What are some of the main advantages of in vitro fertilization?

In vitro fertilization (IVF) is the most widely used assisted reproductive technique today in the face of sterility.

Both types of IVF, classic IVF and IVF-ICSI (intracytoplasmic sperm injection), allow many women to achieve pregnancy, even if they have serious problems with male or female infertility.

IVF has great advantages over low-complexity treatments such as artificial insemination (AI), although it may also have some drawbacks.

Advantages of IVF

IVF treatment consists of ovarian stimulation of the woman in order to obtain a greater number of eggs and, thus, fertilize them in the laboratory with the semen of the couple or an anonymous donor if this is the case.

Then, the development of the embryos obtained in culture is observed and, finally, the best embryo is transferred to the woman's uterus to achieve pregnancy.

Advantages in the IVF process

This whole process, although technically very expensive, has multiple advantages and, therefore, IVF is the most widely used fertility treatment in all fertility centers.

Currently, 42% of the cycles initiated in Spain are IVF. In the following section, we are going to discuss their advantages compared to other techniques such as AI.

Success rates

The likelihood of pregnancy with IVF is much higher than with AI.

These are the success rates obtained according to the latest report of the SEF (Spanish Fertility Society) corresponding to the year 2021 for each established age range and using fresh eggs and the couple's own sperm:

Women <35 years

the gestation rate per IVF-ICSI cycle is 42.7%, while the gestation rate per AI cycle is 14.3%.

Women 35-39 years

the gestation rate per IVF-ISCI cycle is 35.0%, while the gestation rate per AI cycle is 13.1%.

Women ≥40 years

the gestation rate per IVF cycle is 22.3%, while the gestation rate per AI cycle is 6.4%.

Success rates of IVF vs AI

Evidently, in women of advanced maternal age who already have low oocyte quality, the success of IVF begins to be compromised and, therefore, it will be necessary to apply complementary techniques such as preimplantation genetic diagnosis (PGD) or egg donation to achieve pregnancy.

Requirements

To perform IVF, the eggs are obtained directly from the ovary by means of a follicular puncture. This allows patients with blocked fallopian tubes to be able to perform this treatment without affecting the success rate.

The same is true for women with tubal ligation who do not have tubal permeability. The only possible treatment for these sterilized women who regret the decision made in the past is IVF.

IVF with tubal obstruction

On the other hand, IVF does not require regular menstrual cycles or spontaneous ovulation, as all this is controlled with hormonal medication.

Embryo quality

One of the most important advantages of IVF is that it allows us to observe the evolution of embryos from fertilization to day-to-day transfer.

This makes it possible to evaluate certain parameters of their morphology that are related to quality, such as the following:

• Quantity of cells:
• Percentage of fragmentation
• Symmetry
• Quantity of nuclei:
• Others: vacuoles, zona pellucida, cytoplasm, etc.

Parameters to evaluate embryo quality

With this, a degree of quality is assigned to each of the embryos with the aim of selecting the one that has the best chance of implantation.

For more information related to this topic, you can read more here: Embryo Quality & Grading.

Vitrification

Vitrification is a freezing technique used on eggs and embryos that ensures very high survival rates, which has greatly optimized IVF cycles.

After ovarian stimulation and fertilization in the laboratory, several embryos are obtained that may be suitable for transfer to the maternal uterus if they are of appropriate quality.

Besides, vitrification allows the cryopreservation of surplus IVF embryos for future embryo transfers if the first one is not successful or, on the other hand, to have a second child in the future. In these cases, only one endometrial preparation treatment would be necessary, without having to go through the entire IVF process.

Vitrification of supernumerary embryos

In addition, egg vitrification is the technique used to preserving fertility of women who decide to become mothers later. In this way, it is ensured that the oocyte quality is good at the time of IVF and the pregnancy rate is not affected by age.

If you want to read more about this freezing technique, you can access the following post: Freezing and vitrification of gametes and embryos.

PGD

Those couples who need to perform PGD in their embryos, both because of the risk of transmitting a genetic disease to the offspring and because of possible chromosomal alterations that give rise to miscarriages, will necessarily have to undergo IVF treatment.

In fact, the technique used to make a PGD is IVF-ICSI, which has more added advantages than conventional IVF.

PGD allows the identification of embryos with some mutation in their DNA, which are discarded, and ensures the transfer of genetically healthy embryos to the uterus of the future mother.

PGD and embryo selection

You can find out all the details about this treatment in the following article: What is preimplantation genetic diagnosis?

Severe male factor

In order for a natural pregnancy to take place, it is necessary for the male to have optimum seminal quality, with a high concentration of mobile spermatozoa and with good morphology.

When these parameters are greatly affected, resulting in severe male infertility problems, the only possible technique to ensure gestation is IVF-ICSI.

