All About In Vitro Fertilization (IVF)
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All About In Vitro Fertilization (IVF)

calendarJuly 26, 2016

How does in vitro fertilization work?

In vitro definition - In Vitro Fertilization (IVF) is a one of the methods of assisted reproductive technology, used when a couple is unable to have a baby.

What Does In Vitro Mean?

This is the process of fertilization which starts with manually combining an egg and sperm in laboratory conditions. Then, the embryo has to be transferred to the uterus.

What is IVF Used for?

The IVF process can be used to treat infertility. It is suitable for women or couples who have one of the following conditions:

  • problems with the fallopian tubes, including fallopian tubes which have been surgically removed;
  • male infertility – it might be caused by decreased sperm count or sperm motility;
  • different ovulation disorders, premature ovarian failure, uterine fibroids;
  • genetic problems causing infertility;
  • unexplained infertility;
  • endometriosis;
  • low sperm counts;
  • antibody problems which harm sperm or eggs and make them unable to reproduce;
  • inability of the sperm to penetrate or survive in the cervical mucus.

How Does In Vitro Fertilization Work?

The in vitro process has five main steps:

  1. Monitoring and stimulating the development of healthy egg or eggs in the ovaries.
  2.  Collecting the produced eggs.
  3.  Collecting the sperm.
  4.  Gathering the eggs and the sperm in laboratory conditions and ensuring suitable environment for fertilization and for early embryo growth.
  5.  Transferring the grown embryos into the uterus of the future mother.

Development of Eggs

During this step, fertility medications need to be prescribed to the woman in order to stimulate egg production. The purpose is multiple eggs to be produced since some of them will not develop or get fertilized after retrieval. It is essential the health conditioned of the mother to be strictly monitored. Transvaginal ultrasound has to be done to examine the ovaries. Also, blood test samples have to be taken to check hormone levels. If necessary, the hormone levels could be controlled with medications.

Collecting the Eggs

This is the time the eggs to be retrieved. This is done through a minor surgical procedure. An ultrasound imaging has to be used to guide a hollow needle into the pelvic cavity. The needle is used to remove the eggs. Medications are used to reduce the discomfort during the procedure.

Collecting the Sperm

The male needs to produce a sample of sperm. Then, this material will be combined with the eggs.


The process of gathering the sperm and the egg is called insemination. The sperm and the eggs need to be gathered and then stored in a laboratory to encourage fertilization. When the probability of fertilization is lower, intracytoplasmic sperm injection (ICSI) could be used. In these cases, a single sperm is injected directly into the egg. The eggs need to be monitored in order to confirm that fertilization and cell division are taking place. If fertilization and cell division happen, the eggs turn into embryos.

Transferring the Embryos to the Uterus

How successful is ivf?

This usually has to be done three to five days after the egg retrieval and fertilization. A catheter or small tube has to be inserted into the uterus when transferring the embryos. This is usually a painless procedure, although some women might experience slight cramping. If the procedure succeeds, the transferring will occur around six to ten days after the egg retrieval.

IVF Side Effects

The IVF procedure is not hard to bear and most of the women are able to resume their normal activities the following day. The fertility medications used during IVF often cause some side effects. They are usually mild and cause only a slight discomfort. The side effects after an IVF might include:

  • headache;
  • hot flushes;
  • feeling down or irritable;
  • restlessness;
  • ovarian hyperstimulation syndrome.

If you experience any of the following symptoms, call your doctor immediately:

  • heavy vaginal bleeding or blood in the urine;
  • pelvic pain;
  • a strong fever - over 100.5 °F (38 °C).

What Will Happen with me During an Invitro Procedure?

