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Focus on Family Planning

Oct/07/2023 / by Lindsey Galloway
Loving young man and pregnant woman holding hands on belly, feeling inspired waiting for first baby, showing unconditional love, prenatal care, third trimester, IVF advertisement, childbirth concept.

When it comes to managing their future families, more women are turning to IVF. But stigmas around the procedure still remain. Here we demystify the process and talk to women who have been through it.

Whether for infertility, aging, or other health reasons, women have countless reasons for turning to fertility procedures like freezing their eggs or in vitro fertilization (IVF).  However, embarking on the IVF journey comes with many questions and uncertainties, and can still carry misunderstandings and stigmas in South Asian communities. 

To understand more, we spoke with women who have undergone IVF treatment and top fertility experts to hear the physical, emotional, and social aspects of this unique path to parenting. 

The Decision to Try IVF

Rohini Kapur and her husband wanted to start a family, but his frequent overseas work travel made timing conception challenging. When natural conception wasn’t happening, she spoke to her doctor, but he didn’t recommend intrauterine insemination (IUI) or IVF as he believed she was “fit and fertile” to conceive naturally. But after doing the research and knowing her partner’s intense schedule, she advocated for herself and found a fertility specialist. 

IVF seemed like a workable option. In that procedure, mature eggs are collected from ovaries and fertilized by sperm in a lab. The fertilized eggs, called embryos, are then transplanted into a uterus, with the hope that a healthy baby develops. A full IVF cycle can last anywhere from two to three weeks.  

After learning about the prep work and the procedures, Kapur felt confident in moving forward.“I found the process of turning up for appointments, taking medication, and getting injections on time very easy and simple to follow,” she said. “I didn’t have to ‘do’ anything, such as worry about my fertile days, or wonder about my partner’s mood, or mine. All I had to do was show up at the clinic and take the meds.”

For Kapur, IVF offered a path forward that worked with her relationship circumstances and lifestyle. “Even though I had one failed cycle, it was overall much less stressful than trying to have intercourse at the right date and time!” she said.

Focusing on Fertility Health

Even while researching the process of IVF, women can still take steps to optimize their fertility, which can improve the odds of both natural conception and a successful IVF cycle.  

“Women can enhance their fertility in several ways. Firstly, maintaining a healthy body weight is essential. Being overweight or underweight can affect hormone production and inhibit ovulation,” said Dr. Hrishikesh Pai, Chief IVF Specialist and Founder of Bloom IVF. He stressed the importance of a nutritious diet, regular exercise, limiting caffeine and alcohol, and getting checked for any underlying conditions that could impact fertility. Managing stress can also be beneficial. “High stress levels can alter hormone balance and potentially affect ovulation and menstrual cycles,” said Dr. Pai.

Dr. Himali Maniar, OB-GYN and Fertility Expert at ClinicSpots, echoed the value of a healthy lifestyle. “Eating a healthy, balanced diet is incredibly important for not only general health but also reproductive health. Additionally, maintaining a healthy weight as well as avoiding smoking, alcohol, and recreational drugs can all help improve fertility.” She also highlighted the potential benefits of specific activities like yoga for supporting reproductive health.

The Initial Fertility Consultation

If pregnancy doesn’t occur naturally within a reasonable timeframe, meeting with a fertility specialist is the next step. 

“When a woman first visits a fertility specialist they will typically undergo an initial evaluation that includes lifestyle assessment, physical examination, laboratory tests, and imaging,” said Dr. Maniar. “This evaluation is designed to identify any underlying issues that might be preventing pregnancy.” 

This consultation lays the groundwork for determining if fertility treatments are needed and which options may work best. Based on the test results and discussion, the doctor can develop a customized treatment plan.

Deciding on IVF

For some couples, the fertility investigations may point to IVF as the most promising path, but the road is not always easy, and women should be armed with all the facts before moving forward.

“IVF, In vitro fertilization, is a meticulous process that requires significant commitment and patience,” explained Dr. Pai. “The process involves multiple steps over several weeks, including ovarian stimulation, egg retrieval, fertilization in the lab, embryo development, and finally, embryo transfer.” 

He cautioned that the process can be demanding both physically and emotionally. “It’s important for women to understand that not all cycles of IVF result in pregnancy, and it may take several attempts to achieve a successful result.” He advised having a strong support system in place.

Dr. Pai also noted that IVF does carry medical risks, like multiple pregnancies or ovarian hyperstimulation syndrome. “It’s important to have open discussions with your healthcare provider about these potential risks and how they can be managed,” he said. Knowing what to expect and having your doctor address concerns upfront can help you prepare in mind and body for the IVF process.

