Since the first In Vitro Fertilization (IVF) baby was born in 1978, reproductive medicine has been making strides in treating infertility. Although there is one main predictor – success rates vary dramatically by age. In 2013, for example, 40 percent of IVF cycles performed in women who were under the age of 35 resulted in live births, compared with 4.5 percent for women older than 42. All of that changes if one is considering donor egg, and of course the underlying health of the intended parents and who will be carrying the potential child.
But just what is In Vitro Fertilization? IVF is a complicated process, but can offer great hope to intended parents, women or men with infertility or people who would like to build a family but can’t for various reasons. IVF involves using a woman’s eggs and man’s sperm combined to create an embryo. Then that embryo (and sometimes more than one) is inserted in the woman’s uterus through her cervix to enhance the chances of pregnancy.
Of course before an IVF treatment, patients should schedule a consultation with a fertility specialist, which is an RE (Reproductive Endocrinologist), and go through very specific fertility testing to see what is really necessary, or if the process may work for them. The testing usually involves bloodwork, and sometimes and ultrasound or an evaluation of the uterine cavity. Sometimes a hysterosalpingogram (HSG) or a sonohysterogram will be performed to get detailed information about fallopian tubes, the uterus, and the reproductive system. These tests may reveal abnormalities of the uterus which should then be corrected before an IVF procedure. Additionally, the woman’s partner must also undergo blood testing, a semen analysis and possibly a sperm DNA fragmentation index test (DFI).
Once an IVF process starts there will be a course of medications, possibly injections and monitoring to ensure that you are responding appropriately to the medication and to determine if medication dosage adjustments are needed. When your eggs have reached appropriate maturity, the doctor removes your eggs during an egg retrieval process, which is done under vaginal ultrasound guidance. After the retrieval, the eggs are evaluated and if they are of good quality, the process continues with the in lab fertilization of the eggs with the sperm sample. Not all eggs removed may fertilize due to poor quality or due to immaturity, but the resultant fertilized eggs, now called embryos, will be placed in a special culture media to grow. And finally, the embryo transfer happens anywhere between three to six days after the retrieval, typically with the help of abdominal ultrasound guidance and no anesthesia. In Vitro Fertilization can be a safe and successful approach to attaining a pregnancy. Because this procedure is not without risks, there should be careful consideration and discussion with your fertility doctor as to whether this is the right treatment modality for you.