IVF (In Vitro Fertilization) in Iran

 

 

Having children is not an obligation for couples and individuals rather it is most often a choice. Many people who are of fertility ages cannot conceive even though they have tried. In Vitro Fertilization is a type of assisted reproductive technology (ART) that helps pregnancy happen. People can use IVF with other reproductive technologies like gamete donation, surrogacy, PGD, etc.

IVF in Iran is a well-known medical service that has been practiced since 1990. Many couples from all around the world have visited Iran to treat infertility problems in advanced medical centers of Iran. The most affordable costs of the IVF procedure along with the presence of skillful physicians have been the golden merits of undergoing this treatment in Iran.

 

 

What is IVF?

 

In Vitro Fertilization (IVF) is a type of assisted reproductive technology that helps fertilization of eggs and sperm in vitro. This process involves stimulating a woman's ovaries, monitoring and removing ovum or ova from the ovaries. Then the embryologist lets sperm fertilize the eggs in a culture medium in a laboratory environment. One or more embryos may be transferred into the uterus to develop like a normal pregnancy. Having serious complications due to IVF medications and procedures is rare, although there might be some risks with every medical procedure.

 

 

Who Needs IVF Treatment?

 

In some cases, in vitro fertilization is a good option for infertility treatment. In cases where either the male or the female partners have the following conditions, they may consider using IVF.

• Endometriosis
• Low ovarian reserve
• Male infertility, including low sperm number or low motility
• The uterus or fallopian tubes problems
• Uterine fibroids
• Previous tubal sterilization or removal
• Ovulation problems
• hereditary disorders of the parents
• low egg or sperm quality
• Unknown infertility
• History of cancer treatment
• Using frozen eggs or embryo
• Need for the surrogacy process
• Gay couples

In addition to the above factors, when a pregnancy poses a serious health risk for some women, they may need to choose IVF and transfer their embryo into the uterus of a gestational carrier (surrogate).

The Right Age for IVF Treatment

 

The age of a woman is an important factor affecting the success of artificial insemination. Generally, women are the most fertile in their twenties and early thirties. As they get older, their fertility capability declines. Once women get to their mid-thirties, their IVF success rate starts decreasing.

The good news is with the technological advancement in the field of reproductive technologies, now women can use donor eggs to produce high-quality embryos and have a successful pregnancy. Egg donation is an effective technology that is not available in every country. However, Iran is one of the leading countries that offer IVF + Egg donation services to those who are at older ages and do not have proper eggs for inseminating with sperm.  Today, it is possible to get pregnant even when a woman reaches menopause

 

How is IVF Procedure?

 

In vitro fertilization increases the chance of pregnancy if you have fertility problems but there is no guarantee because every person is different from the others. A cycle of IVF can take almost two or three weeks. This procedure involves several steps including ovarian stimulation, egg retrieval, sperm retrieval, fertilization, and embryo transfer. Sometimes this process works on the first try, but many people need more than one cycle to get a result.

 

Step 1: Ovarian stimulation

Each month, ovaries produce one egg. Before starting the IVF procedure, synthetic hormones are used to stimulate egg production. In addition to one egg that is produced each month, in this procedure multiple eggs are needed. This is because some eggs will not fertilize or normally develop after fertilization. Different medications will be used including medications for ovarian stimulation, medications for oocyte maturation, medications to prevent premature ovulation, and medications to prepare the recipient’s uterus (whether is the same woman or a surrogate).

While you are taking your medications, you will be under the monitor of your doctor to know which medications to use and when to stop taking them. To determine when the right time for collecting the eggs is, you need to have vaginal ultrasounds and blood tests. Through vaginal ultrasound, your doctor monitors the development of follicles and with blood tests, your body’s response to ovarian stimulation medications is measured. You should know that sometimes the in vitro fertilization cycle might be canceled before egg retrieval due to some reasons like:

• Inadequate number of developing follicles
• Premature ovulation
• Developing too many follicles that may have the risk of ovarian hyperstimulation syndrome
• Other medical issues detected by the doctor

 

Step 2: Egg retrieval

 34 to 36 hours after your last injection, the egg retrieval process can be done. During the egg retrieval process, you will be sedated by light anesthesia. The usual retrieval method of egg retrieval is transvaginal ultrasound aspiration. To identify follicles, an ultrasound probe and a thin needle is inserted into your vagina. Then a thin needle is inserted into the vagina and into the follicles to retrieve the eggs. The eggs will be retrieved through a needle connected to a suction device. After the egg retrieval process, you may experience a little cramping or pressure, which will go away quickly. Matured eggs will be placed in a culture medium to be used for fertilization.

 

Step 3: Sperm retrieval

A semen sample needs to be provided on the same day of your egg retrieval. After semen retrieval, it may be washed to enhance its quality. Typically, the semen will be collected naturally; however, other methods like testicular aspiration are required in some cases. Donor sperm can also be used in some countries, but this method is outlawed in Iran.

