Q&A: The Basics of IVF

  1. Conventional insemination: Eggs and washed sperm are placed in close proximity and fertilization is left to happen naturally.
  2. ICSI, or intracytoplasmic sperm injection: Individual sperm are injected into each egg. The process of fertilization takes 16–18 hours. Once completed, the single cell divides to become a multicellular embryo. The embryo is then cultured for three to six days and either transferred immediately into the uterus or frozen and transferred at a later time.
  • Age related fertility: The most common indication is for age related infertility. As a woman enters her late 30s/early 40s, both egg quality and quantity decline, and IVF may be needed to achieve a healthy pregnancy. IVF is also indicated if a woman’s fallopian tubes are damaged, blocked, or surgically removed.
  • Ovulatory problems: It can also be used if a woman has an ovulatory problem and does not release eggs due to an underlying endocrine disorder (such as polycystic ovarian syndrome).
  • Male factor: One of the earliest applications of IVF was for male factor, which is present in up to 30% of couples. When sperm counts or quality are low, natural fertilization is not possible and IVF and ICSI are necessary.
  • Known genetic conditions or chromosomal abnormalities: IVF is also used for couples who may not have infertility, but have a known genetic condition which can affect their future offspring — for example, cystic fibrosis or BRCA (breast cancer gene). It might also be considered for fertile couples with a history of recurrent pregnancy loss due to chromosomal abnormalities.
  • Same sex couples: Same sex female couples may choose to undergo reciprocal IVF so that one parent’s eggs are used to make the embryo and the other parent carries the pregnancy. Same sex male couples may choose to build a family using embryos created from a donor egg and their sperm. These embryos are then transferred into a gestational carrier.
  • Infertility
  • History of sexually transmitted infections
  • History of smoking
  • Previous abdominal surgery
  • Preparatory phase: In this phase, birth control pills or other medications may be used to prime the body for the ovarian stimulation phase. This may take two to four weeks depending on the protocol.
  • Ovarian stimulation phase: This phase takes two weeks and usually consists of daily injectable medications and culminates in the egg retrieval. After the procedure, embryos are cultured for three to six days and either transferred into the uterus or frozen for future use.

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