IVF, or in vitro fertilisation, involves removing an egg from a woman's body, fertilising it with a man's sperm and putting it back into her body for implantation in the uterus. It usually is a last resort when a couple suffers from infertility. It is not a guarantee, is very costly but often is a couple's only hope for a child of their own.
In vitro fertilisation treatments date back to 1978. Success rates were relatively low, but research continued based on the procedure used to create the first "test tube baby," born in England. Technology advancement is shown in the success rates: In 1985, only about 5 per cent of treatments resulted in pregnancy, while in 2006, that number had climbed to just under 30 per cent.
The first step in IVF treatment is ovulation induction. The woman's hormones are stimulated to make her ovaries produce more eggs than would normally be possible. Then, the mature eggs are removed via an aspirating needle. Sperm is also aspirated from a sample given by the man and combined with the eggs in petri dishes. The sperm fertilises the eggs, and the embryos are incubated for three to five days to encourage growth. The healthiest embryos are chosen (the number depends upon maternal age and several other factors) and inserted into the uterus via a catheter placed through the cervix. Implantation is left to take place on its own. One advantage specific to IVF is that an embryo is always formed and makes it to the uterus, but implantation is never guaranteed, an obvious drawback. Another disadvantage is the possibility of ovarian hyperstimulation, a situation in which the fertility drugs overstimulate egg production.
Each cycle of IVF takes three to four weeks, from ovulation induction to embryo transfer. There is a waiting period of about two weeks before the couple can test for pregnancy; this wait can seem agonising for the couple. If a cycle does not result in pregnancy, the woman's natural menstrual cycle is often allowed to return before starting the treatment again. The average couple needs to go through three IVF cycles before achieving a pregnancy. Some couples get pregnant on the first round, while others go four rounds (the typical cut-off) with no success. The fact that there is no known success rate for an individual couple is a major disadvantage but has led to the introduction of IVF refund programs.
For the infertile couple, the benefits of IVF are tremendous. No matter the situation, an egg will always unite with a viable sperm cell and be inserted into the woman's body. Procedures such as intracytoplasmic sperm injection (ICSI), assisted hatching, genetic counselling and frozen embryo transfers are all made possible through IVF. Donor sperm and eggs are sometimes used as well, so this is another benefit if the couple is not able to use the man's sperm or the woman's eggs for some reason.
Children resulting from IVF treatment often are thought of as "test tube babies." While the embryo may be created in a petri dish, the child grows just like any other, inside the womb. Another common misconception is that IVF is an easy procedure. In reality, it takes months of planning, and the woman must take fertility injections and monitor her cycles closely to ensure that the egg retrieval and transfer are taking place at the proper times.
The challenge with IVF is implantation. There is no current technology that can be used to implant the embryo into the woman's uterus; the embryo is simply injected into the uterine cavity in hopes that it will implant on its own (assisted hatching can aid in this, however). Another disadvantage to IVF is the cost. One round of treatment can cost over £6,500 as of September 2009, and since there are no guarantees, this can add up very quickly. Lastly, the risk of multiple embryos implanting in the uterus is very high and this can lead to selective termination or at the very least, a high-risk pregnancy that poses a danger to the mother and the babies.