 

Step 4: Fertilization

The process of fertilization can happen in different ways:

• Conventional insemination: during this process, healthy sperm and mature eggs are combined in vitro to conceive and create embryos.
• Intracytoplasmic sperm injection (ICSI): in the ICSI method, healthy sperm is directly injected into a mature egg. This method is often used when the quality, number, or sperm motility has problems or there is a history of prior failed fertilization.
• Assisted hatching: in this technique, the embryo is hatched from its surrounding membrane (zona pellucida) in order to be implanted into the uterus lining. This technique makes a hole in zona pellucida before the transfer to help the embryo hatch and implant. You may use assisted hatching if you are of older age, have had multiple failed IVF attempts, or you use frozen eggs or embryos (freezing can harden the zona pellucida).
• Preimplantation genetic testing (PGT/ PGD) and sex selection (PGS): five or six days after embryo development, a small sample of it can be removed safely and tested for detecting specific genetic disorders and the right number of chromosomes. Embryos that do not have affected genes or chromosomal problems can be transferred to the uterus. Through PGD tests, the likelihood of passing a genetic problem on to offspring is reduced. In this stage, sex selection can happen through the PGS test. PGS can reveal the gender of embryos giving the parents the opportunity of choosing the preferred sex for their baby.

Step 5: Embryo transfer

The last step of the in vitro fertilization is transferring the prepared embryo into the uterus. Embryo transfer usually takes place 2-5 days after egg retrieval. Before starting, you might be given a mild sedative. Your doctor inserts a thin flexible tube called a catheter through your cervix into your uterus. A syringe filled with one or more embryos floating in a small amount of fluid is attached to the end of the catheter, letting the doctor place the embryos into your uterus. If the procedure is successful, the embryo will be implanted in the uterus lining for about 6-10 days. The positive result of the pregnancy test after about 2 weeks can show that pregnancy successfully happened  

 

What are IVF Complications?

 

Like any other medical procedure, in vitro fertilization can have some risks and side effects. The typical complications are:

• Ovarian Hyperstimulation Syndrome (OHSS): this syndrome is an excessive response of ovaries to simulative hormones that leads to swollen and painful ovaries. If too many follicles grow, fluid may leak into the abdomen and cause symptoms. OHSS is usually mild and can be treated with rest and hydration with liquids rich in electrolytes. In rare cases, the patient may need to be treated at the hospital.
• Multiple pregnancies: having multiple babies is more likely with this process because in some cases more than one embryo is transferred into the uterus. Pregnancy with multiple babies increases the risk of preterm labor, high blood pressure, gestational diabetes, and the need for a C-section.
• Ectopic pregnancy: this problem occurs when a fertilized egg implants and grows outside the uterus often in the fallopian tubes, ovaries, abdominal cavity, or the lower part of the uterus (cervix). Ectopic pregnancies cannot proceed normally and if they are left untreated, the growing embryo can cause life-threatening bleeding. Ectopic pregnancy can occur in about 2% to 5% of women who undergo in vitro fertilization.

 

Other possible complications of this process are:

• Bloating
• Cramping
• Nausea
• Hot flashes
• Breast tenderness
• Mood swings
• fatigue
• Headaches
• Bruising from injections
• Bleeding
• Infection
• Constipation
• Allergic reactions to medicines
• Mild pelvic and abdominal pain
• Emotional stress

What is IVM?

In Vitro Maturation or IVM is an assisted reproductive technology (ART) that helps people have their own babies and expand their families. IVM is a part of in vitro fertilization procedure that collects eggs from a woman before they are fully matured and ready to be fertilized.

Women have many eggs stored in their ovaries. One egg will be matured and released from the ovaries every month. In the IVF procedure, the woman needs to go through multiple hormonal injections to stimulate egg maturation while they are still in the ovaries. IVM technology retrieves the eggs and matures them in a laboratory. IVM needs little or no hormonal injections, fewer exams, and a shorter time span before the retrieval.

Does IVF guarantee a 100% result?

The answer to this question is No. In women below the age of 35, the success rate is 50 percent per cycle, and as the age increases, the success rate goes down. In most cases, several cycles are needed before getting any results. It is important to know that the success of this process depends on many factors like age, the woman’s uterus and ovaries condition, quality of ovum, the quality of sperm, and other biological or hormonal conditions. The average success rate of in vitro fertilization around the world is about 35% per cycle.

How Many IVF Attempts should be done?

In vitro fertilization offers no guarantee for success in the first or second cycle. In some cases, the procedure may not work at all; however, about 50% of individuals and couples get a successful result from doing this procedure. The studies show a positive cumulative effect over the IVF cycles. One study in the UK showed that there is a 29% chance for live birth after one cycle while this chance goes up to 43% after 6 cycles. The numbers can vary among different ages. For instance, a 30-year-old woman with primary unexplained infertility has a 46% chance for success while she can have a 93% success rate over 6 cycles. Therefore, you may need to keep on trying.

