This week , we will be talking about Success rates in ART.
Assisted Reproductive Technology refers to treatments and procedures that aim to achieve pregnancy. It works by removing the eggs from a woman’s body, fertilize it with a sperm to make an embryo and place the embryo into the woman’s womb. It could also be the stimulation of a woman’s egg without being removed and injection of sperm cells into the the eggs. Various types of ART include: In Vitro fertilization (IVF) which is the most common, Intrauterine Insemination, Gamete Intrafallopian, Intracytoplasmic sperm injection. Before and after the first successful baby that was born through IVF, there has been successes and failures of ARTs. Success rates is calculated with clinical pregnancies and live births. There is great success rate over the years with advancement in technology. Though ARTS can be expensive and time consuming, it has allowed couples to have children that otherwise would have not been conceived. The most common complication of ARTS is multiple fetuses but this is a problem that can be prevented or minimized in several ways. GIFT is recommended with patients with normal fallopian tubes and adequate sperm and has more success rate than IVF but IVF is mandated with patients with abnormal fallopian tubes and ICSI is mandated with patients with low sperm concentration.
Success rates is however dependent on: age, reason for infertility and where the procedure was carried out. A woman’s age is a major factor in the success of ART when women are using their own eggs. Success rate declines as women’s age specifically after the mid 30’s. Part of the decline is due to lower chance of getting pregnant from ART and part is due to higher risk of miscarriage with increasing age especially over the age of 40.
Success rate vary with number of embryo transferred. However, transferring more embryos does not increase the chance of live birth significantly but may only increase the risk of a multiple pregnancy with its associated risk. The impact of the numbers of embryos transferred also varies with the age of the woman.
IUI has lower success rate per cycle than IVF. In IUI: the sperm washing is done which helps to separate the stronger and healthier sperm from weak sperm, toxins that hinder pregnancy are removed. The strong, healthy sperm at concentrated into a high volume and inseminated in the uterus before ovulation. IUI success rate increases on a cummulative basis. It allows the woman’s body to do more on its own. IUI success is dependent on: age of female, obesity of female, duration of infertility, male factor infertility: low sperm count or decreased motility, abnormal reproductive system of a woman and abstinence. It simply places healthy sperm around as close to the fallopian tubes as possible, giving them a bit of a head start towards the eggs. On average, a woman under 35 years would have a 10-20 % chance of pregnancy with each IUI while a woman over 40 years will have 2-5%. The peak IUI effect is around three to four cycles. Couples are advised to go IVF after these amount of IUIfailed cycle.
Gamete Intra Fallopian Transfer (GIFT)
GIFT was the only acceptable ARTS procedure acceptable to the Roman Catholic Church. It is a surgical procedure where eggs and the sperm are placed are placed in the fallopian tube using a thin flexible tube. The eggs in the fallopian tube becomes fertilized by the sperm and move to the uterus where it will mature. Fertilization takes place in the body rather than in a Petri dish and it requires a surgical procedure. It is rarely used.
Zygote Intra fallopian Transfer (ZIFT)
In ZIFT, the sperm and egg are mixed together in the laboratory, fertilization takes place and It It placed in the fallopian tube.
It is important to note that patient characteristics vary among programs; therefore success rate shouldn’t be used to compare treatment centres.
In some ART procedures, fresh semen and embryos have more success rates than frozen – thawed semen and embryos.
General factors that affect Assisted Reproductive Technology
Age: ARTs has been used successfully to help women at every stage of their reproductive life, so you should never let your age stop you from exploring IVF as an option. While age has been statistically tied to success rates. Physical body and medical history are unique. In consultation with the doctor, the results of comprehensive blood and ultrasound testing are a better indicator of your candidacy for ARTs than age alone.
People who have been pregnant before and have carried a baby to term, either with or without ART, you may have a greater chance of getting pregnant again with IVF.
Recurrent miscarriages can be an indicator of less success, because it may indicate that the particular infertility challenge you are facing is not one that responds well to IVF. If you have suffered previous miscarriages you should not rule out IVF automatically. Your doctor will be able to help you narrow down the probable causes of pregnancy loss and can advise you on your best course of action.
………………………………. To be continued