Many couples turn In vitro fertilization--IVF--if they have been struggling to conceive naturally for some time, if there are known fertility issues (with the female or the male, or both) or if the female is over a certain age. IVF is the process of fertilization outside the human body. An egg from the female and sperm from the male are combined in a laboratory dish and placed in a suitable environment for fertilization and early growth of the embryo, before it is implanted back into the uterus. The term "test tube baby" comes from the fact that the eggs and sperm are mixed together in a laboratory setting.
IVF can be divided into the following stages:
Stage 1: Special medication is prescribed for the female, to control the timing of the ripening of the egg and improve female fertility so that there is more chance of collecting multiple eggs. As some eggs will fail to fertilize or develop following their retrieval, a large number of eggs is desirable.
Stage 2: Ultrasound imaging is used during a minor surgical procedure to retrieve the eggs. A hollow needle is passed through the cavity of the pelvis to remove the eggs. Many women feel discomfort and cramping on this day, but this should be mild and short-lived. A sensation of pressure in the area should be expected for several weeks, however, which is perfectly normal.
Stage 3: The next step is insemination, in which the sperm and eggs are put into incubators to promote fertilization. The eggs are monitored and after cell division and fertilization has occurred, they are considered to be embryos.
Stage 4: A few days following egg retrieval, the embryos are transferred into the uterus using a speculum to expose the cervix. The embryos are suspended in fluid and passed into the womb via a catheter. The number of embryos that are created during any one IVF cycle has been a matter of debate amongst medical professionals for a long time. Generally, it is thought that the transfer of a maximum of four embryos will bring the best results. The transfer of more than four embryos carries a greater chance of multiple pregnancies, which can bring complications. Couples should be aware that if four embryos are transferred, all four of them could implant.
Stage 5: The woman is encouraged to rest and look out for early symptoms of pregnancy. Pregnancy will be determined by a blood test and possibly an ultrasound.
IVF success rates vary, depending on the specific characteristics of the woman, in particular the severity of any fertility issues she has been experiencing. In the United States, approximate live birth rates for IVF are 30 to 35% for women below the age of 35; 25% for women aged between 35 and 37; and 15 to 20% for women aged between 38 and 40. For couples who have genetic concerns or specific problems with their eggs or sperm, donor eggs, sperm or embryos can be used. It is estimated that around 10% of all assisted reproductive technology cycles use donated eggs.
As with all medical procedures, there are some risks associated with IVF; additionally, each stage of the process carries its own specific risks. The act of stimulating the ovaries may lead to hyper-stimulation, resulting in swollen, painful ovaries, however this is a rare side effect. Due to the use of anesthesia, there is a risk of bleeding, infection and injury to the bowel, bladder or blood vessels during the egg retrieval process. Stress, anxiety and depression are common when undergoing IVF, particularly when it is unsuccessful. Couples should be prepared for the emotional side of undergoing IVF, as well as the physical.
Another important issue to consider is ivf cost. Many couples in the United States are unable to afford fertility treatment because of the financial implications; the average cost of a single ivf cycle is $15,000. Many couples have to undergo several cycles before they are successful. Not all states cover IVF treatment as part of standard health insurance policies, meaning couples have to find alternative ways to pay for the treatment. It is believed that ivf cost is higher in the United States than anywhere else in the world. This can add to the stress and anxiety the couples are already experiencing, and have an adverse effect on their chances of success. It is important to discuss cost implications with the doctor at the outset and make sure you ask about the range of payment options available.