• In Vitro Fertilization

    (IVF)

    Definition

    In vitro fertilization (IVF) is a process where sperm and an egg are joined together outside of the body to create an embryo. The embryo can then be inserted into a mother's womb.
    Fallopian Tube, Ovary, and Uterus
    Fallopian Tube, Ovary, and Uterus
    Copyright © Nucleus Medical Media, Inc.

    Reasons for Procedure

    IVF is done to help a woman become pregnant when there is difficulty becoming pregnant naturally.
    It is most often done when infertility is due to:
    • Damaged fallopian tubes
    • Ovulation disorders
    • Cervical factors
    • Male factors, such as low sperm count or poor-quality sperm

    Possible Complications

    If you are planning to have IVF, your doctor will review a list of possible complications, which may include:
    • Still not being able to become pregnant
    • Having multiple babies
    • Ectopic pregnancy (embryo develops outside the uterus)
    • Anesthesia-related problems
    • Short- and long-term adverse effects from fertility drugs
    • Ovarian rupture (rare)
    Factors that may increase the risk of not conceiving and carrying to term include:
    • Women being over age 40 years
    • Drinking alcohol

    What to Expect

    Prior to Procedure

    Your doctor will likely do the following:
    • Physical and pelvic exam
    • Infertility testing for both you and your partner
    • Hormone treatments to stimulate production of multiple eggs
    • Repeated blood tests and ultrasound exams to monitor the development of multiple egg follicles
    • Schedule an appropriate time for harvesting mature eggs—closely timed to coincide with ovulation

    Anesthesia

    • General anesthesia, spinal anesthesia, or IV sedation may be used during harvesting of the eggs.
    • No anesthesia is used during the transfer of the fertilized embryo.

    Description of the Procedure

    The male, if fertile, refrains from ejaculating for two or three days. He then collects semen through masturbation. Penile scar tissue or other conditions may block the natural release of sperm. If this is the case, a sperm aspiration from the testicles may be done. Sometimes, the man's sperm can be frozen ahead of time. If the male partner is unable to produce viable sperm, donor sperm may be used. If male sperm counts are low, the chance of successful fertilization may be improved by directly injecting the sperm into the egg. This is called intracytoplasmic sperm injection (ICSI).
    Egg Harvesting
    An ultrasound-guided technique is often used to harvest the eggs. The ultrasound probe has a needle attached to the end. The instruments are inserted into the vagina. The ultrasound uses sound waves to view the ovaries and the developed egg follicles in the ovaries. The needle punctures the egg follicles. The fluid and eggs are removed through the needle. The fluid is inspected. It is immediately placed in a clean, nutritive culture material. The fluid will be kept in an incubator.
    Between 50,000 and 100,000 of the most mobile, healthy sperm are chosen. They are mixed with the harvested eggs. Sometimes, ICSI may be done. It may help to increase the chances of fertilization. The culture dish is kept at normal body temperature inside an incubator for 2-3 days. During that time, sperm are expected to fertilize 60%-80% of the eggs. Once fertilized, early cell division begins and embryos develop.
    Transferring Procedure
    A certain number of the embryos (usually 1-5) are placed into your uterus (womb). Fewer embryos decrease the chance of multiples (such as twins, triplets). The other embryos may be frozen. They may be saved for future IVF cycles. You may also choose to donate them to other infertile couples.
    A catheter tube is inserted into the vagina. It will be threaded through the cervical canal and into the uterus. The embryos are then passed into the uterus. You may be positioned face down with your knees at your chest. A special table that tilts the uterus downward may also be used. These positions allow gravity to help keep the embryos in the uterus for implantation.

    How Long Will It Take?

    • Harvesting—30 minutes or less
    • Transfer procedure—lasts about 10 minutes

    How Much Will It Hurt?

    The egg harvesting can be uncomfortable. Anesthesia is given to decrease the discomfort.

    Post-procedure Care

    At the Care Center
    Following egg harvesting, expect to rest at the center for a few hours before going home.
    At Home
    Following embryo transfer procedure:
    • You will probably be able to resume normal activities within a few days.
    • Follow the instructions for any medicine given.
    • Return in 10-12 days for a pregnancy test.
    • If the pregnancy test indicates conception, an ultrasound will be scheduled for a few weeks later. It will be able to see if more than one egg is growing.
    • If all is going well, you will start your prenatal care. It is important to go to all of your scheduled appointments.
    It can be difficult to wait two weeks for the results. Even if pregnancy occurs, a miscarriage remains a possibility. If pregnancy did not occur, the next attempt should be at least one month later.
    Success rates for the first three cycles are about the same (about 10% per cycle). The rates then start to decrease. Success rates are influenced by both age and the cause of infertility. IVF has a 25%-30% success rate.

    Call Your Doctor

    After arriving home, contact your doctor if any of the following occurs:
    • Signs of infection, including fever and chills
    • Foul-smelling vaginal discharge
    • Vaginal bleeding
    • Abdominal pain or cramping
    • Cough, shortness of breath, chest pain, or severe nausea or vomiting
    • Any unusual symptoms
    In case of an emergency, call for medical help right away.

    RESOURCES

    American Congress of Obstetricians and Gynecologists http://www.acog.org

    American Society for Reproductive Medicine http://www.asrm.org

    CANADIAN RESOURCES

    The Infertility Awareness Association of Canada http://www.iaac.ca

    Women's Health Matters http://www.womenshealthmatters.ca

    References

    American Society for Reproductive Medicine website. Available at: http://www.asrm.org. Accessed December 9, 2008.

    American Society for Reproductive Medicine, Committee Opinion. FetilSteril. 2008; 90(S3):187.

    The Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov. Accessed December 9, 2008.

    International Council on Infertility Information Dissemination website. Available at: http://www.inciid.org/index.php?page=ivf. Accessed December 9, 2008.

    The National Infertility Association website. Available at: http://www.resolve.org. Accessed December 9, 2008.

    2/4/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Rossi BV, Berry KF, Hornstein MD, Cramer DW, Ehrlich S, Missmer SA. Effect of alcohol consumption on in vitro fertilization. Obstet Gynecol. 2011;117(1):136-142.

    Revision Information

  • Join WellZones today.

    Make a Change For LifeLearn more

    Wellmont LiveWell is creating a new tradition of wellness in the mountains by providing individuals with tools and encouragement to live healthier lifestyles.

  • HeartSHAPE Spotlight

    HeartSHAPE® Test Learn more

    Fight heart disease early and prevent heart attacks with HeartSHAPE® - a painless, non-invasive test that takes pictures of your heart to scan for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.


  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.