In vitro – what is it, how does it proceed, indications, how much does it cost, financing

In vitro fertilization evokes extreme emotions. For some it is the only chance to have children, for others it is a controversial medical procedure. In vitro fertilization is a procedure that has been successfully performed for many years in Poland and around the world. Children conceived using the in vitro method are no different from children conceived naturally. The in vitro method is sometimes called an infertility treatment method. It is worth noting that in vitro fertilization does not restore the proper functioning of the reproductive organs or the hormonal system, but it allows to overcome some natural obstacles that cause infertility.

In vitro – what is it?

In vitro fertilization (IVF) is an in vitro fertilization procedure that involves collecting an egg and sperm and combining them outside the woman’s body, in laboratory conditions, and then placing the embryo in the uterine cavity. In vitro fertilization, i.e. fertilization “in a glass”, is one of the most effective methods used in the treatment of infertility, which is caused by, among others, fallopian tube obstruction, endometriosis and low semen quality.

Infertility – a serious problem for couples of all ages

Fertility problems affect many couples. The most common causes of infertility include:

• the woman’s age (women over 35 more often have problems getting pregnant),

• polycystic ovary syndrome (PCOS),

• ovulation disorders,

• male factor (e.g. low semen quality),

• endometriosis,

• premature menopause,

• abnormal patency of the fallopian tubes,

• cervical factor,

• adhesions in the uterus,

• idiopathic infertility.

Not all causes of infertility allow you to get pregnant through fertilization outside the woman’s body. Before fertilization is carried out in laboratory conditions, tests are performed to determine whether in vitro fertilization is possible. Among other things, it is being investigated: quality of eggs and sperm parameters.

The doctor will suggest embryo transfer if the test results indicate that in vitro fertilization is possible. You should know that not every embryo transfer allows you to get pregnant. In some cases, it is necessary to make several or even a dozen attempts before the baby is born. However, in vitro fertilization offers a chance to have children for couples for whom other infertility treatment methods have not brought the expected results.

In vitro fertilization step by step

The lack of results in trying to conceive for 12 months is the basis for infertility tests. Both women and men should undergo the tests, because fertility problems may affect one or both partners.

The in vitro procedure begins with tests that aim to determine the cause of problems with getting pregnant. Tests performed to determine the cause of infertility include, among others: ultrasound examination and hormonal tests. Before in vitro fertilization occurs, the quality of reproductive cells and semen as well as the patency of the fallopian tubes are also assessed. Other tests include semen culture for aerobic and anaerobic bacteria and specialized genetic tests.

If the cause of infertility does not exclude the in vitro procedure, the woman’s body begins to prepare for the embryo transfer. The in vitro procedure begins with hormonal stimulation of the ovaries (the woman receives hormones in the form of subcutaneous injections). Pharmacological ovarian stimulation (ovulation stimulation) aims to produce healthier eggs. Hormonal stimulation of the ovaries is monitored using ultrasound. After ovulation is confirmed, the eggs are collected under general anesthesia. Semen is collected from the man. In vitro fertilization uses carefully tested egg cells and sperm, which reduces the risk of developing congenital defects. If it is not possible to use the couple’s eggs and sperm, in vitro fertilization using donor gametes is possible.

If nothing prevents the in vitro procedure, the egg is fertilized by sperm collected from the partner in laboratory conditions. As a result of the in vitro procedure, embryos are created, which develop in laboratory conditions for several days and then transferred to the uterine cavity using a thin catheter.

A few days after embryo transfer, tests can be performed to confirm a chemical pregnancy. Each couple looks forward to confirming their pregnancy, but it is not always possible the first time. In many cases, it is necessary to try in vitro fertilization again for the couple to have children.

How much does in vitro cost?

The cost of in vitro fertilization does not include only the procedure itself, which means that you have to be prepared for large expenses. In vitro infertility treatment takes into account the cost of tests performed, drugs used to prepare the woman’s body for embryo transfer, embryonic procedures and in vitro fertilization, as well as the cost of embryo transfer and follow-up tests. On average, one in vitro fertilization attempt costs approximately PLN 10,000. The first in vitro fertilization ends in pregnancy for approximately 65% ​​of women under 35 years of age. For older women, the chances of getting pregnant after the first IVF treatment are lower.

Ultimately, however, it is difficult to determine the total cost of in vitro treatment because each couple requires slightly different tests and medications, which is related to different causes of infertility.

Possibilities of financing IVF treatment

In vitro fertilization is expensive, but some local governments now offer funding for in vitro fertilization. In some regions of Poland, you can benefit from co-financing of 50% or even 80% of the cost of the procedure, which is a great help when trying to have a child.

Moreover, on November 29, 2023, the “Yes to in vitro” act was adopted in Poland, which guarantees its financing from the state budget. After the successful course of legislative work – the Act amending the Act on health care services financed from public funds was published in the Journal of Laws – the in vitro procedure will be financed from the state budget from June 1, 2024. Every year, the government is to allocate at least PLN 500 million for the implementation of the program. zlotys.

In vitro fertilization – contraindications

Unfortunately, not every couple can benefit from in vitro treatment. Contraindications to the procedure include:

• lack of ovarian function,

• some chronic diseases,

• obesity,

• anatomical defects of the uterus that prevent the development of the embryo or carrying the pregnancy to term,

• sexually transmitted infectious diseases,

• poor general health,

• poor mental condition of patients.

Each couple undergoes tests qualifying them for the in vitro procedure. Due to the high risk of failure of the procedure and the risks associated with pregnancy, not all couples pass the qualification process and can benefit from in vitro fertilization.

Sources:

• Joanna Gawinek, Beata Naworska, In vitro fertilization is one of the methods of treating infertility in Poland, Problemy Nursing, volume 22 (1), pp. 99-106, 2014

• Agata Misiurewicz-Gabi, To help fertility, Kurier Medyczny, 5/2020

• K. Łukaszuk, K. Kozioł, G. Jakil et al., Diagnostics and treatment of infertility – recommendations of the Polish Society of Reproductive Medicine and Embryology (PTMRiE) and the Polish Society of Gynecologists and Obstetricians (PTGP), Gynecology and Perinatologia Practical, 3 (3), 2018