In Vitro Fertilization

When a couple is unable to achieve pregnancy for a span of one year of unprotected sexual intercourse, infertility can be suspected. There may be several causes of infertility. These different reasons are the aspects that are determined during the first step of the couple’s fertility work-up. During the course of fertility work-up, there can be many options to assist a couple who would really like to have a child. One of these options is in vitro fertilization.

What is in vitro fertilization?

In vitro fertilization (IVF) is a method of assisted reproduction wherein fertilization takes place by manually uniting the egg cell and the sperm cell in a laboratory dish. IVF, when successful, is combined with another method of assisted reproduction which is called embryo transfer. In this method, the embryo is transferred to the woman’s uterus to allow it to be implanted naturally, so that a normal pregnancy follows. For this one cycle of in vitro fertilization, 2-4 embryos are placed in the woman’s uterus at one time. Children who are successfully conceived via this technique are called test tube babies.

Before the procedure is selected as the best option for the couple, both the woman and the man will be examined to be able to determine what kind of anatomic or physiologic problem most likely hinders them in achieving pregnancy. If after the couple was examined, and was found to have any of these conditions, the couple is indicated for in vitro fertilization:

• Low sperm count for the males
• Endometriosis or any problem with the fallopian tubes for the females
• Infertile couples who have tried other fertility methods , but have not worked

Aside from the medical indication, other factors can be considered by the couple before they decide if they really would like to try in vitro fertilization. The following factors are important to consider during their decision process:

• Cost:  It employs reproductive technology and so, the cost may be relatively high. One cycle costs approximately $12,200.
• Risks:  Recent studies suggest that the procedure is safe, especially with regards to the health of the conceived child. However, there are also other studies that say assisted reproductive technologies slightly increase the risk for the conceived child to have genetic disorders.
• Multiple births: Based on studies, in vitro fertilization increases the possibility of having twins, triplets or more.
• Age: The woman’s age can affect the success rate of the procedure. Studies have found that in vitro fertilization has a higher success rate for women younger than 35 years.

Once the couple is certain that in vitro fertilization is their best option, they should be familiarized with the procedure. These are the steps done when performing IVF:

• First step is ovulation induction, wherein the woman is prescribed to take drugs or hormones to increase the chance for collecting multiple eggs. Retrieving multiple eggs is more favorable for a successful procedure. The development of the egg is monitored by using ultrasound or by checking hormonal levels through urine and blood samples.
• The next step is follicular retrieval wherein the mature eggs are retrieved from the ovaries by using a hollow needle. This procedure is also guided by ultrasound imaging.
• The sperm then is acquired via male ejaculation. Sperm cells are then prepared for fertilization.
• The next step is insemination, wherein fertilization is allowed to occur as the sperms and eggs are placed in an incubator. If there is a suspected low rate of fertilization, it can be aided by a procedure called intracytoplasmic sperm injection, wherein a single sperm is directly injected into the egg.
• The last step is embryo transfer, wherein the embryo formed by a successful in vitro fertilization is transferred to the woman’s uterus. This usually takes place two to three days after retrieval of the egg.