In Vitro Fertilization

In vitro fertilization (IVF) is a type of assisted reproductive technology. IVF involves a series of procedures used to treat fertility or genetic problems in order to assist with the conception of a baby. During IVF, eggs are retrieved from the ovaries and combined with sperm in a lab to fertilize the eggs. One or more of the fertilized eggs (embryos) are inserted into the uterus through the cervix. Candidates for IVF include:

  • People who are infertile.

  • Women who underwent premature menopause or ovarian failure.

  • Women who had both ovaries removed. In this case, donor eggs must be used.

  • Women who have damaged or blocked fallopian tubes.

There is no age limit for having IVF, but it is not recommended for postmenopausal women. The ideal age for IVF is 35 years old or younger. Women age 41 and older are often counseled to consider using donor eggs during IVF to increase the chances of success.

LET YOUR HEALTH CARE PROVIDER KNOW ABOUT:

  • Any allergies you have.

  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.

  • Previous problems you or members of your family have had with the use of anesthetics.

  • Any medical or genetic problems that you or members of your family have had.

  • Any blood disorders you have.

  • Previous surgeries you have had.

  • Previous pregnancies you have had.

  • Medical conditions you have.

  • Any excessive alcohol drinking or smoking you have done.

  • Any history of taking illegal drugs.

RISKS AND COMPLICATIONS

Generally, IVF procedures are safe. However, as with any procedure, complications can occur. Possible complications include:

  • Bleeding and infection.

  • Problems with anesthesia.

  • Blood clots.

  • The procedure not working.

  • Having twins or multiples.

  • Increased risk of early delivery.

BEFORE THE PROCEDURE

Before beginning a cycle of IVF, you and the donor may need various screenings to make sure IVF is the correct treatment option. Some people may not benefit from this type of assisted reproductive technology.

  • You and the donor will need to provide a complete medical history and the medical history of your families.

  • You and the donor will undergo a physical exam.

  • You and the donor may need blood tests to check for infectious diseases, including HIV.

  • Other tests that may be done include:

  • Testing of your ovaries to determine the quality and quantity of your eggs. 

  • Hormone tests and ovulation testing.

  • An exam of your uterus. This may be done by using ultrasound after liquid is injected into your uterus through your cervix (sonohysterography) or by using a thin, flexible tube with a tiny light and camera on the end of it (hysteroscope).

  • The donor's sperm will be taken and analyzed to see if they are normal, there are enough present to fertilize the egg, and they act normally after sexual intercourse (postcoital exam).

PROCEDURE

IVF involves several steps. These procedures can be done at the health care provider's office or clinic. One cycle of IVF can take about 2 weeks, and more than one cycle may be required. The steps of IVF are:

  • Ovarian stimulation. If using your own eggs during IVF, at the start of a cycle you will begin treatment with man-made (synthetic) hormones. This stimulates your ovaries to produce multiple eggs, rather than the single egg that normally develops each month. Multiple eggs are needed because some eggs will not fertilize or develop normally after fertilization.  

  • Egg retrieval. Using ultrasound images as a guide, your health care provider will insert a thin needle through your vagina and into the ovary and sacs (follicles) containing the eggs. The needle is connected to a suction device, which pulls the eggs and fluid out of each follicle, one at a time. The procedure is repeated for the other ovary.

  • Insemination and fertilization. The sperm is mixed together with your eggs (insemination) and stored in an environmentally controlled chamber. The sperm usually enters (fertilizes) an egg a few hours after insemination.

  • Embryo transfer. Your health care provider will place the embryos into your uterus using a thin tube (catheter) containing the embryos. The catheter is inserted into your vagina, through your cervix, and into your uterus. The embryo transfer usually takes place 2–6 days after the egg retrieval. If successful, the embryo will stick to (implant) in the lining of your uterus about 6–10 days after egg retrieval. If an embryo implants in the lining of the uterus and grows, pregnancy results.

AFTER THE PROCEDURE

  • You may have to continue lying down for an hour or more before going home.

  • You may need to continue to take hormone therapy for about 3 months or as directed by your health care provider.

  • You may resume your normal diet and activities.