What Is In Vitro Fertilization?
In vitro fertilization or IVF is a medical treatment that gives infertile couples a chance to conceive. Known as an assisted reproductive technology or ART, IVF is often one of the last treatments a person will turn to when they have been unable to get pregnant. The process works by extracting an egg from the mother and taking a sperm sample from the father. In a laboratory, these are combined to form an embryo. Once the embryos have formed, they are implanted into the mother’s uterus. Because the egg has already been fertilized, ideally a woman will conceive more easily.
The IVF process is not always easily accomplished. It requires completing several steps. The first is to take fertility medications that stimulate a woman’s body to release eggs for fertilization. A woman will often have to go to a doctor’s office to take blood samples on multiple occasions to check her hormone levels to determine when the eggs are most likely to be released. A doctor will also use an imaging tool known as a transvaginal ultrasound to view the ovaries and determine if they are producing eggs. Ideally, a woman will release multiple eggs via the hormone stimulation process.
A doctor will use a special procedure to retrieve the eggs that were released. This involves using a special type of needle to remove the eggs that is inserted into a woman’s pelvic cavity. Ideally, the procedure is not an uncomfortable one. A doctor will provide medications that help to reduce these symptoms as much as possible. Some cramping following the procedure is a normal side effect.
In addition to retrieving eggs for fertilization, a man is asked to donate a sample of his sperm. This sperm is used in a laboratory to mix with the egg. Sometimes, laboratory technicians will use a technique known as intracytoplasmic sperm injection or ICSI. This involves using a special needle to deliver a single sperm into the egg’s cytoplasm. This technique is utilized if there are concerns regarding the quality of a man’s sperm. In the laboratory, these eggs are monitored for cell division. If the cells do start to divide, the egg has been fertilized and is considered an embryo.
After fertilization, a doctor will have a woman return to their office for insemination. This process usually takes place about three to five days after the eggs were retrieved. The insemination process generally does not cause discomfort for the woman. Ideally, the IVF process will be successful and the embryo will implant into a woman’s uterus. From start to finish, the IVF process after egg retrieval takes six to 10 days. However, a woman may take hormones to stimulate egg production for much longer.
What Are the “Pros” to In Vitro Fertilization?
Couples considering in vitro should carefully evaluate pros and cons before proceeding with IVF treatments. On the ultimate pro side is that a couple could successfully conceive through using IVF. There are several other advantages to using this method as well and include the following:
Helps Men and Women Overcome Fertility Issues
Prior to the introduction of IVF, many couples wishing to conceive were simply told they couldn’t have children due to the existence of certain conditions. For example, if a woman had previously had a tubal ligation for sterilization and wished to reverse the process, she would often require a tubal ligation reversal, which may or may not be effective in allowing a woman to get pregnant again. Through IVF, a woman has an alternative to tubal ligation reversal. Other conditions that a couple may experience that could have previously kept a pregnancy from occurring include:
- Fertility of unknown cause
- Impaired sperm production/function
- Premature ovarian failure
- Uterine fibroids
In addition to these considerations, some couples use IVF as a method to preserve fertility. If either is going to undergo cancer treatments that could affect their fertility, they could proceed in having eggs or sperm harvested with embryos created, if desired. At a later time, when the couple wished to conceive or hire a surrogate, they would have a greater chance to have a child.
Hope for Those With Genetic Conditions
In addition to promoting conception, IVF can offer hope to those who have a history of genetic conditions that could potentially be passed down to a child. An example would be cystic fibrosis. A laboratory can perform screening tests to determine if an embryo carries genes that would cause a child to have the genetic condition. This screening ability is not possible for all genetic abnormalities. In addition to these factors, embryos with chromosomal abnormalities are at greater risk for miscarriage. Through earlier genetic screening, a couple is more likely to carry a child to term.
Success rates for IVF can fit in both the pros and cons category. This is because IVF has enabled many women to get pregnant who thought they likely may never get pregnant. However, the success rates are not absolute for conception. The chances for conception are also closely linked with a woman’s age as the quality of her eggs often starts to diminish as she gets older. According to the American Pregnancy Association, the success rates associated with IVF include:
- Age 35 and under: 41 to 43 percent
- Ages 35 to 37: 33 to 36 percent
- Ages 38 to 40: 23 to 27 percent
- Ages 40 and older: 13 to 18 percent
In some instances, the quality of a man’s sperm or woman’s eggs are such that fertilization is not possible. In this case, a couple may choose to utilize donor eggs, sperm, or even embryos to enhance the chances for conception. This is often the case for women who are attempting to conceive when they are older than age 41 as the equality of their eggs is often suboptimal for conception.
