Motherhood is a blessing for every woman. Every woman dreams of becoming a mother someday. But due to many factors, they sometimes fail to conceive a baby. But it can be affirmed that in the current times with the progress of medical science everything has become possible, even attaining motherhood.
On the occasion of World In Vitro Fertilisation (IVF) Day on 25 July, our Fit North East Staff Reporter had an Exclusive Interview with Dr Jutimala Bardoloi Bhattacharya, renowned Gynaecologist and Obstetrician from Guwahati who is also an infertility specialist over the last 10 years. Dr Bhattacharya has answered some questions related to infertility treatment and IVF.
Fit North East: What is IVF in simple language?
Dr Bhattacharya: Firstly to know more about IVF, it is necessary to know what infertility is. If a woman or a couple is not being able to conceive after trying naturally for a period of one year or maximum of two years then it can be a matter of concern. It is generally seen that 80 to 90 per cent of couples conceive naturally in two years and if they don't conceive, then they are labeled as infertile. IVF is just a treatment modality for infertility.
Fit North East:: What may be the reasons behind infertility?
Dr Bhattacharya: There can be various reasons for infertility. It can be a malefactor, a female factor or can be both. Late marriage might be a big hindrance towards parenthood. Physical issues (in the case of women) like having a fibroid, polycystic ovarian syndrome, thyroid, obesity, pelvic pain, menstrual abnormality, workload, stress, smoking and drinking and a sedentary lifestyle add to the reasons for being infertile.
If the couple is unable to conceive in one or two years of effort they need to be tested. The cause should be diagnosed and proper treatment should be started. Infertility can be treated if detected at the right time. In the case of women, the age factor is very important. After 35 years of age, fertility comes down.
Fit North East: When is it important to approach a doctor?
Dr Bhattacharya: If the age of the woman is more than 35, she is unable to conceive naturally, she suffers from the irregular menstrual cycle, has fibroids and has some issues like obesity, blood pressure, diabetes and thyroid, she can approach a doctor. Another very common cause of infertility these days is the presence of chocolate cyst or endometriosis, which can be corrected by a simple laparoscopic surgery.
It is important to note that it may not be necessary for every infertile person to go through IVF. Sometimes a simple lifestyle modification (like weight reduction, correction of thyroid hormones) can make natural pregnancy happen. IVF is the last option in hand.
Fit North East: What are the preventions and precautions to be kept in mind prior to plan a pregnancy?
Dr Bhattacharya: When people are preparing for pregnancy, it is advised to follow a healthy lifestyle and nutritious diet. Through weight reduction, the process of conceiving becomes even easier. It does not need any kind of treatment. It is highly advised to stay away from drinking and smoking. Smoking has a direct impact on semen quality.
When a couple is unable to conceive naturally, they finally take the help of IVF, which can also be considered the last option. In IVF, egg and sperm is put in a Petri dish and is fertilized to make embryos outside the human body in incubators.
It is necessary to take folic acid at least 3 months prior to conception as it can help prevention of major birth defects, neurotic defects, miscarriages and improves fertility. For women, it is extremely important to take folic acid during pre-natal period.
Fit North East: What does a woman need to conceive naturally?
Dr Bhattacharya: A woman has to have eggs (a good ovarian reserve). After 35, the ovarian reserve starts falling. Ovulation is a must. The semen parameter should be good. A woman needs to have open tubes (patent fallopian tubes) as the fertilization of the egg and the sperm happens in the fallopian tubes. These factors are integral for conception. If there is a lack in either of the factor, there might be difficulty in conceiving naturally.
It was even added that women are born with a fixed number of eggs at birth. We have 1 million eggs during birth; it reaches 4 lakh by the time of puberty. The production of eggs is also controlled by our brain.
Fit North East: Please tell us about the process of IVF.
Dr Bhattacharya: When a couple is unable to conceive naturally, they finally take the help of IVF, which can also be considered the last option. In IVF, egg and sperm is put in a Petri dish and is fertilized to make embryos outside the human body in incubators. The sperms are collected through masturbation and the eggs are extracted from the lady. Once the embryos are made, it is transferred into the uterus of the women at an appropriate time (which is called embryo transfer).
When we talk about embryo transfer, there are two types. One is the fresh embryo transfer and the other is frozen embryo transfer. Fresh embryo transfer can be done after 3 days from extracting the eggs and on day 5 (also known as a blastocyst) in which the implantation and pregnancy rate is higher.
Frozen embryo transfer is the process when the embryo can be implanted at any time within or before 5 years of embryo production. In such a case the embryo is preserved in liquid nitrogen which prevents the embryo from damage.
In the case of patients with PCO (Polycystic Ovary Syndrome), there is a risk of hyper-stimulation, if they become pregnant in a fresh cycle. So, frozen transfer is one on PCO cases.
The ovarian stimulation starts on day 3 of the period and injection is started on that day and continued up to minimum of 10-12 days. The ovaries are stimulated by injecting hormones. The eggs are visible on the 3rd day. On the day when eggs are matured, another injection called 'Trigger' is injected after which helps in retrieving the eggs through a small surgical procedure that is done under sedation. This is done through the transvaginal route under sonographic guidance. After the extraction of the eggs, it is put in a Petri dish. On the same day, the semen is also collected from the husband.
Fit North East: What is the perfect age to undergo an IVF pregnancy?
Dr Bhattacharya: There is no fixed age of IVF but it is determined by the age of the women and the indications for why they are opting for IVF. It can be done at any age until eggs are available. The lining of the uterus (endometrial) is very important. If there is a problem there, the success will be below. If the chance of miscarriage in normal pregnancy is 3 to 4 %, it is almost 7 to 8% in IVF pregnancy. The miscarriage rates are due to the quality of the ovum and the semen. Since IVF is done mostly in cases of poor ovum and poor semen, so there is a chance that there may be a poor egg.
Fit North East: Are the people of Assam and the rest of the northeastern region aware of IVF?
Dr Bhattacharya: Definitely they are aware but due to various (social) conditions, they hesitate to say openly that they took the help of IVF. But some openly say. It can be said that in the entire North East, people have accepted IVF and it is becoming popular day by day.