Does IVF ruin my chances of getting pregnant naturally again? 

Sex, mental health and infertility — all categorised as closed-door conversations, though ironically, Sunita chachi’s family property dispute is out in the open for everyone to debate. The numbers want us to reconsider this double standard. Around 17.5% of people globally struggle to get pregnant naturally, that’s one in every six adults. And yet, the mystery surrounding infertility and in vitro fertilisation (IVF) by extension is murkier than any case that Sherlock Holmes ever solved.

Subjects that are not talked about enough fall prey to misinformation and often drown in a sea of myths such as IVF.

• What if someone else’s sperm/egg is used for fertilisation?
• IVF pregnancies are restrictive
• Babies born through IVF are more prone to having disabilities
• The chances of congenital disability in test tube babies are higher

And another common one is ‘Once you conceive through IVF, you don’t have a chance of getting pregnant naturally again’. The main reason this myth is popular is because most people still don’t understand IVF.

Why IVF?

Doctors generally recommend trying naturally for around two years before actively starting an infertility investigation. “Primary infertility is defined as failure to conceive after several tries of unprotected intercourse when the couple has not conceived before and is trying for the first time,” says Dr Saurav Prakash Maity, Kolkata-based fertility specialist and Founder and Director of Rashmika Fertility, Golpark.

It certainly is not as easy as a stork dropping off a baby at your doorstep. Several factors — biological, physical, hormonal as well as emotional — help determine a successful natural conception.

In women, age plays a big role. Post 35, the chances of a successful natural conception are low. Partial or complete blockages in the fallopian tubes due to past ectopic pregnancies or pelvic endometriosis, and Polycystic ovarian syndrome (PCOS) are all leading causes of female infertility.

In men, sperm concentration, motility, quality and morphology or structure of sperm are determining factors for a successful conception. A decrease in any one or more of these may prevent successful natural pregnancies.

Older couples or those with a demanding lifestyle might also directly opt for IVF.

According to Maity, when younger couples are experiencing primary infertility, doctors opt for medication and intrauterine insemination (IUI) first before undertaking an active IVF treatment.

It’s important to remember that IVF can be emotionally, physically and financially challenging. It can bring up complex emotions of grief and guilt. The inability to procreate can trigger anxiety, stress and depression. “Usually, couples opting for IVF already face issues like stress, guilt and lack of confidence in themselves. They feel like failures, and having to undergo a time-taking treatment like IVF, adds to the burden,” says Dr Neha Virk, Infertility specialist and Clinical Director at Virk Fertility Services, Jalandhar.

One cycle of IVF takes around two weeks which includes 10 days of hormonal injections to stimulate the ovaries to release at least 15-20 eggs. Once the follicles are mature, the process of ovum pickup or egg retrieval starts, followed by fertilisation, which can be done in one of two ways. In the first method, the eggs and sperms are kept together in a petri dish where one of the sperms fertilises the eggs. In the second method, known as intracytoplasmic sperm injection (ICSI), the sperm is injected inside the eggs to ensure fertilisation. “When the sperm count is poor or mobility is not good, we have to opt for ICSI,” says Maity.

Once fertilised, the embryo is transferred to the woman’s uterus and she’s given pregnancy support medication to prevent miscarriage. “Around 40-50% of couples will conceive in the first cycle. Around 90% of couples are able to conceive within three IVF cycles,” says Dr Pritimala Gangurde Kadam, fertility specialist and medical director of Pearl Fertility and IVF Centre, Mumbai. But both Maity and Kadam agree that the success rate of IVF is only 40-50%.

Getting pregnant naturally: myth v/s fact

Given the challenges, it’s natural for couples to wonder if having a test tube baby the first time also means undergoing the procedure again for a second time. Several believe that after experiencing primary infertility, getting pregnant naturally the second time is not possible. “One in five women becomes pregnant naturally after having a baby conceived with IVF. Many couples that present for fertility care are subfertile, not infertile,” says Virk.

Fertility treatments can often help in such situations to facilitate a successful natural conception. One study found that out of 2,134 couples who attempted assisted reproductive technology, about 20% became pregnant on their own after treatment.

Kadam and Virk believe that in cases of unexplained infertility — a situation where there is no apparent cause of failure to conceive — couples can naturally get pregnant without assistance the second time. “There is something happening in the body at the molecular level which we cannot diagnose. In such cases, there’s a good chance the couple will conceive naturally the second time,” says Kadam.

Virk recommends improving your lifestyle to better the chances of natural conception the second time. “Sometimes, after a couple has delivered their first child, they become stress-free and relaxed which automatically improves the quality of their eggs and sperm and they’re able to get pregnant without any assistance.”