IVF – PROS AND CONS 

Written By: Caroline Meyer

Fertility issues are experienced by many couples today, especially those that wait until later in life to start a family. There may be a number of options available, depending on your particular situation or for some, the choices are limited. 

If the situation is ideal, with the woman having open tubes and a reasonable amount of eggs still being produced and the semen being adequate, some people will look at intrauterine insemination to start with.  After 3 to 4 unsuccessful attempts, IVF may then be recommended. For most couples, it will depend on their personal situation as well as whether or not they have the finances for IVF. There are a number of pros and cons to IVF which need to be considered before making the decision to have the procedure. 

The Pros of IVF 

IVF can help many people have babies who otherwise would not be able to conceive.  

Blocked/Damaged tubes: Women with fallopian tubes that are blocked or damaged may not be able to have a successful pregnancy using her own eggs without IVF. Blocked tubes can be caused from pelvic infections such as chlamydia. With IVF, eggs can be harvested from the ovaries and the embryo will be implanted directly in to the uterus, so the issue of non-functioning tubes is bypassed. 

Age or otherwise related low egg count: As you age your ovarian reserve drops. Some women do not have a naturally high egg count. IVF helps by concentrating on quality as opposed to quantity, with healthy eggs being fertilized and implanted. 

Male infertility: Men who have fertility problems may not be able to conceive with their partner naturally. IVF improves the chances in cases where the sperm count is low or the motility is bad. IVF helps facilitate successful fertilization through placing the sperm near the egg or by using intra-cytoplasmic sperm injection. 

Infertility with no obvious cause: Where no obvious reason for infertility is found after significant testing and a variety of interventions, IVF may prove a good option to help couples conceive. 

Premature failure of the ovaries: Early menopause or premature ovarian failure can mean that a woman is no longer able to conceive naturally with her own eggs. Through IVF, she can still successfully have a child using donor eggs. 

Polycystic ovary syndrome: PCOS causes irregular menstrual cycles due to a hormone imbalance, which can make conception tricky. IVF can help women with PCOS fall pregnant. 

Endometriosis: This is a condition where parts of the lining of the womb grow outside of the womb.  IVF has helped women with this condition successfully have a baby. 

Prevention of genetic disorders in babies: With IVF, the embryos can undergo pre-implantation genetic screening. This helps reduce the chance of chromosomal disorders such as Down’s Syndrome and Cystic Fibrosis. This is especially important for high risk couples to try and reduce the chance of a baby with a genetic condition. 

The cons of IVF 

It’s expensive: IVF is a costly procedure. There is medication, blood tests and other costs to be considered. Get an idea of the full cost of IVF especially if there are repeat procedures to ensure you can afford the treatment. 

Cycle cancellation: After going through a cycle, you may not react to the treatment as expected and would need to go through a second cycle of treatment. 

Few or no viable eggs: In general, around 80% of follicles will contain an egg. In some cases, there are very few eggs available for collection and on the rare occasion, none at all. 

Fertilisation failure: Even if quite a few eggs are collected, sometimes many of the eggs won’t fertilize. Even those eggs that do fertilize are not always viable. In some cases, no eggs fertilize, yielding no embryos for implantation. This is rare but can occur due to poor sperm or egg quality. 

Implantation failure: One of the more common problems experienced in IVF is implantation failure. Even though the treatment is followed and everything up to the point of implantation goes really well, quite often the implantation fails and you have to start over. 

Miscarriage: Around 20% of pregnancies terminate before 20 weeks of pregnancy, with this rate increasing as you get older. For women over 40, the rate is 50% chance of miscarriage. Most miscarriages take place before 12 weeks of pregnancy. 

Ectopic pregnancy: Even though the embryo is implanted in to the uterus during the IVF implantation procedure, an ectopic pregnancy can still occur. This is when the embryo implants and starts to develop outside of the uterus, often in the fallopian tubes. The risk is slightly higher in IVF patients with damaged fallopian tubes. Ectopic pregnancies occur in around 1% of pregnancies in general. 

Multiple pregnancy: There are added risks to mom and babies in multiple pregnancies. With IVF it is preferred that there only be one baby at a time as this reduces the risk somewhat. Some IVF clinics only transfer one embryo at a time to try and avoid the risk of multiples, but even so, the embryo could split and result in a set of twins.  

Abnormalities: In babies that are not conceived through IVF, the risk of abnormalities is around 3%. The abnormality can range from something small such as a birthmark to a serious disease such as spina bifida. With IVF, the risk of abnormality is doubled. While this may seem to be a massive con for IVF, it still means that around 96% of IVF babies are perfectly healthy. 

Potential problems during egg collection: While the risk is minor and most women have no bad effects from the egg collection procedure, there is a risk of the needle injuring structures such as the bladder, bowl or a blood vessel during the procedure. 

Infection after transfer: Another minor risk is the chance of an infection in the uterus after embryo transfer. This needs to be treated with antibiotic to prevent the infection from spreading and becoming a serious health hazard.  

OHSS: This is a complication of IVF that occurs around 5% of the time and is serious in around 1% of treatment cycles. Ovarian Hyperstimulation Syndrome only occurs after using stimulation drugs and usually lasts for around 10 days. Should you become pregnant during this period, the symptoms become worse and can often last for months. 

Ethics: For some people the ethics of embryos being discarded if they are not implanted can be an uncomfortable topic. In these instances, you may want to have only 1 egg fertilized at a time and the other eggs frozen should you require them at a later stage, instead of fertilizing them all. 

IVF may be the only choice for some couples wanting to have children.  It is important to know all the pros and cons and decide on whether this is a good option for you. For some couples, they may choose to remain childless or perhaps adopt instead of undergoing IVF. For others, the risks and costs are worth the potential outcome. The choice is yours.