Invitro fertilisation

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In vitro fertilization (IVF) is a type of assistive reproductive technology (ART). It involves retrieving eggs from a woman’s ovaries and fertilizing them with sperm. This fertilized egg is known as an embryo. The embryo can then be frozen for storage or transferred to a woman’s uterus.

Depending on your situation, IVF can use:

  • your eggs and your partner’s sperm
  • your eggs and donor sperm
  • donor eggs and your partner’s sperm
  • donor eggs and donor sperm
  • donated embryos

Your doctor can also implant embryos in a surrogate, or gestational carrier. This is a woman who carries your baby for you.

The success rate of IVF varies. the live birth rate for women under age 35 undergoing IVF is 41 to 43 percent. This rate falls to 13 to 18 percent for women over the age of 40.

Why Is In Vitro Fertilization Performed?

IVF helps people with infertility who want to have a baby. IVF is expensive and invasive, so couples often try other fertility treatments first. These may include taking fertility drugs or having intrauterine insemination. During that procedure, a doctor transfers sperm directly into a woman’s uterus.

Infertility issues for which IVF may be necessary include:

  • reduced fertility in women over the age of 40
  • blocked or damaged fallopian tubes
  • reduced ovarian function
  • endometriosis
  • uterine fibroids
  • male infertility, such as low sperm count or abnormalities in sperm shape
  • unexplained infertility

Parents may also choose IVF if they run the risk of passing a genetic disorder on to their offspring. A medical lab can test the embryos for genetic abnormalities. Then, a doctor only implants embryos without genetic defects.

Today, in vitro fertilization (IVF) is practically a household word. But not so long ago, it was a mysterious procedure for infertility that produced what were then known as "test-tube babies." Louise Brown, born in England in 1978, was the first such baby to be conceived outside her mother's womb.

Unlike the simpler process of artificial insemination -- in which sperm is placed in the uterus and conception happens otherwise normally -- IVF involves combining eggs and sperm outside the body in a laboratory. Once an embryo or embryos form, they are then placed in the uterus. IVF is a complex and expensive procedure; only about 5% of couples with infertility seek it out. However, since its introduction in the U.S. in 1981, IVF and other similar techniques have resulted in more than 200,000 babies.

There are five steps involved in IVF:

  1. stimulation
  2. egg retrieval
  3. insemination
  4. embryo culture
  5. transfer

Stimulation

A woman normally produces one egg during each menstrual cycle. However, IVF requires multiple eggs. Using multiple eggs increases the chances of developing a viable embryo. You’ll receive fertility drugs to increase the number of eggs your body produces. During this time, your doctor will perform regular blood tests and ultrasounds to monitor the production of eggs and to let your doctor know when to retrieve them.

Egg Retrieval

Egg retrieval is known as follicular aspiration. It’s a surgical procedure performed with anesthesia. Your doctor will use an ultrasound wand to guide a needle through your vagina, into your ovary, and into an egg-containing follicle. The needle will suction eggs and fluid out of each follicle.

Insemination

The male partner will now need to give a semen sample. A technician will mix the sperm with the eggs in a petri dish. If that doesn’t produce embryos, your doctor may decide to use ICSI.

Embryo Culture

Your doctor will monitor the fertilized eggs to ensure that they’re dividing and developing. The embryos may undergo testing for genetic conditions at this time.

Transfer

When the embryos are big enough, they can be implanted. This normally occurs three to five days after fertilization. Implantation involves inserting a thin tube called a catheter inserted into your vagina, past your cervix, and into your uterus. Your doctor then releases the embryo into your uterus.

Pregnancy occurs when the embryo implants itself in the uterine wall. This can take 6 to 10 days. A blood test will determine if you’re pregnant.

What Are the Complications Associated with In Vitro Fertilization?

As with any medical procedure, there are risks associated with IVF. Complications include:

  • multiple pregnancies, which increases the risk of low birth weight and premature birth
  • miscarriage (pregnancy loss)
  • ectopic pregnancy (when the eggs implant outside the uterus)
  • ovarian hyperstimulation syndrome (OHSS), a rare condition involving an excess of fluid in the abdomen and chest
  • bleeding, infection, or damage to the bowels or bladder (rare)

What Is the Long-Term Outlook?

Deciding whether to undergo in vitro fertilization, and how to try if the first attempt is unsuccessful, is an incredibly complicated decision. The financial, physical, and emotional toll of this process can be difficult. Speak with your doctor extensively to determine what your best options are and if in vitro fertilization is the right path for you and your family. Seek a support group or counselor to help you and your partner through this process.

 

 

 

Best regards
John Kimberly
Associate Managing Editor
Journal of Women’s Health and Reproductive Medicine