In Vitro Fertilization and Embryo Transfer (IVF/ET)
What Is It?
Refers to process of combining egg and sperm outside of female's body in hopes of achieving fertilization with resulting embryo transferred into uterus for hopeful implantation and pregnancy.
In use since
1978, when the first "test-tube" baby, Louise Brown, was born as a result of IVF in Great Britain.
Infertility or one-partner conception with no history of negative reactions to fertility medications
May be particularly useful with
- infertility due to tubal-factor issues (inflammation, blockage, absent tube, etc.)
- abnormal male-factor (low count, poor morphology or motility)
- immunology-based (antibody) issues
- unexplained infertility
How It Works
After superovulation via fertility drugs, oocytes (eggs) are retrieved and then combined with semem specimen in a lab dish with solution. Contents of dish are monitored for fertilization and growth. Resulting conceptus (product of fertilization) which are healthy in appearance are then transferred to uterus, where it is hoped that implantation and pregnancy will result.
Considering all patients seeking this treatment, approx. one in every five women will achieve pregnancy. Studies indicate that take-home baby rates may vary from 13.4% in women 35 years or younger vs. 3.6% in women older than 35. Women over 40 are typically advised to use donor eggs due to poor success rates with their own oocytes.
Typical Procedure Protocol
- thorough evaluation of both male and female for suspected causes of infertility
- determination of drugs to be used and timing of treatment cycle
- initiation of fertility drugs in the first few days of female's cycle
- mid-cycle monitoring by vaginal ultrasound and bloodwork (estradiol, luteinizing hormone, & progesterone) to evaluate ovarian response to drugs and reduce potential side effects
- If drugs result in ovarian hyperstimulation syndrome, treatment cycle will be discontinued immediately.
- patient may additionally monitor own cycle with ovulation predictor kits or other methods
- induction of ovulation by hCG, if necessary
- administration of progesterone supplement begins
- male partner must produce a semen sample, usually in the clinic (may be collected at home in some cases, or may need to be surgically extracted), or donor semen must be available
- approx. 36 hours after hCG adminstration, eggs are retrieved via transvaginal ultrasound and needle aspiration
- various forms of medical sedation and pain relief are available, including in some cases general anesthesia, during egg retrieval
- If egg aspiration is not possible via vaginal route, the procedure may be performed through the abdominal wall.
- approx 3 to 7 days later, resulting embryos are transferred (ET) into female using a cannula (small tube) while lying down, feet in stirrups, on examination table; no pain is expected during ET
- complete bed rest for 2 to 4 days will be prescribed; further advisement is for no strenuous physical activity for remainder of cycle
- pregnancy tests are usually performed 14 days after ET, with follow-up ultrasounds
Average Costs, excluding pre-treatment evaluation
- IVF: US $7,000 to $10,000<
- Sperm washing: US $ 150 - $200<
- Fertility drugs: US $30 to $75/vial of 75IU, depending on drug used;<may require up to 20 or more amps per cycle
- May be a total cost of $25,000
Expected physical effects
- Usual side effects of fertility drugs
- Discomfort, soreness after egg retrieval
Physical effects to report to your doctor
- Pelvic or abdominal cramping
- Vaginal bleeding or spotting
- Ovarian hyperstimulation syndrome (OHSS), a potential life-endangering condition.
- Use warrants appropriate monitoring via blood labs and ultrasound by trained professionals.
- Relatively high incidence of multiple pregnancy, depending on many factors, including the number of embryos transferred to uterus.
- Exercise caution if nursing during use of fertility drugs. May stop breastmilk production.
- Entire IVF process requires the patient and partner have flexible schedules throughout the treatment cycle in order to facilitate the necessary appointments.
© Tracy Morris