Download In Vitro Fertilization

In Vitro Fertilization
A4 The use of IVF of drugs to suspend the normal secretion of hormones, followed by the use of artificial doses of
hormones to induce superovulation and establish a pregnancy.
In Vitro Fertilization is a one assisted reproductive technology (ART) commonly referred to as IVF. IVF is
the process of fertilization by manually combining an egg and sperm in a laboratory dish, and then
transferring the embryo to the uterus.
Why Is IVF Used?
IVF can be used to treat infertility with the following patients:
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Blocked or damaged fallopian tubes
Male factor infertility including decreased sperm count or sperm motility
Women with ovulation disorders, premature ovarian failure, uterine fibroids
Women who have had their fallopian tubes removed
Individuals with a genetic disorder
Unexplained infertility
What Is Involved With In Vitro Fertilization?
There are five basic steps in the IVF and embryo transfer process:
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Monitor and stimulate the development of healthy egg(s) in the ovaries.
Collect the eggs.
Secure the sperm.
Combine the eggs and sperm together in the laboratory and provide the appropriate environment for fertilization
and early embryo growth.
5. Transfer embryos into the uterus.
Step 1: Fertility medications are prescribed to stimulate egg production. Multiple eggs are desired because
some eggs will not develop or fertilize after retrieval. Transvaginal ultrasound is used to examine the ovaries,
and blood test samples are taken to check hormone levels.
The Following Medications Are Used For Ovarian Stimulation:
Clomiphene citrate (CC): There are two types of medications, Clomid® and Serophene®. These medications
work by increasing the amount of FSH the pituitary gland secretes. These are often used to
stimulate ovulation in women who have absent periods, infrequent periods or long cycles. The dosage is
usually started at 50mg a day, for a certain amount of days. Dosage may be increased if ovulation still does
not occur, although the chances of side effects increases as the dosage increases. The American Society for
Reproductive Medicine (ASRM) recommends that clomiphene be prescribed for only 3-6 cycles.
Potential side effects include:
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Increased incidence of multiple birth
Increased incidence of miscarriage
Hot flashes, nausea, and breast tenderness
Headaches or blurred vision
Depression and mood swings
Ovarian cysts and pelvic discomfort from over stimulation of the ovaries
Follicle Stimulating Hormone (FSH): An injection given just below the skin (subcutaneous injection) that
bypasses the hypothalamus and pituitary glands to directly stimulate follicle growth in the ovaries.
Common FSH medications include:
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Bravelle®
 Follistim®
 Gonal-F®
Potential side effects include:
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Increased incidence of multiple birth
Increased incidence of miscarriage and premature delivery
Breast tenderness, swelling, or rash at injection site
Mood swings and depression
Hyper stimulation syndrome which includes enlarged ovaries,abdominal pain and bloating
Step 2: Eggs are retrieved through a minor surgical procedure that uses
ultrasound imaging to guide a hollow needle through the pelv ic cavity to
remove the eggs. Medication is provided to reduce and remove potential
discomfort.
Step 3: The male is asked to produce a sample of sperm, which
is prepared for combining with the eggs.
Step 4: In a process called insemination, the sperm and eggs are mixed
together and stored in a laboratory to encourage fertilization. In some cases
where there is a lower probability of fertilization, intracytoplasmic sperm
injection (ICSI) may be used. Through this procedure, a single sperm is
injected directly into the egg in an attempt to achieve fertilization. The eggs
are monitored to confirm that fertilization and cell division are taking place.
Once this occurs, the fertilized eggs are considered embryos.
Step 5: The embryos are usually transferred into the woman’s uterus three
to five days following egg retrieval and fertilization. A catheter or small
tube is inserted into the uterus to transfer the embryos. T his procedure is
painless for most women, although some may experience mild cramping. If
the procedure is successful, implantation typical ly occurs around six to ten days following egg retrieval.
Side Effects Of In Vitro Fertilization
Although you may need to take it easy after the procedure, most women can resume normal activities the
following day.
