All You Need to Know about IVF
Sponsored Content by HealthPlus Fertility Center, Abu Dhabi
1. In simple terms, what is IVF?
In Vitro Fertilization (IVF) is a well-known method of assisted conception. The process involves hormonal stimulation and the monitoring of ovulation; eggs are collected with a simple needle-guided procedure and fertilised at the laboratory with a sperm sample collected from the husband. Once the embryos are ready, one or two of them will be transferred to the uterus.
2. What are the different reproductive surgeries and infertility treatments?
Currently, the available reproductive technologies include In Vitro Fertilization (IVF), Intracytoplasmic Sperm Injection (ICSI) and Intrauterine Insemination (IUI). The differences in simple words are: In IVF, sperms are mixed with the eggs to allow them to fertilise the eggs, while in ICSI the embryologist will select the best sperm and inject it directly into the egg – under the microscope. An IUI treatment involves the perpetration of the sperm sample and inseminating it in the uterus at the time of ovulation for the fertilisation to occur inside the body.
Some patients may benefit from reproductive surgeries such as hysteroscopic surgery for intrauterine pathology (polyp, fibroid or septum) and laparoscopic surgery for pelvic diseases such as endometriosis or ovarian cysts.
3. What is PGD? How important is it?
Preimplantation Genetic Diagnosis (PGD) testing is a procedure used prior to embryo implantation to help identify genetic defects within embryos fertilised through in vitro fertilisation to prevent certain diseases or disorders from being passed on to the child.
4. What is the percentage of patients suffering from fertility problems in the UAE and what is usually the cause of such problems?
Similar to international statistics, infertility problems are diagnosed in one in six couples as per World Health Organization (WHO) figures. The reasons behind infertility can involve one or both partners and include tubal blockage, low sperm count or motility, ovulation disorders and endometriosis. In some cases, it may remain unexplained.
5. Is IVF legal in the UAE? Who regulates it?
IVF is legal in the UAE and it is strictly regulated by the Ministry of Health, Abu Dhabi Health Authority and Dubai Health Authority. In the UAE, there are clear policies and procedures governing the practice of IVF and gamete storage; these regulations are also in line with almost all the known Islamic authorities.
6. How successful is IVF?
The success rate of IVF depends on the age of the female partner and cause of infertility; generally, with those below the age of 35, the success rate is around 45%, but this varies between centres.
We have successfully achieved these rates and higher at the HealthPlus Fertility Center over the past five years, starting with 600 treatment cycles during 2011 and expecting to perform over 2000 treatment cycles this year.
7. What are the risks and side effects?
Generally, IVF is a safe procedure. Risks include multiple pregnancy such as twin pregnancy which occurs in 20% of the cases. Another risk is Ovarian Hyper Stimulation (OHSS) which is rare, the percentage is only around 2%.
8. Who benefits from egg and sperm freezing? When should a person consider it?
Egg and sperm freezing is available and permitted in the UAE; it is very useful for those who are delaying their pregnancy for career or educational reasons. It is also very useful prior to chemotherapy or cancer treatments.
9. Please brief us on a successful, complex case that underwent IVF in HealthPlus.
Recently, one of our patients achieved a pregnancy after nine failed IVF cycles. The couple were diagnosed with poor ovarian reserve, severe male factor and recurrent implantation failure.
The couple underwent detailed assessment and treatment prior to IVF including screening for natural killer cells, autoimmune antibodies and genetic testing. The husband’s treatment started prior to IVF to improve the outcome.
As she was usually producing only one or two eggs, we adopted the new approach of egg accumulation where we collected the eggs consecutively and froze them until we achieved a number of eight eggs, then fertilization and embryo transfer was conducted. She also received immune modulation treatment from the time of transfer until the end of the first trimester of her ongoing pregnancy.
Dr El Samwal El Hakim
IVF Consultant, HealthPlus Fertility Center, Abu Dhabi