In Vitro Fertilization (Fertility Treatment)

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KEY POINTS

• In vitro fertilization (IVF) is a way to help couples who are having trouble getting pregnant. IVF uses the woman's eggs and the man's sperm to make an embryo, which is placed into the woman’s uterus.
• Check the reputation of a fertility clinic before starting any treatment. The Centers for Disease Control and Prevention keeps a national database of clinics and their success rates.
• Every procedure or treatment has risks. Ask your healthcare provider how the risks apply to you.

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What is in vitro fertilization?

In vitro fertilization (IVF) is a way to help couples who are having trouble getting pregnant. It uses the woman's eggs and the man's sperm. Eggs are removed from the woman’s body and fertilized by sperm in the lab. The fertilized eggs (called embryos) are then put into the woman’s uterus.

IVF results in pregnancy and the birth of a baby in 30 to 40% of the women who have the procedure between the ages of 25 and 37. The success rate is much lower after the age of 37.

IVF is a type of assisted reproductive technology (ART). ART has made it possible for many couples to have children.

When is it used?

IVF may be done to treat infertility. Infertility is not being able to get pregnant after having regular sexual intercourse without birth control for at least 1 year (or 6 months if the woman is 35 or older). IVF may be done if:

• A woman's fallopian tubes are blocked, which means the sperm cannot reach the egg. (Fertilization normally takes place in the fallopian tubes.)
• The woman has endometriosis, which means tissue from the uterus has grown outside the uterus.
• The male partner has no sperm or low sperm counts.
• There are problems with the cervix, such as an infection.
• The woman’s body makes substances that kill the sperm.
• Other fertility treatments have not been successful.
• The cause of infertility is not known.

In some cases, donor eggs (eggs from another woman), donor sperm (sperm from another man), or previously frozen embryos may be used.

If a couple has a high risk of having a baby with genetic problems, they may use IVF to become pregnant using the eggs or sperm of healthy donors

Ask your healthcare provider about your choices for treatment and the risks.

How do I prepare for this procedure?

Make sure that you check the reputation of a fertility clinic before starting any treatment. The CDC (Centers for Disease Control and Prevention) keeps a national database of clinics and their success rates. You can get this information by calling the Division of Reproductive Health at 770-488-5200 or visiting their Web site at http://www.cdc.gov/art/index.html.

How is IVF done?

The man gives a sperm sample so it can be tested before the procedure. Then the woman takes medicine that makes the ovaries produce several mature eggs. At follow-up visits your healthcare provider uses ultrasound to see how the eggs are developing. The eggs should mature within a couple days. When the eggs are mature, they are removed from the ovaries. The man will also give another sperm sample at this time.

To collect the eggs, the woman will first be given medicine to relax her and possibly put her to sleep. The eggs will be removed from the ovaries with a needle inserted through the vaginal wall and into the ovaries. Your healthcare provider will use ultrasound to see the ovaries and guide the needle. The eggs will then be placed in a dish in the lab along with the sperm for fertilization.

If there are only a few sperm in the sample, or if the sperm are not able to fertilize the egg on their own, a single sperm may be injected into an egg to fertilize it. This is called intra-cytoplasmic sperm injection (ICSI).

After about 40 hours, the eggs are examined to see if they have been fertilized by the sperm and become embryos. Two or three of the embryos will then be placed in the woman's uterus. This happens about 2 days after the eggs were removed from the ovaries. Putting the embryos into the uterus is a simple procedure that takes 10 to 15 minutes. The embryos are transferred with a thin, soft tube that is put into the vagina and up into the uterus. The embryos are gently flushed out of the tube and into the uterus. Your healthcare provider may use ultrasound to help put them in the uterus. If several embryos are put into the uterus, there is a chance that you will have more than 1 baby. It is safer to have one baby at a time.

What happens after the procedure?

The woman may be able to leave the clinic several hours after the procedure. She will have blood tests and take hormones for the next 2 weeks to make sure the lining of the uterus is ready to accept the embryos. She will return in 2 weeks for a pregnancy test. If she is not pregnant, another procedure can be done after she goes through a normal monthly menstrual cycle.

Embryos not used in the first procedure can be frozen for later use.

What are the risks of this procedure?

Every procedure or treatment has risks. Some possible risks of this procedure include:

• Infection or injury to the pelvic organs
• Bleeding

Ask your healthcare provider how the risks apply to you. Be sure to discuss any other questions or concerns that you may have.