IVF - In Vitro Fertilization

In vitro fertilization (IVF) has blocked fallopian tubes as one of its original indications, and the decision between surgical correction of blocked tubes and IVF can be a difficult one. This decision is clarified by considering factors such as the cause of blocked tubes, your age, and sperm quality. Many years have passed since the inception of IVF, and as vast improvements have been made in all aspects of IVF, the indications for IVF have expanded. Very poor sperm quality can be addressed by the use of ICSI (intracytoplasmic sperm injection), while very poor egg quality as seen with advanced reproductive age and with premature ovarian failure, can be addressed by the use of donor eggs. The avoidance of certain genetic abnormalities can be addressed by utilizing PGD (prenatal genetic diagnosis) in association with IVF. The excellent success rates for IVF have even encouraged some to consider IVF as a first-line treatment for infertility. However, as with all medical decisions, risks and benefits must be addressed. The excellent success rate must sufficiently balance the cost, invasiveness, and medical risks entailed in IVF.

The IVF cycle can seem to be an overwhelming process, but when broken down into separate steps it becomes more manageable. The first step (follicular development) involves stimulating the ovaries with medication to enhance egg production. The development of these eggs or follicles to maturity is monitored by ultrasounds and blood tests. The second step (egg retrieval) involves collecting the eggs once they are mature. This office-based procedure is performed using medication to keep you comfortable. The eggs are obtained vaginally using ultrasound guidance. The third step (fertilization) occurs in the embryology lab, whereby the sperm and the eggs are mixed and the resulting embryos are incubated to allow further development. The fourth step (embryo transfer) is also an office-based procedure. The embryos are placed into the uterus using a small catheter. Any embryos not transferred may be frozen for later use. Following the transfer, additional medications are used to support the developing pregnancy.

IVF can offer tangible success to those whose infertility problems render other treatments inappropriate, or when other treatments fail. However, when you have a choice of different treatment options, a thorough understanding of the risks and benefits inherent in each option will allow you to make a sound decision.