The probability of getting pregnant as a result of IVF is estimated at an average of 30-45%. But one onset of an "interesting situation" is not enough, you still need to endure and give birth to a baby. Only 80% of those lucky women who managed to get pregnant thanks to the efforts of reproductive specialists keep the pregnancy in the early stages. Premature birth occurs in about 40% of cases.
Pregnancy is without complications in only two women out of ten, and no more than 25% wear out before the baby's term. What is the peculiarity of childbirth after IVF, what the expectant mother needs to tune in to and what are the predictions, we will tell in this article.
Choice of obstetric tactics
Is it possible for a woman to give birth on her own after her pregnancy took place as a result of the IVF protocol, only an obstetrician-gynecologist who leads the pregnancy can answer. More often than not, in 90% of cases, natural childbirth is not encouraged. The fact is that usually the health of the expectant mother leaves much to be desired. The very fact that she had to resort to the services of reproductive specialists suggests that there are certain disorders in the body that prevented natural conception, created many difficulties during gestation and may well complicate childbirth.
The choice of tactics for childbirth is also influenced by information about how the pregnancy proceeded. Usually, after IVF during pregnancy, women are more likely to have a threat of termination in the early stages, and in the second half of gestation, the risk of having a baby prematurely increases. Often, polyhydramnios or low water develop, there are pathologies of the formation or development of the placenta. Since IVF usually implants 2-3 embryos into the uterus, the chance of multiple pregnancy is significantly higher.
It is even more difficult to carry twins or triplets with poor reproductive health. The very fact of multiple pregnancies does not imply a mandatory cesarean section, but after in vitro fertilization, it is precisely this delivery that is recommended, since the risks are twice as high as in singleton IVF pregnancy.
Medical statistics say that only every fifth IVF pregnant woman carries a baby without noticeable problems and complications, then the frequency of natural births after using assisted reproductive technology does not exceed 10%.
Future parents should be well aware that it is not the IVF itself that is to blame for this state of affairs, but the problems that the woman had before she entered the protocol. If a woman is completely healthy and IVF was performed due to the absence of a sexual partner with donor sperm, as well as with a male factor of infertility, independent childbirth is quite possible, since pregnancy is not much different from pregnancy that occurred naturally.
For the choice of delivery tactics, it is also important how the protocol of in vitro fertilization was carried out. There will be more complications during the gestation process if a woman has gone through a long or ultra-long protocol, if her body has been exposed to large doses of hormonal drugs. After a short or natural cycle protocol, the chances of an easier pregnancy are slightly higher.
No one will answer the question of how to give birth in advance. This decision is made at the end of the third trimester, when the obstetrician-gynecologist is well aware of all the possible risks. All over the world, doctors try to use the tactics of natural delivery after IVF to the maximum, but the Russian reality is somewhat different - doctors act according to the order of the Ministry of Health.
The Ministry of Health, in turn, does not want to risk it, because IVF is an expensive procedure, and future parents, who have already passed a long and difficult path to their happiness, should not risk the lives of mother and child. It is from this point of view that a caesarean section looks more appropriate.
It should be noted that among pregnant "eco women" few people insist with foam at the mouth on natural childbirth. Women who are familiar with the concept of "infertility" value the life and health of their baby more than their own ambitions. Therefore, they willingly agree to a cesarean section.
Childbirth process
If a decision is made to carry out childbirth naturally, the woman should go to the chosen hospital in advance. Doctors will take time to understand the peculiarities of pregnancy and develop tactics for coordinated actions during childbirth. Usually it is recommended to go to the hospital at the beginning of 39 weeks. If a woman is carrying twins, then hospitalization should be earlier - at 37 weeks.
Doctors at the maternity hospital or perinatal center decide whether to stimulate labor. Natural childbirth takes place according to the classical canons, complications are most likely in the case of natural childbirth with multiple pregnancies - one child may slow down the progress of the genital tract and "block the road" to the second, and children can also begin to be born at the same time. If any complications occur at any stage of labor in a woman who becomes pregnant through IVF, doctors have clear instructions to stop trying to give birth to a child on their own and to carry out an emergency caesarean section.
A planned cesarean section for IVF pregnancy is prescribed for a period of 38-39 weeks, if twins are carried, then at 36-37 weeks. A woman should also go to the hospital in advance, do all the necessary tests, undergo preliminary consultations with the surgeon who will perform the operation, as well as with the anesthesiologist, who will decide on the choice of anesthesia for the patient.
Caesarean section eliminates the potential health risks associated with a natural birth. The likelihood of birth trauma, placental abruption before the birth of the baby, acute hypoxia, which can be fatal for the baby, is practically excluded.
