What Is In Vitro Fertilization?
In Vitro Fertilization, usually referred to as IVF, is a procedure used to address infertility by manually mixing an egg and sperm in a laboratory dish. If the fertilization works, an embryo transfer will be done to place the embryo in a woman’s uterus.
When Is In Vitro Fertilization Used?
In Vitro Fertilization is generally used after other infertility treatments such as IUI (intrauterine insemination) have failed. In Vitro Fertilization is used when one or both partners have an infertility problem such as blocked fallopian tubes in the woman or mild issues with the man’s sperm. In Vitro Fertilization is also used when a couple has been trying to conceive for a lengthy period of time with no success.
What Is Involved With In Vitro Fertilization?
In Vitro Fertilization, including the embryo transfer process, involves five steps:
- Monitoring and stimulating the development of healthy egg(s) in the ovaries. This is referred to as ovulation induction and may be done using fertility drugs, which will stimulate the woman’s ovaries to develop mature eggs. Having more than one egg is preferred because some eggs will not mature and others may not fertilize after retrieval. When fertility drugs are used, the woman will be closely monitored for side effects.
- Egg collection. When the eggs are mature, which can be detected by monitoring blood hormone levels, they will be retrieved using a fine, hollow needle. Light sedation or local anesthesia is used to minimize discomfort while the woman is sedated.
- Sperm collection. Either the male partner or other donor will provide a fresh sperm sample or frozen donor sperm will be used.
- Insemination. The sperm and eggs are combined and placed in incubators in the lab, and then a single sperm is injected into the egg to try to fertilize it. When fertilization and cell division have happened, the eggs are considered embryos.
- Embryo transfer. Using a speculum, the healthiest embryos are transferred to the woman’s uterus. This can happen any time from one to six days after egg retrieval, though it’s usually done after two or three days. Some women experience mild cramping during the transfer.
When In Vitro Fertilization is successful, one or more embryos will implant. Pregnancy will be confirmed through a pregnancy test.
How Many Embryos Should Be Transferred?
In 2008, the American Society for Reproductive Medicine came out with new guidelines for embryo transfer:
- For women under 35, one embryo is recommended (two at most)
- For those aged 35-37, two embryos - at most - should be transferred.
- For women 38-40, three embryos - at most - should be transferred.
For those 40 and over, five embryos - at most - should be transferred.
What Is The Success Rate For In Vitro Fertilization?
The likelihood of success with In Vitro Fertilization depends on many different things, including the individuals’ health and fertility problems, and the specific approach used. Women who have previously been pregnant or who have already had a baby have a greater chance of success.
The average success rate is approximately 20%, with slightly higher success rates for women under 35 and decreasing success rates in women over 35. (Note that success for In Vitro Fertilization is based on a live birth.)
Experts generally agree that if a couple hasn’t been successful after three In Vitro Fertilization attempts it’s not likely to work.
Other Considerations for In Vitro Fertilization:
There are both risks and benefits to In Vitro Fertilization. It offers an option for couples dealing with infertility issues such as damaged, blocked or missing fallopian tubes, and has been in use long enough for studies to be done on the extended health of children conceived through In Vitro Fertilization.
Risks For In Vitro Fertilization:
The risks related to In Vitro Fertilization include:
- Risks related to use of anesthesia during egg retrieval.
- Potentially severe side effects from the use of fertility drugs, including Ovarian Hyperstimulation Syndrome (OHSS). Though rare, OHSS can be painful and may have other side effects such as nausea, vomiting, bloating or lack of appetite. Severe cases may require hospitalization.
- Risk of multiples (as with all assisted reproduction) and the risks associated with multiples such as premature delivery.
- Increased risk of ectopic pregnancy, when the embryo implants in the woman’s fallopian tube or abdominal cavity.
- In Vitro Fertilization is a very expensive approach to assisted reproduction.
- Many couples also find it stressful or emotionally very difficult.
Related Resource Pages on Band Back Together:
Additional Resources for Infertility:
Resolve is the site for The National Infertility Association. Resolve is a non-profit organization with the only established, nationwide network mandated to promote reproductive health and to ensure equal access to all family building options for men and women experiencing infertility or other reproductive disorders.
Fertility Plus provides an overview of IVF and as well as hints on taking care of yourself during an IVF cycle, things to consider and suggestions to increase chances of success.
The International Council on Infertility Information Dissemination (INCIID ) is an extensive resource for infertility information.
The Infertility Network UK is a membership-based resource for all infertility related information and support.