In vitro fertilization (patient information): Difference between revisions
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* More than one embryo may be placed into the womb at the same time, which can lead to twins, triplets, or more. The exact number of embryos transferred is a complex issue that depends on many factors, especially the woman’s age. Unused embryos may be frozen and implanted or donated at a later date. | * More than one embryo may be placed into the womb at the same time, which can lead to twins, triplets, or more. The exact number of embryos transferred is a complex issue that depends on many factors, especially the woman’s age. Unused embryos may be frozen and implanted or donated at a later date. | ||
==Who needs in vitro fertilization?== | ==Who needs in vitro fertilization?== | ||
IVF is done to help a woman become pregnant. It should be considered as a treatment option for infertility in patients with following risk factors: | IVF is done to help a woman become pregnant. It should be considered as a treatment option for infertility in patients with following risk factors: | ||
Revision as of 22:55, 26 February 2014
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In vitro fertilization |
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In vitro fertilization On the Web |
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Risk calculators and risk factors for In vitro fertilization |
For the WikiDoc page for this topic, click here Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
In vitro fertilization (IVF) is one of the treatments for infertility. A woman’s egg and a man’s sperm are fertilized in a laboratory dish. In vitro means outside the body. Fertilization means the sperm has attached to and entered the egg.
How is the in vitro fertilization done?
IVF is a form of assisted reproductive technology (ART). This means special medical techniques are used to help a woman become pregnant. IVF has been successfully used since 1978.
Procedure
Step 1: Stimulation
- Fertility medicines are given to the woman to increase her egg production. Normally, a woman produces one egg per month. Several eggs are produced under the influence of fertility drugs. During this step, the woman will have regular transvaginal ultrasounds to examine the ovaries and blood tests to check hormone levels.
Step 2: Egg Retrieval
- Follicular aspiration (a minor surgical procedure) is done to remove the eggs from the woman’s body. The surgery is normally done as an outpatient procedure in the doctor’s office. The woman will be given medicines so that she does not feel pain during the procedure. Using ultrasound images as a guide, the health care provider inserts a thin needle through the vagina and into the ovary and sacs (follicles) containing the eggs. The needle is connected to a suction device, which pulls the eggs and fluid out of each follicle, one at a time. The procedure is repeated for the other ovary. The woman may have some cramping after the surgery, but it usually goes away within a day. In rare cases, a pelvic laparoscopy may be needed to remove the eggs.
- If a woman does not or cannot produce any eggs, donated eggs may be used.
Step 3: Insemination and Fertilization
- The man’s sperm is placed together with the best quality eggs and stored in an environmentally controlled chamber. The mixing of the sperm and egg is called insemination. The sperm usually enters (fertilizes) an egg a few hours after insemination. If the doctor thinks the chance of fertilization is low, the laboratory staff may directly inject the sperm into the egg. This is called intracytoplasmic sperm injection (ICSI). Many fertility programs routinely do ICSI on some of the eggs even if everything is normal.
Step 4: Embryo Culture
- When the fertilized egg divides, it becomes an embryo. Laboratory staff will regularly check the embryo to make sure it is growing properly. Within about 5 days, a normal embryo has several cells that are actively dividing.
- Couples who have a high risk of passing a genetic (hereditary) disorder to a child may consider pre-implantation genetic diagnosis (PGD). The procedure is done about 3-4 days after the fertilization. Laboratory scientists remove a single cell from each embryo and screen the material for specific genetic disorders. According to the American Society for Reproductive Medicine, PGD can help parents decide which embryos to implant, which decreases the chance of passing a disorder onto the child. The technique is controversial and is not offered at all the centers.
Step 5: Embryo Transfer
- Embryos are placed into the woman’s womb 3-5 days after egg retrieval and fertilization. The procedure is done in the doctor’s office while the woman is awake. The doctor inserts a thin tube (catheter) containing the embryos into the woman’s vagina, through the cervix, and up into the womb. If an embryo sticks to (implants) in the lining of the womb and grows, pregnancy results.
- More than one embryo may be placed into the womb at the same time, which can lead to twins, triplets, or more. The exact number of embryos transferred is a complex issue that depends on many factors, especially the woman’s age. Unused embryos may be frozen and implanted or donated at a later date.
Who needs in vitro fertilization?
IVF is done to help a woman become pregnant. It should be considered as a treatment option for infertility in patients with following risk factors:
- Advanced age of the woman (advanced maternal age)
- Damaged or blocked fallopian tubes (can be caused by pelvic inflammatory disease or prior reproductive surgery)
- Endometriosis
- Male factor infertility, including decreased sperm count and blockage
- Unexplained infertility