Natural childbirth after IVF?.
Many women wonder whether natural childbirth after in vitro fertilisation is possible. Of course it is! From the moment the embryo is placed in the uterus, all processes take place in exactly the same way as with any other pregnancy.
The qualification for natural childbirth or caesarean section depends on the health of the mother and the foetus. This decision is made by the obstetrician and the indications for the choice of method are the same as for natural conception.
However, the percentage of natural births after IVF is lower. Why?
However, the chances of having a natural birth after in vitro fertilisation are lower than with traditional fertilisation. There are several reasons for this.
1. the chance of a multiple pregnancy is higher
In vitro fertilisation is more likely to lead to multiple pregnancies, for which doctors usually opt for a caesarean section. Why does this happen? Women who are still under the age of 35 are usually given one embryo. However, if the patient exceeds this age threshold, implantation of two embryos is recommended to increase the chance of IVF success. This rule also applies to couples in whom previous attempts have failed. In Poland, unlike in other countries (e.g. the United States or France), doctors from infertility clinics transfer a maximum of two embryos into the uterus. This is motivated by concern for the health and safety of patients and their future children.
Multiple pregnancy means more effort for the mother's body and involves more risks. For the mother, it means greater weight gain and strain on the spine. In addition, it can cause certain complications such as hypertension, anaemia, frequent nausea or diabetes. Secondly, twins can be born prematurely, which also means a lower birth weight. The earlier they are born, the longer they will need medical care.
Multiple pregnancies end by caesarean section in 70% cases. The most common indications for abandoning a natural birth include a large difference between the babies' body weights (more than 20%), their abnormal positioning for delivery, the occurrence of TTTS syndrome (babies develop unevenly) and the low weight of both babies (less than 1,500 g).
2. women giving birth after IVF are on average 3-5 years older.
The age of the mother, regardless of how she became pregnant, makes the risk of certain complications increase. If a woman is over the age of 35, the likelihood of having a caesarean section increases, as certain health problems or complications during pregnancy may develop with age, including: high blood pressure, gestational diabetes, uterine myomas, slow expansion of the cervix, a heavy baby, the baby adopting an uncomfortable position in the womb. If these problems are present, caesarean section will prove to be a safer option.
This does not mean that age is always an indication for caesarean section. Completion of 35 years of age by a pregnant woman does not rule out her chances of having a natural birth. Much depends on her physical condition, mental form, health and the course of the pregnancy.
(3) Sometimes the same factor that prevented a woman from becoming pregnant naturally prevents a natural birth.
An example is polycystic ovarian syndrome. This disorder increases the risk of metabolic syndrome complicating the patient's overall health and can disrupt the course of pregnancy.
Other factors that usually dictate the need for a caesarean delivery include: mental illness or poor mental health, ophthalmological problems (especially the condition of the retina), orthopaedic defects, serious heart disease, placenta previa (placenta in very close proximity to the cervix), previous miscarriages, genital herpes.
Course of pregnancy after in vitro fertilisation
The mere conception of a child by in vitro fertilisation is not an indication to treat a pregnancy as being at risk. Of course, there are certain risks associated with this method, including a higher risk of miscarriage. However, this is not related to the fertilisation method itself, but to previous problems that have influenced infertility in patients (e.g. genetic abnormalities or comorbidities). For this reason, the management of the patient during pregnancy is somewhat more careful. Despite this, the woman has the chance to give birth naturally if there are no other contraindications.
Patients who become pregnant through IVF have to take hormonal medication to maintain the pregnancy until around 10-12 weeks. After this period, the course of pregnancy and medical care does not differ from standard care for natural pregnancies. Any further need for medication depends on the state of health, test results and the doctor's recommendations. If necessary, the doctor may order additional diagnostics or prenatal tests.
So mothers-to-be: rely on the care and experience of your doctor. You are in good hands!
