In Vitro Fertilization (IVF)

In vitro fertilization (IVF) is an assisted reproduction technique that combines a man’s sperm and a woman’s egg outside of the body in a laboratory; then the resulting embryos are implanted back into the uterus. IVF has very high success rates and is used for many fertility issues.

Medical advancements have made transferring just one embryo for a successful pregnancy possible, which eliminates multiple birth and its associated health risks. Patients who carry genetic diseases may choose to have their embryos tested (PGD) prior to embryo transfer.

ABOUT IVF

In vitro fertilization (IVF) is an assisted reproduction technique that combines a man’s sperm and a woman’s egg outside of the body in a laboratory. Once fertilized embryos begin developing, one or more of the best embryos are transferred back into the woman’s uterus. If the procedure is successful, the embryo(s) will implant in the uterine lining and grow, resulting in a normal pregnancy. If more embryos were created than what was needed, they can be frozen through cryopreservation for future transfer.

IVF is a significant breakthrough in infertility therapy because of its high success rate. The national pregnancy average using IVF is above one in three, and can be much higher depending on the patient’s age. Since 1978, when the first IVF baby was born, 4 million babies have been born around the world using IVF. In addition, long-term studies have shown that children conceived through IVF are just as healthy and intelligent as naturally conceived children. In the United States more than 1 percent of all the babies born today are the result of IVF.

At first, IVF procedures were performed on women with blocked, damaged, or absent fallopian tubes, but now IVF is used for many infertility causes. In addition, medical advancements have made transferring just one embryo for a successful pregnancy possible, which eliminates multiple birth and its associated health risks.

Today’s IVF treatment has such success, that IVF pioneer Robert Edwards won the 2010 Nobel Prize for medicine, three decades after the first IVF baby.

When is IVF recommended?

IVF may be the recommended initial treatment for women who have absent or non-functional fallopian tubes, or if the male has very poor sperm quality. In other instances, alternative infertility treatments, such as intrauterine insemination, may be considered before IVF, but if these are not successful IVF is often the next step. Undergoing IVF is also beneficial to perform genetic diagnosis on embryos, which is especially helpful when one or both parents carry potential genetic diseases.

IVF can be used to treat:

Age related infertility: A woman’s egg quality diminishes with age. IVF can be used to try to overcome this problem by increasing the number of eggs retrieved and enhancing selection of good quality eggs.

Anovulation: If a woman is not ovulating (anovulation), simple treatments such as ovulation inducing pills often achieve pregnancy. However, if the woman fails to achieve pregnancy with these conservative measures, IVF has very high success rates, particularly in younger women.

Recurrent pregnancy loss/miscarriage: When a woman has had multiple miscarriages, IVF may be an effective treatment in helping begin a successful pregnancy.

Unexplained infertility: One fifth of infertile couples will be diagnosed with unexplained infertility (the cause for infertility is unknown despite numerous tests). However, these couples often get pregnant using IVF.

Fallopian tube damage and tubal factors: If significant tubal damage exists, the only fertility treatment options are surgical repair, which has a low success rate, or bypassing the fallopian tubes by using IVF.

Male factor infertility: Intracytoplasmic sperm injection (ICSI) has been used since 1993 to achieve pregnancy using abnormal sperm. Using a device known as a micromanipulator to inject sperm directly into an egg, ICSI improve fertilization chances. ICSI is recommended in cases of poor sperm quality, where the sperm are obtained surgically from the male partner or if a previous cycle has resulted in failure to fertilize.

Endometriosis: Endometriosis can be successfully treated using a combination of surgery and medication. However, if the first round of treatment fails, IVF is a viable second treatment.

Patients who carry genetic diseases may choose to have their embryos tested prior to embryo transfer. Preimplantation genetic diagnosis (PGD) can help detect these issues before an embryo is transferred to the woman’s uterus.

IVF can also help patients experience pregnancy and biological parenthood that wouldn't otherwise. These include women in their late 30s or early 40s wanting to conceive, men and women who need donor sperm or eggs to conceive, same sex couples, and single mothers by choice.

THE IVF PROCESS

The process of IVF involves five basic stages:

1. Controlled ovarian hyperstimulation – the use of fertility drugs to create multiple oocytes (eggs).

2. Oocyte retrieval – a surgical procedure to remove oocytes (eggs) from the ovaries.

3. Fertilization of the oocytes by sperm

4. Embryo creation and growth.

5. Transfer of the embryos into the uterus.