In Vitro Fertilization
Alternate Names : Assisted Reproductive Technology, IVF, ART
In vitro fertilization, also called IVF, is a method used to
enable couples who are unable to conceive naturally, to have a child. IVF
refers to the combining of egg and sperm outside the woman's body. Once the
egg is fertilized, the embryo is put back into the woman's body for full
development.
Who is a candidate for the procedure?
IVF is used for women who have:
blocked or absent fallopian tubes
endometriosis, a condition in which tissue that normally lines the uterus is found elsewhere in the body
other medical reasons that prevent the egg and sperm from joining
naturally within the woman's body
How is the procedure performed?
Fertility medications or hormonal preparations are used to help
stimulate ovulation and/or support the development of the uterine lining.
These medications are taken daily, at home, usually by injection.
Normally, the ovaries take turns releasing one egg each menstrual cycle. With IVF, fertility medications
suppress normal hormone function and reduce the risk of eggs being released
from the ovary before they can be retrieved. Later in the cycle, more
medications are given to cause the ovaries to produce many mature eggs at the same time. Vaginal ultrasound and blood testing every 2 to 3 days can monitor the body's response to these medications, and the maturity of the eggs. When enough eggs have matured, another type of medication is given to stimulate their release from the ovary. These mature eggs are removed 32 to 36 hours later.
The egg retrieval process is done in the doctor's office or special procedure room. The woman is sedated to keep her comfortable. An ultrasound device is inserted through the vagina to see the follicles in the ovaries that house the mature eggs. The doctor then inserts a needle through the vaginal wall and withdraws the eggs. This procedure takes 15 to 60 minutes, and usually only causes mild pelvic discomfort.
Once the eggs have been withdrawn, they are incubated for several hours before sperm cells are added. When the sperm cells are added to the eggs, they are again incubated for about 12 to 18 more hours to allow for fertilization. After fertilization occurs, the embryos are checked for quality and viability. Not all embryos will develop well enough to be transferred to the womb.
Embryos are usually transferred 3 to 5 days after egg retrieval. This transfer occurs in the doctor's office or procedure room. No anesthesia is used. It is much like a regular pelvic exam. The embryos are inserted into the uterus using a soft, flexible catheter attached to a syringe. Usually 2 to 5 embryos are inserted. This will depend on the quality of the embryos and the age of the woman. Extra embryos, if any, can be frozen for future use.
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