IVF is the most effective form of assisted reproductive technology. The procedure can be done using a couple's own eggs and sperm. Or IVF may involve eggs, sperm or embryos from an anonymous donor. In some cases, a gestational carrier - someone who has an embryo implanted in the uterus - might be used.
(IVF) is a complex series of procedures used to help with fertility or prevent genetic problems and assist with the conception of a child.
Why it's done: In vitro fertilization (IVF) is a treatment for infertility or genetic problems. If IVF is performed to treat infertility, you and your partner might be able to try less-invasive treatment options before attempting IVF, including fertility drugs to increase production of eggs or intrauterine insemination - a procedure in which sperm are placed directly in the uterus near the time of ovulation.
Sometimes, IVF is offered as a primary treatment for infertility in women over age 40. IVF can also be done if you have certain health conditions. For example, IVF may be an option if you or your partner has:
- Fallopian tube damage or blockage. Fallopian tube damage or blockage makes it difficult for an egg to be fertilized or for an embryo to travel to the uterus.
- Ovulation disorders. If ovulation is infrequent or absent, fewer eggs are available for fertilization.
- Impaired sperm production or function. Below-average sperm concentration, weak movement of sperm (poor mobility), or abnormalities in sperm size and shape can make it difficult for sperm to fertilize an egg. If semen abnormalities are found, a visit to an infertility specialist might be needed to see if there are correctable problems or underlying health concerns.
- Unexplained infertility. Unexplained infertility means no cause of infertility has been found despite evaluation for common causes.
- A genetic disorder. If you or your partner is at risk of passing on a genetic disorder to your child, you may be candidates for preimplantation genetic testing - a procedure that involves IVF. After the eggs are harvested and fertilized, they're screened for certain genetic problems, although not all genetic problems can be found. Embryos that don't contain identified problems can be transferred to the uterus.
- Fertility preservation for cancer or other health conditions. If you're about to start cancer treatment - such as radiation or chemotherapy - that could harm your fertility, IVF for fertility preservation may be an option. Women can have eggs harvested from their ovaries and frozen in an unfertilized state for later use. Or the eggs can be fertilized and frozen as embryos for future use.
Before beginning a cycle of IVF using your own eggs and sperm, you and your partner will likely need various screenings, including:
- Ovarian reserve testing. To determine the quantity and quality of your eggs, your doctor might test the concentration of follicle-stimulating hormone (FSH), estradiol (estrogen), and anti-mullerian hormone in your blood during the first few days of your menstrual cycle. The test results, when combined with an ovarian ultrasound, assist in predicting the ovarian response to fertility medication.
- Semen analysis. If not done as part of your initial fertility evaluation, your doctor will conduct a semen analysis shortly before the start of an IVF treatment cycle.
- Infectious disease screening. You and your partner will both be screened for infectious diseases, including HIV.Practice (mock) embryo transfer. Your doctor might conduct a mock embryo transfer to determine the depth of your uterine cavity and the technique most likely to successfully place the embryos into your uterus.
IVF involves several steps - ovarian stimulation, egg retrieval, sperm retrieval, fertilization, and embryo transfer. One cycle of IVF can take about two to three weeks. More than one cycle may be needed.
Typically, you'll need one to two weeks of ovarian stimulation before your eggs are ready for retrieval. To determine when the eggs are ready for collection, you may have:
- Vaginal ultrasound, an imaging exam of your ovaries to monitor the development of follicles - fluid-filled ovarian sacs where eggs mature
- Blood tests, to measure your response to ovarian stimulation medications - estrogen levels typically increase as follicles develop, and progesterone levels remain low until after ovulation
About 12 days to two weeks after egg retrieval, your doctor will test a sample of your blood to detect whether you're pregnant.
- If you're pregnant, your doctor will advise medications needed to support the pregnancy and advice you regarding the dos and don'ts.
- If you're not pregnant, you'll stop taking progesterone and likely get your period within a week. If you don't get your period or you have unusual bleeding, contact your doctor. If you're interested in attempting another cycle of in vitro fertilization (IVF), your doctor might suggest steps you can take to improve your chances of getting pregnant through IVF.
The chances of giving birth to a healthy baby after using IVF depend on various factors, including:
- Maternal age. The younger you are, the more likely you are to get pregnant and give birth to a healthy baby using your own eggs during IVF. Women age 41 and older are often counseled to consider using donor eggs during IVF to increase the chances of success.
- Embryo status. Transfer of embryos that are more developed is associated with higher pregnancy rates compared with less developed embryos (day two or three). However, not all embryos survive the development process. Reproductive history. Women who've previously given birth are more likely to be able to get pregnant using IVF than are women who've never given birth. Success rates are lower for women who've previously used IVF multiple times but didn't get pregnant.
- Cause of infertility. Having a normal supply of eggs increases your chances of being able to get pregnant using IVF. IVF success is lower for women with severe endometriosis compared to those with unexplained infertility, highlighting unique challenges in conception.
- Lifestyle factors. Women who smoke typically have fewer eggs retrieved during IVF and may miscarry more often. Smoking can lower a woman's chance of success using IVF by 50%. Obesity can decrease your chances of getting pregnant and having a baby. The use of alcohol, recreational drugs, excessive caffeine, and certain medications also can be harmful.
These are some of the important factors to keep in mind while considering IVF. It's a beautiful yet very hard process to go through and it's best to trust a clinic that looks after your needs and understands your concerns as well.