After the first step of IVF, you need to be tested in order to determine whether you are ready for egg retrieval. If you are, you will be given injections of a medication which ripens the developing eggs and starts the ovulation. Timing is essential for the success of the procedure; the eggs need to be retrieved just before they emerge from the follicles in the ovaries. If the retrieval is made too early or too late, the eggs will not develop normally. During the retrieval procedure, your doctor needs to locate follicles in the ovary with ultrasound and then to remove the eggs with a hollow needle. The procedure takes less than 30 minutes in most of the cases but it can take up to 1 hour. The eggs need to be mixed with your partner's sperm on the same day. Then, the fertilized eggs will be kept in the laboratory under observation. This will ensure their optimal growth. It is possible to wait up to five days until the embryo reaches a more advanced blastocyst stage and get ready for the final step of IVF.

How Successful is IVF?

The success of the procedure will depend on a number of factors. Two of the most important of them are the reason for infertility and your age. It also depends on the clinic in which the IVF will be done. So, the best thing to do if you want to know what is your chance of success is to ask in your clinic what their success rates are.

IVF Statistics

Success rates by age in the United States:

  • 41-43% for women under age 35;
  • 33-36% for women ages 35 to 37;
  • 23-27% for women ages 38 to 40;
  • 13-18% for women ages over 40.

IVF Risks

The IVF procedure might lead to the following health conditions and problems:

  • Multiple births. When more than one embryo has been implanted in the uterus, the chance of having multiple babies – twins, etc. is high. So, you should be emotionally and financially prepared that you might have more than one baby. The risks are that a pregnancy with multiple fetuses might lead to an early labor and low birth weight.
  • Miscarriage. The risk of miscarriage after IVF with fresh embryos is relatively the same in comparison with women who conceived naturally — about 15 to 20 percent. The risk in both cases increases with maternal age. If frozen embryos were used during IVF, the risk of miscarriage slightly increases.
  • Ovarian hyperstimulation syndrome. It might be caused by the use of injectable fertility drugs, such as human chorionic gonadotropin (HCG) to induce ovulation. The common symptoms include nausea, mild abdominal pain, bloating, and diarrhea and they last a few days. If you get pregnant, these symptoms could last a few weeks. The more severe form of ovarian hyperstimulation syndrome can lead to weight gain and shortness of breath. In these cases, you should consult your doctor as soon as possible.
  • Ectopic pregnancy. Between 2 and 5 percent of the women develop an ectopic pregnancy after IVF. This condition happens when the fertilized egg implants outside the uterus, instead of inside it. Because the fertilized egg could not survive outside the uterus, the pregnancy cannot continue. Also, ectopic pregnancy might be quite dangerous for the mother. So, if you notice intensive vaginal bleeding or other symptoms that bother you, call your doctor immediately.
  • Birth defects. Birth defects depend much more on the age of the mother, rather than the way of conceiving. Although there are not still enough scientific proofs, some experts consider that the use of IVF does not increase the risk of having a baby with birth defects.
  • Ovarian cancer. Although a connection between the IVF procedure and cancer is still not proved, it is considered that Invitro might increase the risk of developing ovarian cancer.
  • Emotional stress. The IVF procedure could have strong negative effects on all financial, physical and emotional plans.

In Vitro Fertilization Cost

This is an expensive procedure. Unfortunately, many insurance plans do not provide coverage for fertility treatment. The price range of IVF procedures is $12,000-$17,000.

What if I am Unable to Produce Healthy Eggs or My Partner is Sterile?

There are medical solutions to these problems - you may choose to use donor eggs, sperm, or embryos. Consult with a doctor in the IVF clinic what is the best option for you.

Is IVF the Best Option?

The IVF procedure is never the first step in the treatment of infertility because it is expensive and the cheaper options might have the same effect. It is usually being done if other methods such as fertility drugs, surgery, and artificial insemination fail. If you think that IVF is the best choice for you, e.g. if you are after 40, make a detailed research which IVF clinic to choose. This is a very important decision and the success of the procedure depends on it.

How Many Embryos Have to be Created or Transferred during the IVF Procedure?

This usually depends on the number of the eggs collected and on the age of the woman. Since the rate of implantation decreases with years, more eggs need to be implanted to increase the chances of success.

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