in the vagina,
through cervix and into the uterus4.

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 Abid M et al. Journal of Biological & Scientific Opinion · Volume 1 (4). 2013

The following matter is to be taken into consideration · Pulmonary embolism occurred in 8 women out of every
· Patient should be aware about drugs and the IVF 10,000 who have IVF
procedure Fertility medication or hormones are prescribed · Compared with six out of 10,000 who get pregnant
to encourage the follicle production before IVF procedure naturally9.
patient must aware about those fertility hormones or
drugs and associated side effects using in IVF treatment. Ectopic Pregnancy
· Patient should aware how fertilisation takes placeprocess In-Vitro Fertilisation (IVF) and Intrauterine Insemination
either has been performed naturally or by using ICSI and (IUI) have increased risk of ectopic pregnancy. Ectopic
resultant effects pregnancy occur when the substantial embryo implants
· Patient should aware about risk with an IVF procedure somewhere outside the woman's womb. When the embryo
such as great pain called as ovarian hyper stimulation and grows outside the woman`s womb the life threatening
side effect of anaesthesia that is nausea and occasionally situation may occur for both mother and foetus. According to
bleeding. National Health Service data, 95 per cent of ectopic
· Patient should aware about the success rate of IVF pregnancies results due to the embryo remains in the
process5. fallopian tube - even though ectopic pregnancy can occur in
the cervix (the neck of the womb), the ovary and the
Drugs used in IVF and Their Effects abdominal cavity. Due to this affected organ will rupture and
In IVF procedures medicines are generally used to prepare cause severe haemorrhage generally, an embryo cannot
body for treatment so that increase the probability of more survive an ectopic pregnancy and therefore treatment always
healthy eggs is released from ovaries but have serious side requires the removal of the embryo10.
effects also on both child and mother both. They are
· Increased rate of multiple birth Neurological Problems inKids
· Increased incidence of miscarriage Low birth weight, premature birth and minor problems
· Burning flashes, vomiting with brain progress have all been co -related
· Headache or blurred vision with fertility treatments, which include IVF as well as
· Depression and mood swings complicated insemination techniques. In the latest study
investigating the association, published online in the journal
· Ovarian cysts and pelvic discomfort from overstimulation
Archives of Disease in Childhood, researchers report that the
of the ovaries
latter may be largely responsible for the neurological
Medicines are generally used are Clomiphene citrate, Follicle
differences documented among children born via fertility
Stimulating, Bromocriptine, Cabergoline and Gonadotropins-
treatments11.
Releasing Hormoneetc6.
Safety Precautions after IVF
Possible Risk Associated with IVF Treatment
Women should take proper safety precautions to avoid
Multiple pregnancies
complications after undergoing IVF. Following your doctor's
Multiple pregnanciesare a greater risk appears in IVF which
guidance after IVF treatment is also a must. Read on to know
carries important risks to both the mother and the infants as
about essential safety measures after IVF. If you have
compared to singleton pregnancies. Due to multiple
undergone IVF you need to take proper safety measures so
pregnancies Medical complications are increased and include
that it increases the chances of IVF becoming successful.
an increased high blood pressure (pre-eclampsia) and ante
Here are some safety precautions which you should take after
partum haemorrhage (bleeding before the onset of labour).
your IVF12.
There is also a risk of growth retardation in infants and
· Avoid vigorous activities which involves forceful bodily
greater risk of premature birth in twins7.
movement
Maternal risks related with multiple pregnancy · Avoid heavy workout and exercises
· Miscarriage · Keep away from smoking
· Haemorrhage · Try to avoid the caffeine as much as possible
· Pregnancy induced high blood pressure · Avoid indulging yourself in a sexual intercourse
· Diabetes · Avoid lifting heavy weights
· Anaemia · Avoid involving yourself in the activities like aerobics
· Polyhydramnios (excessive amounts of amniotic fluid that · Avoid consuming alcohol or alcoholic products and
surrounds the foetus) drinks
· Prolonged hospitalization resulting in higher cost of · Do not take sunbaths and avoid swimming
medical care8. · Stay away from tough household work.

Increases blood clot IVF - Chance of Success

Pulmonary embolism is a leading cause of maternal death. According to NHS (National Health Service) data in 2010,
The study, published on bmj.com, took data from 23,500 the percentage IVF treatments that resulted in a live birth (the
women who had IVF and 117,000 women with natural success rate) were13:
pregnancies and found that: · 32.2 % for women under 35
· 4.2 % out of every 1,000 women who had IVF suffered · 27.7 % for women aged 35-37
blood clots · 20.8 % for women aged 38-39
· 13.6 % for women aged 40-42

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 Abid M et al. Journal of Biological & Scientific Opinion · Volume 1 (4). 2013

· 5 % for women aged 43-44

· 1.9 % for women aged over 44

success rate
35.00%
30.00%
25.00%
20.00%
15.00%
10.00%
5.00% success rate
0.00%

Success rate of in vitro fertilization according to National Health Service data in 2010 in India

IVF Influencing Factors bill and rules-2008 which is drafted by Ministry of Health
Age and Family welfare and the Indian Council of Medical
While younger women have higher chances of IVF success. Research15.

