Infertility and In Vitro Fertilization

In vitro fertilization (IVF), is a process of fertilization where an egg is combined with sperm outside the woman’s body in a laboratory. IVF is practically a household word today compared to decades back when it was first referred to as test-tube babies. In 1978, the first test-tube baby, Louise Brown, born in England, was the first such baby to be conceived outside her mother’s womb.

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IVF involves combining eggs and sperm outside the body in a lab. Once an embryo or embryos form, they are placed in the uterus. Apart from being complex, IVF is an expensive procedure. Only about 5% of couples with infertility issues go for this option of conceiving. However, since its introduction in the U.S. in 1981, IVF and other similar procedures have given rise to in more than 200,000 babies.

What Causes of Infertility Can be Treated with IVF?

When it comes to infertility, IVF may be an option if you or your partner have been diagnosed with:

  • Endometriosis
  • Low sperm counts
  • Problems with the uterus
  • Problems with fallopian tubes
  • Ovulation problems
  • Antibody problems that harm sperm or eggs
  • The inability of sperm to penetrate or survive in the cervical mucus
  • An unsolved fertility problem

IVF is never the first step in the treatment of infertility except in cases of complete tubal blockage. Instead, it’s reserved for cases in which other methods such as fertility drugs, artificial insemination, and surgery have been unsuccessful.

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Before deciding to choose IVF as the last option, carefully assess any treatment center before undergoing the procedure. Here are some questions to ask the staff at the fertility clinic:

  • What is your pregnancy ratio per embryo transfer?
  • How much does it cost to store embryos and how long can we store them?
  • What is your pregnancy rate for couples in our age group and with our fertility problem?
  • How many of those deliveries are twins or other multiple births?
  • What is the live birth rate for all couples who undergo this procedure each year at your facility?
  • Do you participate in an egg donation program?
  • How much will the procedure cost, including the cost of the hormone treatments?

What To Expect From IVF

The first step in IVF involves injecting hormones so you produce multiple eggs monthly instead of only one. You will then be tested to determine whether you’re ready for egg retrieval.

Before the retrieval procedure, you will be given injections of a medication that develops the eggs and starts the process of ovulation. Timing is important; the eggs must be retrieved just before they emerge from the follicles in the ovaries. If the eggs are taken out too early or too late, they won’t develop normally. Your doctor may perform blood tests or an ultrasound to be sure the eggs are at the right stage of development before retrieving them. The IVF facility will provide you with special instructions to follow the night before and the day of the procedure.

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Most women are given pain medication and the choice of being mildly sedated or going under full anesthesia.

During the procedure, your doctor will locate follicles in the ovary with ultrasound and remove the eggs with a hollow needle. The procedure usually takes less than 30 minutes to one hour.

Immediately following the retrieval, your eggs will be mixed in the laboratory with your partner’s sperm, which he will have donated on the same day.

While you and your partner go home, the fertilized eggs are kept in the clinic under observation to ensure optimal growth. Depending on the clinic, you may even wait up to five days until the embryo reaches a more advanced blastocyst stage.

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Once the embryos are ready, you will return to the IVF facility so doctors can transfer one or more into your uterus. This procedure is quicker and easier than the retrieval of the egg. The doctor will insert a flexible tube called a catheter through your vagina and cervix and into your uterus, where the embryos will be deposited. To increase the chances of pregnancy, most IVF experts recommend transferring up to three embryos at a time. However, this means you could have a multiple pregnancy.

You will remain in bed after the procedure for several hours and be discharged four to six hours later. Your doctor will probably perform a pregnancy test on you about two weeks after the embryo transfer.

A man’s sperm count may be very low in some cases. If this happens, the doctors may combine IVF with a procedure called intracytoplasmic sperm injection. In this procedure, a sperm is taken from semen or in some cases right from the testicles and inserted directly into the egg. Once a viable embryo is produced, it is transferred to the uterus using the usual IVF procedure.

What Are the Success Rates for IVF?

A woman’s age and the cause of infertility are some factors that determine the success rates for IVF. The CDC compiles national statistics for all assisted reproductive technology (ART) procedures performed in the U.S., including IVF, GIFT, and ZIFT, although IVF is by far the most common; it accounts for 99% of the procedures. The most recent report from 2009 found:

  • Pregnancy was achieved in an average of 29.4% of all cycles (higher or lower depending on the age of the woman).
  • The percentage of cycles that resulted in live births was 22.4% on average (higher or lower depending on the age of the woman).

Are There Other Issues With IVF to Consider?

Embryos that you do not use in your first IVF attempt can be frozen and kept for later use. This will save you money if you undergo IVF a second or third time. You may decide to donate them to another infertile couple if you do not want your leftover embryos. Also, you and your partner can decide to ask the clinic to destroy the embryos. Both you and your partner must agree before the clinic will destroy or donate your embryos.

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A woman’s age is a major factor in the success of IVF for any couple. For instance, a woman who is under age 35 and undergoes IVF has a 39.6% chance of conceiving, while a woman over age 40 has an 11.5% chance. However, the CDC recently found that the success rate is increasing in every age group as the techniques are refined and doctors become more skilled.

What Are The Costs of IVF?

According to the American Society of Reproductive Medicine, the average cost of an IVF cycle in the U.S. is $12,400. This price will differ depending on where you live, the amount of medications you’re required to take, the number of IVF cycles you undergo, and the amount your insurance company will pay toward the procedure.

 

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