IVF Process and Other Infertility Treatments: Are They For You?

In vitro fertilization, commonly referred to as IVF, is a method of assisted reproduction, by which egg cells are fertilised by sperm outside the womb. After fertilization, the embryos are transferred into the uterus through the cervix with the intent to establish a successful pregnancy. The process involves ovulation induction using various medications, monitoring of hormone levels, and ultrasound monitoring of follicle development. IVF is the treatment most often used in infertility when other methods of assisted reproductive technology have failed.

Each IVF cycle takes four to six weeks to complete. The following presents the major steps in the IVF process.

--Step 1: Ovulation Induction.-- The woman is given fertility drugs with instructions how to take them. The drugs stimulate the ovary to develop several eggs during one cycle and to control the timing of the egg development. The woman may choose not to take the drugs, but that will reduce her chances for successful pregnancy. The whole process is monitored to examine the egg development in the ovaries; as well as by collecting blood samples to test hormone levels.

--Step 2: Egg Retrieval.-- The eggs are retrieved during follicular aspiration, a minor surgical procedure that takes about 15-30 minutes. During the procedure, the surgeon inserts a hollow needle through the pelvic cavity into the woman's ovary to remove eggs. The woman is sedated and local anesthesia is used to avoid any discomfort.

--Step 3: Sperm Preparation and Insemination.-- The sperm and eggs are mixed together in a dish containing special nutrient medium, and are then placed in an incubator. When the fertilization occurs and cells start dividing, the fertilized eggs - now called embryos - are ready for transfer.

--Step 4: Embryo Transfer.-- After 2-3 days, the embryos are ready for transfer. The doctor then transfers the embryos into the woman's uterus through the cervix with a catheter (a long slender tube). One or more (usually 2-3) embryos are placed using a catheter in the womb. The woman will feel no pain, just a little cramping. After the procedure the woman is told to go home and take it easy.

--Step 5: Pregnancy Test.-- The woman continues to take medications for the next 2 weeks. A pregnancy blood test is scheduled about two weeks later. If implantation works (the egg or eggs attach to the uterine wall and grow), the pregnancy test result is positive.

At this stage the woman may start watching for early pregnancy symptoms.

The question "how many embryos should be created or transferred during a single IVF cycle" is often debated. Usually, to reduce the risk of multiple pregnancy, doctors do not transfer more than 2-3 embryos. Any extra embryos are usually frozen for future use in case the present attempt at conceiving is not successful.

Transferring fewer than four embryos per IVF cycle is believed to yield optimal results. Transferring more than four increases the risk of multiple pregnancies. Multiple pregnancy is undesirable as they have significantly increased rates of complications. Although transferring four embryos versus one or two increases the chances for successful pregnancy, it's also possible that all four embryos could implant. Data suggest that about 10-25% of women, who have a successful IVF pregnancy, will have twins.

If you have concerns regarding what happens to leftover embryos, you should discuss it with your physician.

How successful is IVF? The success rate of IVF procedure varies depending on a number of factors patient age, causes of infertility, treatment approaches, and clinic.

The average couple will need three attempts before achieving a pregnancy, depending on their diagnosis and the number of problems they are facing. However, for couples with multiple causes for infertility, IVF is the only realistic option for successful pregnancy.

One of the most critical factor for IVF success is woman's age. The following presents approximately live birth rates for each cycle in the US for different age groups:

• 30-35% for women less than 35 years old;
• 25-30% for women between 35 to 37;
• 15-20% for women between 38 to 40
• 6-10% for women over 40

When studying the success rates of various IVF clinics it is important to understand that pregnancy rates do not equate to live birth rates, so always check what the statistics are presenting.

What you should consider:

• Cost: One cycle of IVF costs between $10,000-$15,000, including medication, but not including other special assisted technology procedures that you may need, such as ICSI, or genetic testing.
• Multiple births: Women who use IVF, about 63% give birth to single babies, 32% have twins, and 5% have triplets or more.
• Although studies suggest that IVF procedure is safe, although some studies have found a slightly increased risk of genetic disorders in children conceived through assisted reproductive technologies.

A final note: I have a beautiful son as a result of an IVF treatment. If I had to do it all over again - I would not hesitate to do it again. The chances of successful pregnancy diminish with age, so do not wait until it is too late!