In vitro fertilization (IVF)
In vitro fertilization (IVF)
In vitro fertilization (IVF) is a procedure used to treat fertility problems and assist with the conception of a child. During in vitro fertilization, mature eggs are retrieved from your ovaries and fertilized by sperm in a lab. Then the fertilized egg (embryo) or eggs are implanted in your uterus. One cycle of in vitro fertilization takes about two weeks.
In vitro fertilization is the most effective form of assisted reproductive technology (ART). The procedure can be done using your own eggs and your partner's sperm, donor eggs, donor sperm or donor embryos. In some cases, a gestational carrier — a woman who has an embryo implanted in her uterus — might be used.
Your chances of having a healthy baby using in vitro fertilization depend on many factors, such as your age and the cause of infertility. In addition, in vitro fertilization can be time-consuming, expensive and invasive. If more than one embryo is implanted in your uterus, in vitro fertilization can result in a multiple pregnancy.
Your doctor can help you understand how in vitro fertilization works, the potential risks and whether this method of treating infertility is right for you.
Why it's done
In vitro fertilization is a possible treatment option for infertility. Depending on the cause of infertility, you and your partner might try less invasive treatment options before attempting in vitro fertilization, including fertility drugs to increase your production of eggs (superovulation) or intrauterine insemination — a procedure in which sperm are placed directly in your uterus. Occasionally, in vitro fertilization is offered as a primary treatment for infertility in women older than age 40. In vitro fertilization can also be done if you have certain health conditions.
For example, in vitro fertilization may be an option if you or your partner has:
In vitro fertilization can be used by a couple to conceive a biological child or with the use of donor eggs, sperm or embryos. Donors can be known or anonymous. The embryo can also be implanted in the uterus of a gestational carrier.
Specific steps of an in vitro fertilization cycle carry potential risks, including:
How you prepare
When choosing an in vitro fertilization clinic, you might have many options. The Centers for Disease Control and Prevention and the Society for Assisted Reproductive Technology provide information online about U.S. clinics' individual pregnancy and live birth rates. Keep in mind, however, that a clinic's success rate depends on many factors, such as patients' ages, the number of embryos being transferred during each in vitro fertilization cycle and the number of cycles that have been done. If the expense of in vitro fertilization is a concern, ask for detailed information about the costs associated with each step of the procedure.
Before beginning a cycle of in vitro fertilization using your own eggs and sperm, you and your partner will likely need various screenings, including:
Before beginning a cycle of in vitro fertilization, consider important questions, including:
What you can expect
During the procedure
Your doctor will work with you to determine which medications to use. During treatment, your doctor will likely use vaginal ultrasounds — a procedure that uses sound waves to create an image of the inside of your ovaries — to monitor the development of fluid-filled ovarian cysts where eggs mature (follicles). Blood tests also will be used to measure your response to ovarian stimulation medications. Estrogen levels typically increase as follicles develop and progesterone levels remain low until after ovulation. When the follicles are ready for egg retrieval — generally after eight to 14 days — you'll be given HCG or other medications to help the eggs mature.
Sometimes in vitro fertilization cycles need to be canceled before egg retrieval. Causes for in vitro fertilization cancellation include:
Your doctor might recommend changing medications to promote a better response during future in vitro fertilization cycles.
On the day of egg retrieval or at the time of embryo transfer, your doctor might recommend that you begin taking progesterone supplements — in the form of oral tablets, injections or vaginal suppositories — to make the lining of your uterus more receptive to implantation.
If you're an older woman or have had multiple failed in vitro fertilization attempts, your doctor might recommend assisted hatching — a technique in which a hole is made in the membrane (zona pellucida) surrounding the embryo to help the embryo hatch and implant in the lining of your uterus. Assisted hatching is done just before embryo transfer. Preimplantation genetic testing — a procedure in which cells are removed from the embryo and tested for specific genetic diseases — also can be done at this time. Embryos that don't contain affected genes can be implanted in your uterus. While preimplantation genetic testing can reduce the likelihood that a parent will pass on a genetic problem, it can't eliminate the risk. Prenatal testing may be recommended.
After the procedure
Typical side effects include:
If you develop moderate or severe pain after the embryo transfer, contact your doctor. He or she will evaluate you for factors such as infection, twisting of an ovary (ovarian torsion) and severe ovarian hyperstimulation syndrome.
Your doctor will take a blood sample to detect pregnancy hormones about two weeks after egg retrieval. If you're pregnant, your doctor will refer you to an obstetrician or other pregnancy specialist for prenatal care. If you're not pregnant, you'll stop taking progesterone and likely get your period in one to three days. If you don't get your period or have unusual irregular bleeding, contact your doctor. He or she may examine you to rule out an ectopic pregnancy. If you're interested in attempting another cycle of in vitro fertilization, your doctor might suggest steps you can take to improve your chances of getting pregnant through in vitro fertilization.
The chances of giving birth to a healthy baby after using in vitro fertilization depend on various factors, including:
Last Updated: 2011-04-22
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