The Step-by-Step IVF Process

The first part of the process typically begins with a couple of weeks of hormone therapy to stimulate the ovaries to produce multiple eggs. This is followed by an egg retrieval procedure, where the eggs are collected from the woman’s body and mixed with sperm in a laboratory setting. The resulting embryos are then implanted into the uterus. 

The hormone injections used to stimulate the ovaries allow for multiple eggs to mature, as opposed to the single egg naturally selected in an ovulation cycle. Retrieving numerous eggs maximizes the chances that several will successfully fertilize and develop into quality embryos for transfer. But women should go in knowing the possible side effects during this time. “The process can be physically and emotionally demanding, with possible side effects from medications including bloating, mood swings, and fatigue,” cautioned Dr. Pai.

Preparing for the Emotional Toll

Along with the physical side effects, the emotional stress and pressure on the procedure can feel overwhelming — especially if you undergo multiple cycles toward trying to get pregnant. 

Kapur says it’s important to manage expectations and emotions during IVF, and give yourself guidelines. “First, have a deadline. This could be in terms of number of cycles, a specific financial figure, or even a certain date, or your age,” she says. “I know this sounds a bit crazy when you’re desperate for a child, but do you really need to put the rest of your life on hold for a super long time?” 

She explained that an open-ended process prolongs stress and heartbreak. Setting limits allows for resetting life plans if IVF is unsuccessful.

“Second, don’t over-stress. Some amount of stress during the process is natural and expected, but don’t go crazy in your efforts to conceive,” she continued. She advised maintaining normal routines as much as possible. 

Finally, she emphasized accepting the lack of guarantees. “Remember that no doctor, no matter how famous or qualified, or expensive, can guarantee anything,” she said. She said to remember that even failed IVF does not preclude the possibility of “rainbow babies” later conceived naturally against the odds.

Considering Cultural Perceptions 

Dr. Pai also addressed the cultural misconceptions that some families still harbor about IVF. “Despite the medical advances, there persists a cultural stigma associated with IVF in certain societies. Some people may hold misconceptions or lack understanding about the process,” he acknowledged. 

To help family members see IVF more positively, he advised focusing on its goals and benefits. “When explaining the benefits of IVF to family members who may not understand or endorse this path, emphasize the core aim of this procedure – to help couples have a child who may not be able to conceive naturally.” Noting positive outcomes for others who did IVF can also help change perceptions.

“Choosing IVF is a personal decision taken after thoughtful consideration and medical consultation,” said Dr. Pai. “It does not devalue or undermine the concept of natural pregnancy.” Reframing IVF as an empowering option, rather than a last resort, can help combat stigma.

Kapur only shared her IVF journey with her mother and a handful of close friends to avoid added scrutiny. But open communication with loved ones can often ease the process. “Inviting family members to join in consultations or meetings with healthcare providers could provide them with factual information and dispel any myths they may hold about IVF,” said Dr. Pai. 

While IVF can seem like an isolating and private experience, sharing your story with family and friends can help generate invaluable support. 

Empowered by Knowledge  

For many, IVF offers a beacon of hope after natural conception proves challenging. Seeking lifestyle adjustments, supportive healthcare, emotional outlets, and family understanding all pave the path toward becoming an empowered IVF patient. While IVF does not guarantee instant success, knowledge, resilience and community help couples navigate the journey. By better understanding this process, women can move forward on building their families with greater clarity and compassion.

IVF By the Numbers

1 million: Number of babies born in the United States between 1987 and 2015 through the use of IVF or other assisted reproductive technologies. 

21.3 percent: The chance of having a full term, normal birth weight and live birth per cycle using fresh embryos from nondonor eggs  for women younger than 35. 

$10,000: The average cost of a single IVF cycle in the U.S. More states are passing laws requiring insurance companies to cover the procedure in cases of infertility, but many couples still pay out of pocket. 

1 to 2 percent. The percentage of all U.S. births annually via IVF.

Source: Penn Medicine

How PCOS May Affect South Asian Women Fertility Differently

Polycystic ovarian syndrome (PCOS), is a condition that has been shown to affect South Asian women differently than other ethnic groups, and researchers are starting to explore how that might affect fertility and reproductive procedures like IVF. 

One recent study showed that when South Asian women with PCOS underwent ovarian stimulation (when women take injectable hormones to retrieve more eggs) for IVF, they required a lower dose of hormone injections and had a higher number of eggs retrieved compared with Caucasian women with PCOS.

Data has also shown that with fresh embryo transfer when eggs are inseminated and immediately transferred into the uterus, South Asians had a significantly lower live birth rate compared with Caucasians. But in frozen eggs, there was no difference, suggesting South Asian women may need more time to adjust their hormones after ovarian stimulation in order to produce a healthier uterine lining. 

While specific ethnicity data remains scant, it’s worth discussing with your doctor the optimal path for your circumstances.

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