Some side effects after IVF may include:
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Passing a small amount of fluid (may be clear or blood-tinged) after the procedure
 Mild cramping
 Mild bloating
 Constipation
 Breast tenderness
If you experience any of the following symptoms, call your doctor immediately:
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Heavy vaginal bleeding
Pelvic pain
Blood in the urine
A fever over 100.5 °F (38 °C)
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What Are The Risks Associated With In Vitro Fertilization?
As with most medical procedures, there are potential risks. Fertility medications can have various side effects
including headaches, mood swings, abdominal pain, hot flashes, and bloating, amongst other side effects.
Although it is rare, fertility medications may cause ovar ian hyper-stimulation syndrome (OHSS). Symptoms
of OHSS may include abdominal pain or a feeling of being bloated. More severe symptoms include the
following:
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If you
Nausea or vomiting
Decreased urinary frequency
Shortness of breath
Faintness
Severe stomach pains and bloating
Ten pound weight gain within three to five days
experience any of these symptoms above, contact your doctor right away.
Additional risks of IVF include the f ollowing:
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How
Egg retrieval carries risks of bleeding, infection, and damage to the bowel or bladder.
The chance of a multiples pregnancy is increased with the use of fertility treatment. There are additional risks and
concerns related to multiples during pregnancy including the increased risk of premature delivery and low birth
weight.
Assisted reproductive technology (ART) involves a significant physical, financial, and emotional commitment on
the part of a couple. Psychological stress and emotional problems are common, especially if in vitro fertilization
(IVF) is unsuccessful.
IVF is expensive, and many insurance plans do not provide coverage for fertility treatment. The cost for a single
IVF cycle can range from at least $12,000-$17,000.
successful is in vitro fertilization?
The success rate of IVF clinics depends on a number of factors including reproductive history, maternal age,
cause of infertility, and lifestyle factors. It is also important to understand that pregnancy rates are not the
same as live birth rates.
In the United States, the live birth rate for each IVF cycle started is approximately:
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What
41-43% for women under age 35
33-36% for women ages 35 to 37
23-27% for women ages 38 to 40
13-18% for women ages over 40
if I don’t produce healthy eggs or my husband is sterile?
You may choose to use donor eggs, sperm, or embryos. However, make sure to talk with a counselor
experienced with donor issues. You will want to be informed about various legal issues related to gamete
donation including the legal rights of the do nor.
How many embryos should be created or transferred?
The number of embryos transferred typically depends on the number of eggs collected and maternal age. As
the rate of implantation decreases as women age, more eggs may be implanted depending on age to increase
the likelihood of implantation. However, a greater number of eggs transferred increases the chances of having
a multiples pregnancy. Make sure to talk with your doctor before the procedure so you both agree on how
many embryos to implant.
How do I choose an infertility clinic?
There are a number of questions to ask regarding the cost and details of specific centers and fertility
programs. Some suggested questions are available online inSelecting Your ART Program.
Last Updated: 09/2014
American Society for Reproductive Medicine. (2014). Gamete and embryo donation: Deciding whether to tell. Retrieved
fromhttps://www.asrm.org/FACTSHEET_Gamete_Donation_Deciding_Whether_To_Tell/
Human Fertilisation & Embryology Authority. (2014).IVF- What is in vitro fertilisation (IVF) and how does it work? Retrieved
from http://www.hfea.gov.uk/IVF.html
Human Fertilisation & Embryology Authority. (2014).Risks of fertility treatment. Retrieved fromhttp://www.hfea.gov.uk/fertilitytreatment-risks.html
MedlinePlus. (2014). In vitro fertilization (IVF). Retrieved fromhttp://www.nlm.nih.gov/medlineplus/ency/article/007279.htm
Mayo Clinic. (2013, June 27). In vitro fertilization (IVF). Retrieved from http://www.mayoclinic.org/tests-procedures/in-vitrofertilization/basics/definition/prc-20018905
RESOLVE: The National Infertility Association. (n.d.) IVF/ART. Retrieved fromhttp://www.resolve.org/family-buildingoptions/ivf-art/
http://americanpregnancy.org/