In recent years, a new method of performing a caesarean section, the so-called "slow cesarean", has been gaining momentum in Russia. This is an attempt to choose a cross between natural childbirth and surgery. Doctors make a small incision in the lower uterine segment, and the baby is born for real, but not through the genital tract, but through this small opening in the uterus.
The woman is given an epidural. Such operations are so far not carried out in every region and not in every maternity hospital, but if one is puzzled in advance, a woman may well find an obstetric institution whose specialists will undertake such "work".
Training
A woman who becomes pregnant through IVF needs a special approach during pregnancy. She visits her doctor at the antenatal clinic more often than other expectant mothers, she is assigned an extended list of tests and examinations in order to notice any pathological changes in time, if they appear.
It is possible that she will often have to go to the hospital to save the baby. But future IVF mothers cannot be scared by such prospects either - they know the cost of their pregnancy well and know how to value it, therefore obstetricians-gynecologists characterize such patients as very obedient and executive.
Preparation for such an important event as childbirth begins from the moment of registration. Women are encouraged to attend courses for expectant mothers, where they will be taught how to eat right, monitor weight gain. It is important to avoid complications of the last trimester - gestosis, the risk of which after IVF is usually assessed as increased. A woman should monitor her emotional and psychological state. If she has chronic diseases, it is imperative to visit a narrow-profile doctor in order to prevent the development of exacerbations of ailments.
The psychological readiness for childbirth in women after IVF is always noticeably better than in women who become pregnant naturally. There are several good reasons for this:
- Conscious and long-awaited pregnancy, the woman in her head “lost” the birth many times long before she saw two strips on the test or the fetal egg on the ultrasound monitor.
- Mutually welcome child - and the father participated in IVF, and he went through each stage with his wife, and therefore the joy was common, and now the common is expectation.
- The woman is calm and confident in the future., at least in his financial side - if the couple allowed themselves to pay for the expensive IVF protocol, with a high degree of probability, everything is fine with the finances in the family. Even if IVF was done at the expense of a quota, the couple had time to prepare both financially and morally for an important event - the birth of an heir (or heiress).
- High level of awareness - women who first planned pregnancy for a long time, then fought with infertility for a long time, and then went through several protocols of in vitro fertilization, are usually very well aware of the intricacies of pregnancy and childbirth as physiological processes, they read a lot on this topic, talked a lot with doctors. The high level of knowledge in this area gives a certain clarity and calmness - the pregnant woman knows exactly what to expect.
Subsequent recovery
The postpartum period for IVF moms passes like other women in labor, without significant differences. After natural childbirth, a woman recovers somewhat faster than after a cesarean section, although today the technique of performing this abdominal operation has stepped far forward. So, the seam is made in the lower abdomen, almost at the upper line of the pubis, it is thin and neat. This means that it will be invisible even if the woman is wearing an open swimsuit.
Recommendations after childbirth are given by the doctor who delivered or performed surgery. It reminds you of the need to eat well in order to provide the baby with the right amount of breast milk. With lactation after a cesarean section, there are much fewer problems than it might seem from the abundance of questions asked by women on the forums. Milk comes, only a little longer than after a natural birth, but in the first few days, the baby's needs can be satisfied by colostrum.
Subsequently, the performed caesarean section does not affect either the quantity or the quality of breast milk.
It is recommended to do repeated IVF after childbirth no earlier than 2 years later. If the delivery was performed by surgery, the most optimal period of rest and recovery, lasting at least 3 years. Before the next IVF, it is imperative to be examined, to pass all the necessary tests. Doctors emphasize that during the recovery period, a woman needs to protect herself using barrier contraception. Hormonal drugs should not be used, since they can affect the state of the endocrine system, and this is very important if a woman is going to do another IVF.
Pregnancy and childbirth stimulate the woman's reproductive system, sometimes the problem of infertility that existed before goes away by itself after childbirth and the woman becomes fertile. In this case, early pregnancy will increase the risks of its unfavorable termination - miscarriage, missed pregnancy, premature birth will become likely because the endometrium of the uterus, its muscles and the endocrine system have not yet "rested" after the previous birth.
How many children can be given in this way is difficult to answer. In Russia, there is a practice of performing a caesarean section no more than three times. However, in recent years, the fourth and even the fifth caesarean section has been increasingly performed. It all depends on whether the scar on the uterus from previous operations will be wealthy.
And finally, an important advice - carefully approach the choice of obstetric institution. It will be good if you give birth in a clinic that performed IVF, if such services are included in its license. If not (and this happens often), then it is best to opt for modern perinatal centers. Having a birth certificate gives a pregnant woman the freedom to choose a maternity hospital.
For information on whether IVF leads to a cesarean section, see the following video from a fertility specialist.
