In Vitro Fertilization (IVF) Basics
The first baby born by in vitro fertilization, Louise Brown, was born in England in 1978. She was called the world’s first “test tube baby.” Test tube babies have come a long way since then. You probably know someone who has used IVF, but what do you really know about IVF?
Photo: Louise Brown, the first IVF baby
What is IVF?
IVF is the most commonly used type of assisted reproductive technology. The word in vitro means outside the body. For IVF, eggs and sperm are taken the body and combined outside the body – the test tube part – to make a fertilized egg. The eggs or sperm may be your own or they might be donated. The test tube part does not always work, but if a fertilized egg results, it is placed inside the womb to grow.
Who can benefit from IVF?
Couples who are infertile can benefit from IVF. Infertility is not being able to get pregnant with regular unprotected sex. If the woman in the couple is under age 35, infertility may be the problem after one year of failure to conceive. If the woman is over age 35, infertility starts to be considered after six months of failure. But it is important to know that the cause is just as likely to be male as female.
Some causes of male infertility and female infertility can be found and treated. In these cases, IVF may not be needed. IVF is most likely to benefit couples when:
- The cause of infertility cannot be found.
- The woman has abnormal fallopian tubes. Her eggs cannot get down to the womb. The tubes may be blocked, damaged, or removed.
- The woman has early menopause (premature ovarian failure).
- The cause is male infertility (abnormal sperm production) that cannot be treated.
- One member of the couple has an identified genetic disorder that could be passed to the baby. In these cases, the egg or the sperm will come from a donor.
What happens during IVF?
There are several steps to a cycle of IVF:
- The woman may start by taking a drug that stimulates egg production.
- Testing will be done to check for egg production.
- When eggs are available, a minor surgical procedure removes the eggs.
- The male partner or donor gives a sperm sample.
- The eggs and sperm are mixed in a laboratory and watched for a few days.
- Some eggs become fertilized.
- Some fertilized eggs become embryos.
- A minor surgical procedure using a special tube, inserts the embryos into the womb.
- Embryos that form but are not used can be frozen for future use.
How often does IVF work?
IVF may not work every time. Many couples need to go through the procedure more than once. Success rates vary from clinic to clinic. The Centers for Disease Control and Prevention (CDC) tracks success rates of IVF clinics around the country.
Success depends on the clinic, the cause of infertility, and the age of the male donating the sperm. But probably the most important predictor of success is the age of the woman producing the eggs and carrying the baby. Overall, about four out of ten women under age 35 have a successful pregnancy with IVF. For a woman over age 40, the success rate drops to about one in ten.
Potential risks of IVF
The biggest potential risk of IVF is going through the physical and emotional stress of the procedure and failing to conceive. There are also other potential risks to consider:
- Most embryos do not grow into babies. In many cases, several embryos are implanted to increase success rates. This may result in too much success: twins, triplets, or more!
- A multiple birth may cause high-risk pregnancies. These risks include premature births and possibly a higher risk of birth defects. Some clinics are trying to reduce the risk of multiples by keeping the embryos longer and selecting only the healthiest for implantation.
- IVF is expensive. It is usually an out-of-pocket procedure. A single cycle can cost over $8,000, not including medications, tests, or counselling. It will be very important to talk about payment plan options and financing.
IVF has come a long way in the last 40 years. In 2016, in America alone, there were about 175,000 IVF cycles performed, resulting in about 63,000 babies.