In vitro fertilization is the most effective form of assisted reproductive technology that helps women become pregnant, in which mature eggs retrieved from a woman are fertilized by sperm in our laboratory. IVF is a type of fertility technique that helps women become pregnant when other less expensive techniques have failed. IVF has been successfully used since 1978. The procedure can be done by using your own eggs and your spouse or partner’s sperm, donor eggs, donor sperm, and/or donor embryos.
IVF can be used when you or your spouse or partner has:
- Fallopian tube damage or blockage
- Ovulation disorders
- Premature ovarian failure
- Endometriosis
- Uterine fibroids
- Previous tubal sterilization
- Impaired sperm production or function
- Unexplained infertility
- Genetic disorders
- Other health conditions such as cancer treatment
IVF is broken down into four stages:
- Ovarian stimulation and monitoring: Fertility medications such as Gonal F, Follistim, Bravelle, and Menopur are used to stimulate the ovaries to develop more follicles. Follicles are fluid-filled sacs that contain eggs. Large numbers of follicles are created to increase the chances of fertilization. Follicle development is monitored through ultrasounds and blood tests.
- Oocyte (egg) Retrieval: When follicles are mature, 16-20 millimeters in diameter, a human chorionic gonadotropin (HCG) injection is administered to stimulate the maturation of eggs.Oocyte retrieval is a minor surgical procedure that uses ultrasound imaging to guide a hollow needle through the pelvic cavity. Local anesthesia and IV sedation are provided to reduce and remove any potential discomfort.
- Fertilization: A semen sample is usually obtained by ejaculation to combine with the eggs. The sperm and eggs are placed together by a process called insemination, in an incubator for fertilization to occur. When sperm count is low, intracytoplasmic sperm injection (ICSI) technique is used to fertilize the eggs. In this procedure, a single sperm is injected into an egg to achieve fertilization.
- Embryo Transfer: Embryos are transferred into the uterus one to six days after egg retrieval. This procedure does not involve sedation or anesthesia. The physician uses a catheter to place the embryo(s) into the uterine cavity.
After the embryo(s) is successfully transferred, it has the opportunity to implant into the lining of the uterus within a day or two of the embryo transfer.
Pregnancy is confirmed by a blood test 12-14 days after the embryo transfer.
Some of the risks associated with in vitro fertilization include ovarian hyperstimulation syndrome (OHSS), which is a significant enlargement of the ovaries, possible fluid retention in the abdomen, and rarely generalized abdominal pain. Other risks may include bleeding, infection and damage to the bowel, bladder and/or blood vessels. There is a 20% risk of multiple births with all assisted reproductive procedures.
The success rate of IVF depends on multiple factors such as the patient’s age, past medical history, and the type of treatment plan. It is very important to understand that pregnancy rates are not the same as live birth rates. In the United States, the live birth rates for all certified clinics can be found on the website of the Center of Disease Control and Prevention. HYPERLINK "http://www.cdc.gov" www.cdc.gov
Assisted reproductive technology (ART) involves significant physical, financial, and emotional commitment on the part of the patient and couple.
