Do you really need IVF? What happens if you need IVF, but you don’t want to do IVF? These are pertinent questions that the average infertile couple is bound to ask.
It is a common assumption that if you are unable to get pregnant, IVF treatment is the infallible solution. In reality this is not so.
Ideally, a small percentage of couples with infertility will ultimately require IVF.
When it comes to those in need of IVF, people generally fit into one of two categories.
These are those for whom IVF is their only option for a biological child, and those who have not had success with lower tech treatments.
There are instances in which IVF is the first and only option to have a biological child.
In a situation that you have severe tubal disease, for instance, if both fallopian tubes are blocked, IVF is your only option for a biological child.
The fallopian tubes are the pathway that connects your ovaries to your uterus. If an egg released from your ovaries can’t reach the uterus—and sperm can’t get to the egg—you can’t get pregnant.
There are instances in which surgical repair of the fallopian tubes can avoid the need for IVF. However, success rates vary considerably, and it’s not always a good option for most women with severe tubal disease.
Another instance for IVF is severe male infertility. These are cases of severe male infertility, intrauterine insemination (IUI) with a sperm donor or IVF with Intracytoplasmic Sperm Injection (ICSI) may be your only option for biological children.
With basic IVF, sperm cells are placed in a petri dish with an egg. Eventually, one of the sperm cells will hopefully fertilize the egg.
With IVF-ICSI, one single sperm is injected directly into an egg. IVF-ICSI is necessary in cases of severe problems with sperm motility (movement) or morphology (sperm shape.) It may also be required if the sperm count is very low.
IVF is widely utilized and effective in couples where there is zero sperm count known as Azoospermia. Most affected men can still have a biological child through IVF-ICSI combination.
What happens is that immature sperm cells are biopsied directly from the testes. The sperm cells are then allowed to mature in the lab. Sperm cells that matured this way can’t fertilize an egg themselves, and IVF with ICSI is required for conception.
If you and your partner are at high risk of passing on an undesirable or deadly genetic disease, IVF may be your best or only option. For couples that are experiencing recurrent miscarriage due to genetic problems, IVF with Preimplantation Genetic Screening (PGS) or Preimplantation Genetic Diagnosis (PGD) is ideal.
PGS is when an embryo is generally checked for normal chromosomal counts and PGD entails an embryo tested for a particular disease e.g. Sickle Cell disease or any other inherited diseases. If you have frozen eggs, ovarian tissue, or embryos, you’ll need IVF to conceive with that cryopreserved tissue.
Frozen sperm cells can be used via an IUI procedure and may not require IVF. However, if there is a small amount of preserved sperm cells, IVF may be a better choice due to the increased success rates.
If a woman is missing her uterus either because she never had one or it was removed for medical reasons, she won’t be able to conceive or carry a pregnancy. She may be able to have a child via a gestational carrier/ surrogacy.
If the woman in question has her ovaries intact, or she has cryopreserved eggs or ovarian tissue, she may also be able to have a biological child with the help of a gestational carrier.
If not, an egg donor may be used along with the biological father’s sperm cells. All of this requires IVF.
The point to stress here really is that there is no treatment map that fits every couple perfectly. Therefore, it’s not possible to say what your personal path to IVF may look like.
Some couples may require surgery before they try any fertility treatments. Some may first need to treat an underlying medical condition. Some may never need fertility treatments.
If you’re wondering when IVF may become the next step in your personal circumstances, speak to your doctor. If you disagree that IVF should be the next step, or you are curious if you have alternative options, don’t be afraid to get a second opinion before making a decision. Deciding to pursue IVF is a big decision.
You always have the option not to pursue IVF, whether it is the first treatment recommended by your doctor, or you only are facing IVF after several attempts of non-assisted reproductive technologies.
You may not want to do IVF as a result of financial inability, or the wish to avoid risks and invasiveness of the procedure among others.
Sometimes, you will have no chance of having a biological child without IVF. In other cases, your odds of conception may be low, but not impossible.
For example, if you a woman with primary ovarian insufficiency (POI), you may unlikely conceive on your own. But you shouldn’t assume your infertility diagnosis will keep you from conceiving on your own naturally.
If you don’t want IVF, there are other possible options available, but if you decide to pursue further lower tech cycles, or try alternative treatments, discuss with your doctor the actual odds of treatment success.
If you require IVF treatment, but you are concerned about costs, explore available options for financing. However, if you don’t want to do IVF, it’s not the end of the road. There are other options to explore e.g. adoption.
Abayomi Ajayi
MD/CEO Nordica Fertility