Previous pregnancy IVF Baby’s Birth Problems

If women were pregnant previously with the same partner There many problems associated with IVF baby’s birth.
that’s currently undergoing IVF treatment, there is a greater These are malformed limb or organ, congenital abnormality,
probability of IVF success. Factors such as a history problems in musculoskeletal malformations, genitals, and the
of recurrent miscarriage or a different partner may reduce the digestive and neurological systems16. The risk of a premature
chances of IVF success. birth is roughly doubled, according to Dutch researchers and
there may be a slight rise in the risk of death after birth.
Type of fertility problems There was partial evidence of a three times increased risk of
Very important to know the IVF success factors are having a very premature baby born prior to 32 weeks
dependent on ovulation. Ovarian dysfunction, like high FSH gestation. There was also a higher risk that IVF babies would
levels which indicate a low ovarian reserve, may reduce the be "small for dates" - that is, not weighing as much as would
chances of IVF success. Factors that may lower pregnancy normally be expected for a baby born after a similar-length
rates and reduce success with IVF include needing large pregnancy17.
amounts of ovulation stimulation drugs. When both partners
are infertile with lower chances for IVF success, factors such Who Needs IVF?
as the length of time you have been infertile is important to For some situation, such as tubal factor, Fallopian Tube
consider. The chances of IVF success decrease with the Damage/Tubal Factor, Male Factor Infertility, Endometriosis,
amount of time a couple has been infertile14. Unexplained infertility and genetic problem18.

IVF Scenario in India Limitations of IVF

In India there is an unprecedented and unregulated growth of The limitations that are appropriate to natural fertility also be
ART clinics providing IVF procedures over the years within relevant to IVF treatment. Though IVF can give older women
the frame work of medical tourism. IVF is the latest addition. a better chance of getting pregnant than natural fertility, it
Low cost, easy access and easy availability and economical does not overcome the fall in fertility that is seen when
prices of. India is estimated to be doing currently 80000 women usually reach their late 30’s and early 40’s - if a
cycles per year. To be more precise it is estimated that 70000 woman’s eggs are of poor quality or there are none left, the
to 85000 Ova pick up and 90000 to 95000 as embryo transfer only option will be to use donor eggs. Success with IVF also
and it is expected that the growth of IVF in India is growing relies on a woman responding to the drugs. If she does not
at the rate of 10-15 % every year. The estimated number of respond, the ovaries will only produce one egg as usual,
clinics in India is almost 500 and going up every day and which greatly reduces the chance of success. Generally, IVF
with such high growth and potential in IVF segment has will not be useful if a woman has suffered from
attracted close consideration of the Government. Also easy miscarriages19.
availability of Surrogate mother, gamete donors have made
India a favoured destination for various IVF procedures Reasons IVF Should Always be the Last Option
especially Surrogacy. The resulting surge of the ART · Injected fertility drugs can influence women to
Industry in the country has posed a number of ethical, legal, chromosomal irregularities and are linked to increased
social and moral dilemmas and the Government is working risk of uterine cancer, ovarian cancer and fatal
towards bringing regulation in form of all ART regulation abnormalities.

Published by Moksha Publishing House. Website www.mokshaph.com · © All rights reserved. Page 400
 Abid M et al. Journal of Biological & Scientific Opinion · Volume 1 (4). 2013

