We can see that in today’s society, people who want to have children often cannot, while those who do not want children can easily have them. Many times, women who want to have children face disappointment because they become “infertile couples”. In vitro fertilization (IVF) is considered another solution that helps increase the chances of having children for this group of patients.
What is in vitro fertilization?
It is fertilization outside the body, where a woman’s egg and a man’s sperm are combined outside the body through scientific processes. Normally, a woman ovulates only one egg per month, which comes from the competition among many small eggs from both ovaries during menstruation. Eventually, the best egg that is fully mature and ready to ovulate is selected to be fertilized—only one egg per cycle!
However, if we wait for nature to select only one egg to ovulate, the chance of having a child in one menstrual cycle is very low. Therefore, IVF requires hormone injections to stimulate the ovaries at the beginning of the menstrual cycle to allow many small eggs that start competing to mature simultaneously. When the eggs are fully mature, they are collected in full quantity, increasing the chances of obtaining more embryos. Therefore, “if naturally there is only a chance of one egg ovulating, IVF increases the chances many times over.”
Once the eggs are collected, they are fertilized with sperm and the embryos are cultured for about 3-5 days to select the best quality embryos. After that, the embryos are transferred back into the uterus. Before transfer, it is recommended to check the chromosomes to see if the embryos are normal because good growth and quality do not guarantee normal embryos, especially for women over 35 years old, men with severe sperm abnormalities, or those with a history of more than two miscarriages.
The IVF process consists of..
Egg stimulation > Egg retrieval > Fertilization > Embryo culture for 3-5 days > (Chromosome check) > Embryo transfer into the uterus
There are 2 types of embryo transfer:
- Fresh embryo transfer is transferring the embryo 3-5 days after egg retrieval. After 7-9 days of transfer, the result will show whether the embryo has implanted and if pregnancy has occurred. However, fresh transfer has disadvantages such as bloating, abdominal distension from ovarian stimulation injections causing swollen ovaries, and abnormal hormone levels compared to natural cycles. These conditions may make the body less suitable for embryo implantation, reducing the success rate of fresh embryo transfer.
- Frozen embryo transfer is when embryos obtained from a fresh cycle are frozen and stored. When the body is ready, the embryos are thawed and transferred later. Frozen transfer usually occurs about 3 weeks after menstruation, and the pregnancy result is known 7-9 days after transfer. This method has a higher success rate than fresh transfer. However, if the laboratory is not up to standard, problems during thawing may reduce embryo quality and success rates compared to fresh transfer.
Post-embryo transfer care
You should rest as much as possible and avoid any impact or trauma to your abdomen. Avoid fast walking, running, or exercising for now. Even sitting and straining during bowel movements for a long time can cause uterine contractions, making embryo implantation difficult. The belief that you must lie still and not move at all is not entirely correct. You can lie on your side, turn left or right, or lie face down. Even going up and down stairs is allowed but walk slowly and avoid strong impacts. Eat soft foods, avoid spicy foods, and be careful not to have diarrhea. Drink water frequently to reduce straining from constipation. These measures can increase the chances of embryo implantation.
Dr. Panya Saksangwong
Specialist in Reproductive Medicine
Infertility Treatment Center, Phyathai 2 Hospital