In Vitro Fertilization (IVF)
In vitro fertilization (IVF) is a complex of medical procedures used to help a conception of a child. During these procedures, eggs are surgically removed from the body and then combined with sperm in a laboratory. After that, the fertilized and prepared eggs, which we will already call embryos, are transferred into the woman’s uterus.
IVF provides a chance at parenthood to those couples who until recently would have had no hope of having a child. There are many causes of infertility, and couples usually consider IVF in the following cases:
- Woman’s fallopian tubes are removed, damaged or ligated
- Ovulation disorders and ovarian failure (donor eggs may be needed)
- Uterus disorders* (e.g., endometriosis, uterine fibroids)
- Advanced reproductive age
- Impaired sperm production and function
- Preimplantation genetic diagnosis (to avoid any inherited disease)
- Upcoming chemotherapy or radiation for cancer treatment (to harvest eggs for later use)
- Unexplained infertility
*If a woman has uterus disorders or if pregnancy is a serious risk for health, she can choose IVF using another person’s uterus to carry the pregnancy. The woman who cares a baby is called gestational carrier. She is no way genetically related to the child.
The IVF technique includes several steps and lasts a few months. A patient must be fully familiar with the course and risks of the procedure.
Before beginning the cycle, the couples should pass some screening tests to determine any deviations and disorders:
- Ovarian reserve testing
- Semen analysis
- Infection disease screening
- Practice embryo transfer
- Uterine cavity exam
In case of positive results, it is necessary to evaluate a situation and conduct an appropriate treatment.
The first step of the cycle is ovarian stimulation. A patient is prescribed to take fertility medications and some days later, she is instructed to give an injection of hCG (human Chorion Gonadotropin) to trigger the ovulation. As a result, a physician is able to remove several mature eggs from the body, which will be prepared for fertilization in the laboratory dish.
In 32-36 hours after injecting hCG, the physician is going to retrieve the eggs for the implantation (second step). This procedure lasts about 15-30 minutes during which the patient may be sedated. After the anesthesia has passed and the procedure is over, a patient is allowed to go home.
By this time semen sample must be obtained (the partner’s or donor’s sperm can be used).
After last techniques, fertilization can be done (third step). Approximately half of the eggs become fertilized. In case of male infertility (sperm count or sperm motility is low) intracytoplasmic sperm injection (ICSI) is used.
In certain situations, a woman may be recommended other procedures before the last step would had be done:
- Assisted hatching in a case of advanced reproductive age or multiple failed IVF
- Preimplantation genetic testing in case of parents’ genetic diseases.
In two-five days one or usually more embryos (fertilized eggs) are gently transferred in the woman uterus. Anesthesia is not usually needed for this procedure, and woman resumes their daily activity in a couple of hours.
Usually in six-ten days after egg retrieval, an embryo will fully implant. If successful, woman becomes pregnant.
Each person need to be patient, because often more than one cycle of IFV is necessary.