IVF or in vitro fertilisation is used to treat infertility after more conventional methods have failed to help conceive a child. It may also be used if a woman's Fallopian tubes are damaged or in cases of severe male infertility. An estimated three million children have been conceived using IVF and other assisted reproduction techniques since they were first introduced in 1978, according to data presented to the European Society of Human Reproduction and Embryology.
IVF involves fertilising and egg with sperm in a laboratory in a process known as assisted reproductive technology. The process begins even before a woman's eggs are retrieved, when she must take hormones to stimulate egg maturation. Then, she is monitored to see when the maturation is complete. Next, the eggs are harvested using a vaginal ultrasound probe while the woman is under local anesthetic. Next, sperm is collected from the man, washed and added to the eggs in a lab culture dish.
For men with abnormal sperm or couples who had previous IVF failures, an additional procedure, called intracytoplasmic sperm injection, allows for a sperm to be injected directly into a mature egg to assist fertilisation. Three to five days later, the fertilised eggs, now called embryos, are injected into the woman's uterus using a catheter. If implantation occurs, there will be a pregnancy. Extra embryos may be frozen for future IVF attempts.
According to the Centers for Disease Control, women in the U.S. had 138,198 assisted reproductive cycles which resulted in 41,343 births in 2006. Because some of the births were multiples, 54,656 infants were born using this technology. This is roughly a 30 per cent pregnancy success rate. Because of more effective IVF techniques, this rate has increased from 1996, when it hovered around 22 per cent.
There can be complications from using IVF. Sometimes, the drugs used to assist egg harvesting lead to ovarian hyperstimulation syndrome. According to the Mayo Clinic, about 25 per cent of women on gonadotrophins develop mild OHSS, which causes swollen and painful ovaries and abdominal pain.
Sometimes the embryo implants in the Fallopian tube, resulting in an ectopic pregnancy. This happens at a slightly higher rate for those using IVF. Because most women on IVF have an ultrasound within 14 days of implantation, most ectopic pregnancies are caught before they can damage the Fallopian tube.
Multiple pregnancies are more likely to occur in IVF. While twins do not compromise the health of the mother or each other, three or more embryos can lead to premature labour and other health consequences for both mother and children.
Because IVF can be expensive and may not be covered by insurance, couples usually choose to thoroughly research any clinic before they seek this treatment. The CDC maintains a database of statistics on assisted reproduction at fertility clinics and advises that couples should consider the type of patients accepted and the causes of infertility when comparing clinic pregnancy success rates.
Donor Eggs or Sperm
If a woman does not produce eggs, the couple may wish to use an egg donor for IVF. The same is true if a man does not produce enough sperm. In both cases, the couple will need to decide if they will ask a friend or family member or if they prefer an anonymous donor. Factors like cost and psychological consequences should also be evaluated.
IVF treatment was first successfully used in England in 1978 by Dr. Patrick C. Steptoe, a gynecologist, and Dr. Robert G. Edwards, an embryologist. It was here the term "test tube baby" was coined to describe fertilisation in the lab rather than in the uterus. Since then, the technique has been refined and its success rate increased.