IVF literally means allowing fertilization of the male and female gametes (sperm and egg) to occur outside the human body. IVF is an established treatment for many forms of infertility where an egg or eggs are extracted from the ovary or ovaries of a woman and mixed or injected with human sperm in the laboratory to achieve fertilization. After normal fertilization is achieved, the fertilized eggs are cultured in the laboratory for an appropriate period of time before they are placed inside a woman’s uterus (womb) with the intent of making the woman pregnant.
The first IVF baby in the world was born in 1978. At last count in 2012, over 5 million babies have been born worldwide as a result of IVF. There are many variations of the treatment depending on the medical indications and social circumstances, including use of donor eggs, donor sperm and/or gestational surrogates.
When IVF Might Be an Option
Some of the types of fertility that might be helped with IVF include:
- Absent fallopian tubes or tubal disease that cannot be treated successfully by surgery
- Endometriosis that has not responded to surgical or medical treatment
- A male factor contributing to infertility, in which sperm counts or motility are low but there are enough active sperm to allow fertilization in the laboratory
- Severe male factor in which sperm must be obtained surgically
- Unexplained infertility that has not responded to other treatments
- Previous sterilization including tubal ligation or vasectomy
- Failed to conceive after an adequate trial of insemination with (super) ovulation
- Genetic diseases that result in miscarriage or abnormal births
Specific Steps in IVF
An IVF cycle typically includes the following steps or procedures:
- Controlled ovarian stimulation: use of medications to grow multiple eggs
- Monitor ovarian and uterine responses
- Procurement of sperm sample
- Retrieval of eggs from the ovary or ovaries
- Fertilization of eggs: insemination or injection of sperm into the egg
- Culturing of any resulting fertilized eggs (embryos)
- Placement (transfer) of one or more embryo(s) into the uterus
- Support of the uterine lining with hormones to facilitate and sustain pregnancy
For more information about each of the specific steps, please see page 5 of the Consent to ART page.
In some cases, additional procedures are employed. These include:
- Intracytoplasmic sperm injection (ICSI) to increase the chance for fertilization
- Assisted hatching of embryos to potentially increase the chance of embryo attachment (implantation)
- Embryo Cryopreservation (freezing)
- Pre-implantation Genetic Diagnosis/Screening (PGD)
Success of IVF
IVF is the most successful treatment modality for infertility. The success rate of a single IVF cycle of treatment varies from over 50% live birth rate per cycle in women under 35 years old, especially among women with good quality embryos, to less than 10% live birth per cycle in women 42 years old or older. The national average live birth rate in the U.S. for all women undergoing IVF between 2006 and 2008 is about 30% per cycle of treatment.
The number of embryos transferred influences the pregnancy rate and the multiple pregnancy rate. The age of the woman and the appearance of the developing embryo have the greatest influence on pregnancy outcome and the chance for multiple pregnancy. Unlike many countries in Europe, there is no federal or state legislation in the U.S. dictating the number of embryos to be transferred. Family Fertility Center follows the guidelines set by the Society for Assisted Reproductive Technologies, (S.A.R.T.) regarding the recommended limits on number of embryos to transfer.
Risks of IVF
Risks of IVF include
- side effect of different medications used for IVF, the most serious of which is ovarian hyper-stimulation syndrome
- risks associated with oocyte retrieval such as infection, bleeding and trauma
- risks associated with pregnancy resulting from IVF
- risks to the child/children conceived as a result of IVF
For an in-depth discussion on the risks of IVF, please refer to the references listed below.
References: Click on the title to view the document