In vitro fertilization (IVF) is a procedure in which
eggs (ova) from a woman's ovary are removed. They are fertilized with
sperm in a laboratory procedure, and then the fertilized egg (embryo) is
returned to the woman's uterus.
IVF is one
of several assisted reproductive techniques (ART) used to help
infertile couples to conceive a child. If after one year of having
sexual intercourse without the use of birth control a woman is unable to
get pregnant, infertility is suspected. Some of the reasons for
infertility are damaged or blocked fallopian tubes, hormonal imbalance,
or endometriosis in the woman. In the man, low sperm count or poor
quality sperm can cause infertility.
IVF is one of several
possible methods to increase the chance for an infertile couple to
become pregnant. Its use depends on the reason for infertility. IVF may
be an option if there is a blockage in the fallopian tube or
endometriosis in the woman or low sperm count or poor quality sperm in
the man. There are other possible treatments for these conditions, such
as surgery for blocked tubes or endometriosis, which may be tried before
IVF will not work for a woman who is not capable of ovulating or a man who is not able to produce at least a few healthy sperm.
screening procedures and treatments for infertility can become a long,
expensive, and sometimes, disappointing process. Each IVF attempt takes
at least an entire menstrual cycle and can cost $5,000-$10,000, which
may or may not be covered by health insurance. The anxiety of dealing
with infertility can challenge both individuals and their relationship.
The added stress and expense of multiple clinic visits, testing,
treatments, and surgical procedures can become overwhelming. Couples may
want to receive counseling and support throughout the process.
vitro fertilization is a procedure where the joining of egg and sperm
takes place outside of the woman's body. A woman may be given fertility
drugs before this procedure so that several eggs mature in the ovaries
at the same time. Eggs (ova) are removed from a woman's ovaries using a
long, thin needle. The physician gains access to the ovaries using one
of two possible procedures. One procedure involves inserting the needle
through the vagina (transvaginally). The physician guides the needle to
the location of the ovaries with the help of an ultrasound machine. In
the other procedure, called laparoscopy, a small thin tube with a
viewing lens is inserted through an incision in the navel. This allows
the physician to see inside the patient, and locate the ovaries, on a
Once the eggs are removed, they are mixed with
sperm in a laboratory dish or test tube. (This is where the term test
tube baby comes from.) The eggs are monitored for several days. Once
there is evidence that fertilization has occurred and the cells begin to
divide, they are then returned to the woman's uterus.
procedure to remove eggs, enough may be gathered to be frozen and saved
(either fertilized or unfertilized) for additional IVF attempts. A 2004
study from the Mayo Clinic found that frozen sperm was as effective as
fresh sperm for IVF.IVF has been used successfully since 1978, when the
first child to be conceived by this method was born in England. Over the
past 20 years, thousands of couples have used this method of ART or
similar procedures to conceive.
Other types of assisted
reproductive technologies might be used to achieve pregnancy. A
procedure called intracytoplasmic sperm injection (ICSI) uses a
manipulation technique that must be performed using a microscope to
inject a single sperm into each egg. The fertilized eggs can then be
returned to the uterus, as in IVF. In gamete intrafallopian tube
transfer (GIFT) the eggs and sperm are mixed in a narrow tube and then
deposited in the fallopian tube, where fertilization normally takes
place. Another variation on IVF is zygote intrafallopian tube transfer
(ZIFT). As in IVF, the fertilization of the eggs occurs in a laboratory
dish. And, similar to GIFT, the embryos are placed in the fallopian tube
(rather than the uterus as with IVF).
a woman is determined to be a good candidate for in vitro
fertilization, she will generally be given "fertility drugs" to
stimulate ovulation and the development of multiple eggs. These drugs
may include gonadotropin releasing hormone agonists (GnRHa), Pergonal,
Clomid, or human chorionic gonadotropin (hcg). The maturation of the
eggs is then monitored with ultrasound tests and frequent blood tests.
If enough eggs mature, the physician will perform the procedure to
remove them. The woman may be given a sedative prior to the procedure. A
local anesthetic agent may also be used to reduce discomfort during the
After the IVF procedure is
performed the woman can resume normal activities. A pregnancy test can
be done approximately 12-14 days later to determine if the procedure was
The risks associated with in
vitro fertilization include the possibility of multiple pregnancy (since
several embryos may be implanted) and ectopic pregnancy (an embryo that
implants in the fallopian tube or in the abdominal cavity outside the
uterus). There is a slight risk of ovarian rupture, bleeding,
infections, and complications of anesthesia. If the procedure is
successful and pregnancy is achieved, the pregnancy would carry the same
risks as any pregnancy achieved without assisted technology.
rates vary widely between clinics and between physicians performing the
procedure and implantation does not guarantee pregnancy. Therefore, the
procedure may have to be repeated more than once to achieve pregnancy.
However, success rates have improved in recent years, up from 20% in
1995 to 27% in 2001.
An ectopic or
multiple pregnancy may abort spontaneously or may require termination
if the health of the mother is at risk. The number of multiple
pregnancies has decreased in recent years as technical advances and
professional guidelines have led to implanting of fewer embryos per
Key TermsFallopian tubes
In a woman's reproductive system, a pair of narrow tubes that carry the egg from the ovary to the uterus.
for gamete intrafallopian tube transfer. This is a process where eggs
are taken from a woman's ovaries, mixed with sperm, and then deposited
into the woman's fallopian tube.
for intracytoplasmic sperm injection. This process is used to inject a
single sperm into each egg before the fertilized eggs are put back into
the woman's body. The procedure may be used if the male has a low sperm
Stands for zygote intrafallopian
tube transfer. In this process of in vitro fertilization, the eggs are
fertilized in a laboratory dish and then placed in the woman's fallopian