In Vitro Fertilization (IVF)

In Vitro Fertilization (IVF)

In vitro fertilization (IVF) is a method of assisted reproduction in which a woman’s egg (or a donated egg) is fertilized in a laboratory with her partner’s sperm or donated sperm. The resulting embryo is then transferred to the uterus to develop naturally.

IVF is usually the treatment of choice for a woman with damaged or absent fallopian tubes. IVF is also used to treat infertility caused by endometriosis or a male factor. IVF can also be used to treat couples with unexplained infertility who have failed to achieve pregnancy with other infertility treatments.

IVF was successfully used for the first time in the U.S. in 1981. Since then, more than 114,000 babies have been born in the U.S. as a result of the technique.

The Procedure

IVF consists of five basic steps:

1. Ovarian follicle development. Medications are administered to the women to stimulate the maturation of multiple eggs.
2. Egg retrieval. Eggs are usually recovered in an outpatient surgical setting using a transvaginal ultrasound-guided aspiration procedure.
3. In vitro fertilization. The eggs are then fertilized with sperm in the laboratory.
4. Uterine embryo transfer. The embryos are transferred into the woman's uterus using a tiny catheter.
5. Monitoring and support. During this phase, the woman will be monitored to check for blood levels to assess the quality of the uterus lining. If a pregnancy is achieved, an ultrasound two weeks after a positive result can determine the fetal heartbeat and number of fetuses.

There are many variations on the IVF procedure, depending on individual circumstances. Variations include:

• Transfer of cryopreserved (frozen) embryos
• Gamete intrafallopian transfer (GIFT)/ zygote intrafallopian transfer (ZIFT)
• Intracytoplasmic sperm injection (ICSI)
• Assisted hatching
• Donor oocytes
• Frozen oocytes

Success Rates

According to data provided by the Centers for Disease Control and Prevention (CDC), assisted reproductive technologies account for slightly more than 1 percent of total U.S. births. In 2006 about 35 percent of cycles in the U.S. in which women underwent IVF and embryo transfer with their own eggs resulted in the live birth of at least one infant.

This rate has been improving steadily over the years. While success varies with many factors, the age of the woman is the most important factor when women are using their own eggs. Success rates decline as women age, and drop off dramatically after about age 37. Part of this decline is due to a higher risk of miscarriage with increasing age. Chances for success are also greater among women who do not have uterine abnormalities and have had previous successful pregnancies.