For example, IVF has allowed men with the following fertility problems to become fathers today:

• Oligozoospermia
• Astenozoospermia
• Teratozoospermia
• Azoospermia
• Vasectomized men
• Infertile males from chemotherapy or radiation therapy

Alterations in semen quality

Men who have a total absence of sperm in the ejaculate, whether due to vasectomy or other sterility problems, will have to obtain the sperm sample through an epididymis biopsy or testicular biopsy. Since these spermatozoa are of very poor quality, fertilization will necessarily have to be carried out by microinjection of sperm.

ICSI in cases of severe male infertility

Men who are going to undergo cancer treatment it is important that they first preserve a sperm sample in order to remain frozen and use it in the future if they wish to become parents.

These frozen semen samples can be used for both AI and IVF. However, since they are considered valuable semen samples, it is more common to perform an IVF in order to have a greater probability of success.

FAQs from users

Does it have any advantage to perform IVF with PGD if there is no medical indication?

It is always one more tool that will provide us with more information. This technique allows us to select chromosomally normal embryos and, therefore, increases the pregnancy rate for each embryo transferred and reduces the risk of miscarriage.

What are the advantages of AI over IVF?

Artificial insemination is usually the first treatment to apply when patients go to a fertility clinic, because it is simple, fast and painless. Furthermore, compared to IVF, the ovarian stimulation process is much smoother, which reduces possible side effects and treatment costs.

Higher doses of hormonal medication as well as surgical intervention under anesthesia to obtain the eggs are the main disadvantages of IVF. The final price of the treatment is also much more expensive for all the material, personnel and technology required.

I have had 4 unsuccessful artificial inseminations, what advantage do I have if I switch to IVF?

The pregnancy rate is much higher in IVF when compared to intrauterine insemination cycles. Through IVF, the quality of both the eggs and the embryos can be evaluated and with this the information on the prognosis is more realistic.

When three or four inseminations have failed, the ideal is to move on to IVF. This technique will save time in achieving gestation and may have the additional advantage of freezing embryos that can be used in subsequent pregnancies, thus overcoming one of the main conditioning factors in fertility, which is the age of the patients.

Knowing when to stop performing inseminations is a virtue that is highly valued by any reproductive specialist and this moment will depend on many factors such as the age of the couple, the diagnosis, the quality of the semen or the presence of pathologies such as endometriosis, among others.

Are there any advantages or disadvantages to ICSI treatment compared to normal IVF?

The conventional IVF and ICSI processes are the same in terms of the treatment, medication and process that the patient must follow. In this sense, there are no advantages or disadvantages to doing one or the other method.

The only difference takes place in the laboratory in the way in which the egg and sperm are joined (fertilization). Conventional IVF is less invasive than ICSI, as it is the sperm themselves that have to enter the egg by their own means. This brings us closer to the biological process, allowing the natural selection of those sperm with the greatest reproductive potential and, therefore, with the greatest possibility of giving rise to a viable embryo capable of developing into a healthy child.

In ICSI, for its part, a spermatozoid is introduced into the ovum in a forced way by means of microinjection. This makes the fertilization rate higher than in the case of conventional IVF.

Although the cost of IA is a considerable advantage for me, should I rather opt for IVF when having a non-permeable tube?

While it is true that the cost of artificial insemination is a distinct advantage over IVF, priority should be given to the probability of success. With only one permeable tube, the possibility of pregnancy with artificial insemination is reduced, so it would be necessary to assess whether it is advisable to perform AI or IVF.

It is advisable to take into account all the advantages and disadvantages when choosing the technique to be applied.

What are the benefits of in vitro fertilization for human beings?

In vitro fertilization allows pregnancy in many women and couples who wish to have a child and do not achieve it naturally. It is the main reproductive medicine technique for solving serious male and female fertility problems and is currently used in 42% of infertile patients.

Is there a high probability of having twins with IVF?

One of the general disadvantages of assisted reproduction treatments is the increased likelihood of twin pregnancy due mainly to the process of ovarian stimulation and the practice of transferring more than one embryo after IVF.

For this reason, the transfer of a single embryo is increasingly encouraged today, with the aim of reducing the multiple pregnancy rate and the risks involved. In the last 10 years, the double birth rate has already been reduced by 8% after assisted reproduction treatment.

Are there any drawbacks to IVF?

Of course. Although IVF IVF has great advantages compared to other fertility treatments such as AI, it also has some drawbacks.

First of all, the effectiveness of IVF treatment is not 100%, as it is also important to take into account aspects such as the woman's age, the quality of the gametes, etc.

On the other hand, IVF can lead to multiple pregnancy, which poses risks for the woman and the fetuses.

In addition, IVF treatment requires the patient to be administered hormonal medication to stimulate the development of multiple ovarian follicles. These drugs could lead to the development of ovarian hyperstimulation syndrome. Therefore, some women experience dizziness, nausea, abdominal pain, etc. during IVF treatment.

Recommended reading

Artificial insemination and in vitro fertilization treatments are usually compared to find out which is best for each patient. If you want to read more information about the differences between the two processes, you can click here: What are the differences between IA and IVF?

On the other hand, IVF also has some drawbacks that must be taken into account when undergoing treatment. You can consult them here: Problems in In vitro fertilization.