· The Telegraph mentioned on 24 Apr 2012 about a French · Some surgery may be required
research which concluded that IVF drugs were linked to · Some can increase the chances of having a multiple
childhood cancer. pregnancy
· The same newspaper had mentioned on 25 Jul 2010 that · Some may increase the risk of miscarriage and preterm
the risk of women dying during pregnancy increases more labor23.
than threefold after IVF.
· A recent study from the Netherlands show that overall CONCLUSION
rate of death in IVF pregnancies was higher than the In Vitro Fertilization are not embedded in one single aim but
maternal death rate in the general population (42 mothers’ founded upon several opinion, Taken together, these
deaths per 100,000 IVF pregnancies compared to 6 deaths arguments are all the more compelling to reject IVF as a way
per 100,000 pregnancies overall)20. of alleviating the problem of infertility due to its resulting
side effects to mother as well as to baby. IVF treatment is
How to Improve the Success Rate in IVF normally carried out by specialist and well qualified
There many ways by which we can increase the success rate personnel; still having complications which depends on many
in IVF technology. These are factors. Despite the fact that the IVF treatment has its share
· Reducing Stress of disadvantages, the treatment has had its fair portion of
· Diet success rate, moreover, in many cases, it is the only
· Exercise alternative for the couple, affected by infertility. IVF and
· Acupuncture21 ICSI intra cytoplasmic sperm injection technologies have
· Preimplantation Genetic Screening etc22. reached a generalized level where they are widely known and
performed, but still not even the status of genetic risks is
Alternative to IVF clearly known. Furthermore, concerns about the risk to
The three most popular alternatives to IVF include: mother including multiple pregnancy, ectopic pregnancy,
· Gamete Interfallopian Transfer (GIFT) – similar to in ovarian cancer, cervical cancer, ovarian hyper stimulating
vitro fertilization but fertilization of the egg takes place syndrome and have studied also the risk to child including
inside the fallopian tubes. This creates a more “natural” birth defect, neurological problems etc. In India IVF is a
method of conception and is preferred by many couples developing technique success rate is found to be moderate on
who have not had success with traditional IVF. the age group of fewer than 35. Although IVF is a developing
· Zygote Intrafallopian Transfer (ZIFT) – unlike IVF, the treatment for infertility still have a various limitations and
fertilized eggs are placed back into the fallopian tubes major side effects so that it should be last choice when all the
alternative treatments for infertility are failed.
instead of in the uterus. Women must have healthy
fallopian tubes in order to enjoy success with this IVF
REFERENCES
alternative. 1. Rowe PJ, Comhaire FH, Hargreave TB. WHO Manual for the
· Tubal Embryo Transfer (TET) – this IVF alternative is Standardized Investigation, Diagnosis and Management of the Infertile
almost identical to the ZIFT procedure, but the embryos Male. Cambridge University Press, Cambridge, UK; 2000.
2. Nature Publishing Group Editorial – Cheap IVF needed. Nature; 2006.
are transferred back to the woman at a much later stage of p. 442, 958–958
development23. 3. Fertility: assessment and treatment for people with fertility problems.
· Surrogacy is a non-direct medical alternative to traditional NICE clinical guideline CG156 http://EzineArticles.com/599334; 2013.
IVF treatment. Surrogacy comes in two forms. In the first, 4. http://www.dailymail.co.uk/health/article-197979/How-IVF-affects-
body.html; 2013.
Traditional surrogacy a woman agrees to be artificially 5. http://americanpregnancy.org/infertility/infertilitymedications.html;
inseminated with donor sperm and carries the baby to 2012.
term. The surrogate female is directly related to the baby, 6. http://www.coastalivf.com.au/risks-21.htm, Coastal IVF, Level 4,
its mother. Esplanade and Second Avenue, Maroochydore - Sunshine Coast, QLD,
Australia.
· Gestational surrogacy involves implantation of both 7. Georgina M Chambers, Mbathio Dieng, Elizabeth A Sullivan, Yueping
sperm and egg from the patient and their partner into the Alex Wang. Australian Institute of Health and Welfare National
surrogate and the child is then carried to term. The Perinatal Statistics Unit. Australian Institute of Health and Welfare and
the University of New South Wales; 2009.
surrogate is not related to the child as it is direct offspring
8. IVF blood clot alert: Women pregnant as a result of fertility treatment
of the patient and their partner. These methods can be have higher embolism risk. Daily Mail; 2013.
discussed with qualified medical staff24. 9. http://www.genea.com.au/Library/Fertility-Treatments/Assisted-
conception/IVF/More-About-IVF/Things-to-be-aware-of-with-IVF;
2011.
Advantages to IVF Alternatives 10. http://news.yahoo.com/fertility-difficulties-linked-kids-neurological-
· May offer higher success rates than traditional IVF problems-study-suggests-223441677.html. By Rachael Rettner, My
procedures Health News Daily Staff Writer; 2013.
· Some can mimic the natural conception process 11. http://www.indiaparenting.com/fertility-issues/50_2822/safety-
precautions-after-ivf.html; 2013.
· Popular choice by couples who have not been able to 12. http://www.hfea.gov.uk/fertility-clinics-success-rates.html; 2010.
conceive for at least a year, or after five to six cycles of 13. American Pregnancy Association: Infertility: In Vitro Fertilization;
ovarian stimulation with intrauterine insemination 2009.
14. http://www.alphaeart.com/ivf-india.php; 2013.
· Physician select only the best embryos 15. http://www.naturalnews.com/035676_birth_defects_IVF_babies; 2012.
16. http://news.bbc.co.uk/2/hi/health/3420265.stm; 2004.
Disadvantages of IVF Alternatives 17. http://www.shadygrovefertility.com/who-needs-ivf; 2010.
· May not be appropriate for women who have damaged 18. http://www.ivf-lings.co.nz/Where-Did-I-Come-From-.aspx
19. http://homeopathyclinic.co.in/safe-ivf-treatment-clinic-mumbai; 2013.
fallopian tubes or tubal blocks 20. Article Source: http://EzineArticles.com/; 2013.

Published by Moksha Publishing House. Website www.mokshaph.com · © All rights reserved. Page 401
 Abid M et al. Journal of Biological & Scientific Opinion · Volume 1 (4). 2013

21. http://www.nejm.org/doi/full/10.1056/NEJMoa067744; 2007. Cite this article as:

22. www.locateadoc.com/article/alternatives-to-ivf Abid M, Rupali, Islam G, Gahlot K, Khan NA. In vitro fertilization. J Biol
23. Article Source: http://EzineArticles.com/3503035 Sci Opin 2013; 1(4): 398-402 http://dx.doi.org/10.7897/2321-6328.01425

Source of support: Nil; Conflict of interest: None Declared

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