Sometimes a couple may have to go through several IVF cycles before successfully conceiving. If the first cycle is unsuccessful, a doctor may recommend adjusting the medications prescribed in favor of others. Having one unsuccessful IVF round does not mean that a person will not or cannot conceive. However, the fertility doctor should evaluate the previous IVF round and determine steps that can be taken to improve the couple’s chances of getting pregnant with any further rounds.
This consideration is another potential pro and con, much like the cost associated with IVF. Often, doctors will recommend implanting multiple embryos to increase the likelihood a woman will become pregnant. This technique can increase the chances a woman will become pregnant with multiple babies, such as twins or triplets. It is important a couple discuss this possibility with their doctor in determining the best approach to IVF.
What Are the “Cons” to In Vitro Fertilization?
While the potential rewards to IVF are great, it is important to consider the impacts of the “cons” as well. A doctor at a fertility clinic should also go through these potential risks and impacts to a person’s mental well-being.
IVF can be a very costly undertaking. According to the American Pregnancy Association, a single round of IVF can cost between $12,000 and $17,000. Because most health insurance plans do not cover IVF treatment, this can represent a significant cost to a couple wishing to become pregnant. Sometimes, fertility clinics will charge excessive prices for IVF. If possible, couples should do their research and go to several fertility clinics to determine if they are receiving a fair price. They also should consider the cleanliness of the facility, the availability of convenient hours, and the expertise of the physician(s) and staff.
IVF is not without its side effects and complications. For example, taking the recommended fertility medications can cause a condition known as ovarian hyperstimulation syndrome. This syndrome occurs after a woman receives injections of human chorionic gonadotropin (hCG) hormone. The syndrome causes the ovaries to swell, which can cause significant lower abdominal pain. Other symptoms associated with the condition include the following:
Another potential complication associated with IVF is an ectopic pregnancy. This is a pregnancy where the embryo implants outside the uterus. As a result, a woman may experience some initial symptoms associated with pregnancy, including increased hormone levels. However, the pregnancy cannot continue because the embryo is not properly implanted. According to the Mayo Clinic, an ectopic pregnancy occurs in about 2 to 5 percent of pregnancies.
Risk for Premature Delivery and Low Birth Weight
According to the Mayo Clinic, women who conceive with IVF are at increased risk for having babies preterm. Most doctors define preterm delivery as birth before a baby is 37 weeks. The earlier a baby is born, the less time the baby has to mature in the womb. Preterm delivery is associated with low birth weight as well as increased risk for problems such as poor lung function. Doctors do not know exactly why IVF may be associated with preterm delivery, but it is important for parents to consider this when considering IVF.
Although this has been discussed on the “pros” side, it is also important for couples to understand that IVF is in no way a guarantee that a couple will be able to have a baby. Infertility can be a devastating occurrence to a couple whose wish is to have and raise a child. IVF is an expensive and time-consuming process that may potentially not yield a baby. Many fertility doctors will recommend a couple undergo counseling throughout the process so they are prepared to cope if the IVF round does not result in conception. The process can be as stressful and heartbreaking as it is one of hope.
What Questions Should I Ask My Doctor?
According to the Mayo Clinic, IVF is the most common assisted reproductive technology used in the United States. Thousands of couples use this method to get pregnant when they didn’t believe it was possible for them to otherwise. For couples wishing to undergo the IVF process, they will often begin by meeting with a doctor or doctors at a fertility clinic. Questions to ask in this initial meeting can include:
- What are your clinic’s success rates for IVF?
- What training have you pursued in relation to the fertility specialty?
- From your initial assessment, what challenges do you foresee us potentially having in the IVF process?
- What are the costs associated with each step of the process?
- What preliminary testing do you recommend we undergo before beginning the process?
- What technologies do you have to improve our success rate?
- What are your business hours? Do you offer evening or weekend appointments?
Also, be aware that some fertility clinics may have a waiting list for IVF. You may wish to ask how long the average couple waits to begin IVF treatments. A doctor may also offer some recommendations before beginning the IVF cycle that could increase the likelihood a woman will become pregnant. For example, if a woman smokes, her chances for conception via IVF are reduced, sometimes by as much as 50 percent. A doctor will often advise completely quitting smoking before attempting an IVF cycle. Other habits that could affect a couple’s success include using alcohol and recreational drugs or drinking excessive amounts of caffeine. Living a healthy lifestyle while working to minimize stress can be extremely helpful in enhancing the likelihood of conception through IVF cycles.
In Vitro Fertilization Pros and Cons – Conclusion
Ultimately, the decision to pursue IVF is the couple’s alone. A doctor may identify potential red flags that may indicate a couple needs to consider donor eggs or sperm or choosing a surrogate. Thanks to modern technological innovations, more and more couples are successfully conceiving through IVF.
American Pregnancy Association: In Vitro Fertilization
Mayo Clinic: In Vitro Fertilization
MedlinePlus: In Vitro Fertilization (IVF)