There is no limitation on the number of IVF cycles that you can have. The decision is totally up to you and your fertility specialist’s opinion. Some couples have gone through more than 10 cycles while some others have stopped after their first attempt. You can decide about the number of the cycles according to your medical condition and also your financial budget.

IVF Success Rate in Iran

Thanks to the modern equipment and the latest technology used by expert fertility specialists, the IVF success rate in Iran is high. Each year, many couples travel to Iran in order to overcome their infertility problem and make their dream of having a baby come to reality. Statistics show that the success rate of this procedure in Iran is equal to the universal rate or more than that.

For estimating the success rate, patients would be evaluated based on their ages. On average, the success rate of this process in Iran among women under the age of 35 is approximately 40% and among women older than 35, the success rate is 15% to 20%.  It is important to note that the in vitro fertilization success rate varies among different fertility centers; therefore, getting the help of a professional agency would be priceless to foreign patients who have no knowledge about the most expert specialists and best IVF clinics in Iran.

Legal Aspects of IVF in Iran

Assisted reproductive technologies (ART) including IVF, egg donation, embryo donation, PGD, and surrogacy are all legitimized in Iran which has made Iran a leading country for fertility treatment in the Middle East. In Iran, using assisted reproductive technologies has helped the country’s latest policy related to a growing population.

Unlike most secular countries where the legitimization of biotechnologies including assisted reproductive technologies is the responsibility of a secular committee of experts and the parliament, in Iran this decision has fallen on the Islamic jurists or Foghaha with the help of medical practitioners to understand the ethical implications of them better.

In 1999, Ayatollah Khamenei the supreme leader of Iran declared that surrogacy and egg or embryo donations are allowed under certain terms. IVF is legal in Iran because it is a part of the other mentioned medical procedures. By legalizing the use of assisted reproductive technologies, Iran has become the leading country in the region and one of the most popular destinations in the world in the field of infertility treatment.

Religious Aspects of IVF in Iran

In Islam religion, there are different attitudes towards using ART. In Sunni-majority countries, there are more restrictions on using third-party as a treatment for infertility compared to Shia-majority countries. However, taking advantage of in vitro fertilization for husband and wife aiming to have a child is possible in both Sunni and Shia schools of thought.

Iran is a Muslim country with a majority of Shia followers. By the fatwas of the Shia school of thought including Ayatollah Khamanei who is the supreme leader of Iran, using IVF, egg donation, embryo donation, and surrogacy are all legal and approved by the dominant religion. Experienced fertility specialists, well-equipped clinics, modern technologies, and the support of law have all distinguished Iran as an eligible destination for infertility treatment.

Furthermore, the presence of Muslim doctors and donors who are highly responsible for the health of babies encourages more couples to pursue their treatment in this country. It is good to know that drinking alcohol is illegal in Iran, so the patients can be sure that donors and surrogates will not be drinking during the pregnancy!

IVF Cost in Iran

Many couples are not able to treat their infertility due to their low budget. Affordable cost along with the quality of treatment are two important factors involved in choosing the medical destination. In vitro fertilization tends to be an expensive treatment since most often several cycles are needed before pregnancy. For example, in the USA, you should expect $12000 to $14000 for each cycle. This cost can go higher even to $30000 according to your needs.

In Iran, there is a significant difference in the costs compared to other countries. The cost of IVF and other fertility treatments is very affordable for international patients due to several factors. You should know that low cost is not always equal to low quality or a problem in the process. There is no significant relationship between the cost of IVF and the success rate. The most important factor affecting the low price of this process in Iran is the country’s low currency rate; therefore, high-quality medical services are available in Iran at a much lower price. The list of common fertility services and their cost are offered below.

Service	Cost
IVF (with own eggs)	$2800
IVF + Egg donation	$4500
Embryo donation	$4200
Egg freezing	$1800
Sperm freezing	$400
Donor sperm	Not offered in Iran
IVF + PGD/PGS	$4900
TESE/MESA	$500
IVF+ Egg donation+ PGD	$5500

 

In general, many couples travel to Iran to follow their infertility treatment due to many reasons, including:

• Low cost
• Low living costs such as accommodation, city transfer, and living expenses
• High success rate
• Well-experienced and highly skilled doctors
• Equipped fertility centers accordant to the world’s standards
• Religious and ethical factors
• Etc.

FlytoTreat is a professional healthcare agency facilitating your medical travel to Iran right from the starting point to the end. Our experience in the field of infertility treatment, the presence of medical doctors as the consultants of FlytoTreat, and our priority in satisfying our clients are important factors in making patients trust us comfortably during their medical journey. Feel free to ask your questions free of charge 24/7.