IVF

What is In Vitro Fertilization-IVF

The IVF process involves:

  • Stimulating multiple follicles and eggs to develop
  • Egg retrieval to get the eggs
  • Fertilizing the eggs in the laboratory
  • Embryo transfer to the uterus
  • Louise Brown was the first IVF baby in the world. She was born in July of 1978 in England.
  • Louise was 28 (in 2006) when she had her own baby (without IVF).
  • Hundreds of thousands of children are now born every year as a result of IVF.

Who should be treated with in vitro fertilization?

IVF can be used as an effective treatment for infertility of all causes except for women with infertility caused by an anatomic problem with the uterus, such as severe intrauterine adhesions.

It is generally used in couples who have failed to conceive after at least one year of trying who also have one or more of the following:

  • Blocked fallopian tubes or pelvic adhesions with distorted pelvic anatomy. Women that have had tubal ligation and are considering tubal reversal surgery as well as men that are considering vasectomy reversal surgery might also consider IVF.
  • Failed 2-4 cycles of ovarian stimulation with intrauterine insemination
  • Advanced female age - over about 38 years of age. In vitro fertilization and advanced maternal age is discussed in detail on the female age page.
  • Male factor infertility (low sperm count or low motility). ICSI is an IVF procedure that can fertilize eggs even with poor sperm quality.
  • Reduced ovarian reserve, which means lower quantity (and sometimes quantity) of eggs. A day 3 FSH and estradiol test, antral follicle counts and AMH hormone levels are often done as screening tests for egg quantity. Reduced egg quantity and quality is usually treated with either IVF, or with IVF with egg donation.
  • Severe endometriosis
  • Unexplained infertility when inseminations have failed. Unexplained infertility means standard fertility tests have not found the cause of the fertility issue.

Therefore, with IVF:

  • We stimulate with medications to produce multiple follicles and eggs (only one follicle with one egg inside develops in a natural menstrual cycle)
  • We retrieve the eggs from the ovaries when they're ready (release and tubal pickup of the egg can be inefficient naturally)
  • We coerce fertilization in the lab (sperm or egg issues can cause fertilization problems in a natural situation)
  • We culture the embryos for several days and then pick the best one (or more) for transfer to the woman - selection of the best one(s) increases success.
  • We transfer the embryos to the best location in the middle of the uterine cavity (tubal transport of the embryo to the uterus is bypassed) Once the embryo is transferred, The implantation has to attain in the uterus endometrium which give confirmation about the rate of pregnancy. The implantation rate is usually defined as the percentage of embryos transferred that implant and develop to the stage of ultrasound documented fetal heartbeat. And Hence confirming the pregnancy.