In Vitro Fertilization (IVF): A Guide
IVF — in vitro fertilization — is one of a number of methods used by physicians who specialize in assisted reproductive technology (ART) to help you conceive a child. It involves the surgical removal of eggs from your ovaries, fertilizing them with sperm in the lab and implanting the embryo into your uterus.
The Benefits of IVF
IVF may help couples who suffer from a variety of conditions that affect their ability to conceive, including:
Women with blocked, damaged fallopian tubes or who have undergone tubal ligation.Women who can't or have difficulty ovulating, or have premature ovarian failure, endometriosis or uterine fibroids. Women who are starting cancer treatment that might harm fertility. In this case, eggs or embryos are frozen for future implantation. Men who suffer from infertility, including low sperm count or low sperm motility.One or both partners have a genetic disorder, other unexplained infertility.
*Special circumstances:
In cases where the female parent can't carry a child to term, another woman may act as a gestational carrier, and the embryo is implanted in her uterus.
In cases where either the woman's eggs or man's sperm can't be used, potential parents may choose to use donor eggs, sperm or embryos.
Factors that affect IVF success rates
A number of factors affect the success of IVF treatment, including maternal age, reproductive history and the cause of infertility. Your physician will evaluate and consult with you on these factors before you begin IVF.
How IVF works
There are several types of IVF cycles and protocols. You will work with your fertility team to decide the best IVF treatment plan for you. One IVF cycle can take 814 days of medication followed by an egg retrieval and then an embryo transfer.
1. Ovarian Stimulation
Your doctor prescribes special fertility medication that stimulates numerous eggs to grow. It's important to retrieve multiple eggs because some eggs won't fertilize or develop normally, and retrieving many at once reduces the number of invasive procedures you must undergo.
2. Egg Retrieval
This is when eggs of a female are surgically removed and joined, in an embryology lab, with a male’s sperm. Your fertility specialist determines when the eggs are mature using vaginal ultrasound and blood tests. Most often, the eggs are retrieved with a minor outpatient surgical procedure, which generally takes less than 30 minutes.
3. Sperm Collection
Your partner or sperm donor provides a semen sample the morning of egg retrieval. Sperm are separated from the semen in the lab. In some cases of male factor fertility, sperm aspiration may be necessary. This involves the use of a tiny needle to extract sperm directly from the testis.
4. Fertilization and Embryo Culture
The eggs are placed in an IVF culture medium in an incubator and injected with the donated sperm. Once the egg and sperm meet, they should form an embryo. The embryo is kept safely (and in accordance with strictly regulated policies) in an embryo incubator within an embryology lab. Usually, 65 to 75 percent of mature eggs will fertilize and develop into embryos.
5. Embryo Transfer
When ready, an embryo is transferred to the female’s uterus, where implantation occurs. From two to six days after egg retrieval, one or more embryos are inserted via catheter into your uterus. This procedure is quick and generally painless. Successful implantation takes place six to 10 days after transfer, and after nine to 14 days, your doctor tests your blood to determine if you are pregnant.
Any remaining embryos or sperm may be frozen. Most fertility clinics will walk you through an IVF consent form that outlines your choices with remaining human gametes or embryos. Most give options of freezing, disposition or donation.
CDC data shows that, in 2014, 70,354 live births resulted from assisted reproductive technology, and IVF is considered to be the most effective form of ART. Infertility shouldn't keep you from becoming a parent, and IVF is a viable option for most infertile couples.