IN VITRO FERTILIZATION

In vitro fertilization is the most common form of assisted reproductive technology, used for women who are unable to get pregnant. In vitro fertilization actually means "in glass." A woman's egg is removed, fertilized with sperm in a glass dish in the lab, and then put into her uterus.

Good candidates for this procedure are women whose fallopian tubes have been damaged, have not been able to find out why they cannot get pregnant, or have husbands who are infertile. About 20 to 25 percent of the women who have this procedure will get pregnant. In vitro fertilization is most successful in women who are under 34 years of age.

This procedure is usually done after intensive fertility testing has been done and the cause of the infertility is known. In most cases other fertility treatments have already been tried before this expensive procedure is attempted.

The process begins by giving hormones to the woman to increase the ovaries ability to produce eggs. The woman is asked to take her temperature and do urine tests at home. She also receives blood tests and is watched closely by the medical team. This is done to try to determine, within hours, the time of ovulation. Her partner will give a sperm sample so it can be tested before the procedure. This specimen can be frozen for the procedure, if the partner will not be able to be there.

When ovulation is expected, the couple returns to the clinic or outpatient area. An IV is started and the woman receives mild sedation. General anesthesia is usually only used if other procedures are also needed. The partner gives a sperm sample. A long needle is guided through the vagina and cervix, into the uterus. Its progress is watched on an ultrasound. The eggs are removed and immediately placed in an incubator in the lab. The procedure takes 30 to 60 minutes. The eggs are mixed with the sperm and allowed to fertilize and incubate 30 to 60 hours.

Putting the fertilized eggs into the uterus is a simple procedure that takes 10 to 15 minutes. A thin plastic catheter is inserted through the vagina and cervix, into the uterus. The eggs, usually 3 or 4, are implanted in the uterus. Because of this, there is a greater chance for having a multiple pregnancy. Some of the eggs can also be frozen in case this procedure is not successful.

The woman is given hormones and has blood testing for the next 2 weeks to make sure the lining of the uterus is prepared to accept the egg. She returns in 2 weeks for a pregnancy test. There is no evidence of increased birth defects or premature births from in vitro fertilization pregnancies. If the woman is not pregnant, counseling is recommended. Another procedure can be done after waiting one month.

In vitro fertilization is one of the fastest growing procedures with new techniques being developed frequently. For this reason, it is important for couples with fertility problems to investigate the credibility and procedures of a fertility clinic before starting any treatment. The Centers for Disease Control and Prevention maintain a national database of in vitro fertilization clinics and their success rates. This information can be obtained by calling the Division of Reproductive Health at (770) 488-5200 or visiting their website at www.cdc.gov.

In vitro fertilizations are expensive, time-consuming, and emotionally draining. Insurance companies may not pay for an in vitro fertilization and it may need to be repeated. It is important for couples to decide early in the process what they can afford, both emotionally and financially. This includes understanding the in vitro fertilization procedure, the drug therapy, the tests and ultrasound monitoring, the egg retrieval and fertilization process, and how many times they are willing to try the procedure. Open, sensitive communications are important at all times between the woman, her partner, and the fertility specialist.

For more information on fertility, in vitro fertilization, or choosing a clinic or specialist, contact your healthcare provider or one of these national organizations:

RESOLVE, formerly known as the National Infertility Association, at (617) 623-0744 or visit their website at www.resolve.org or
American Society For Reproductive Medicine at (205) 978-5000 or visit their website at www.asrm.com

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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