In Vitro Fertilization (IVF)

What Is In Vitro Fertilization Treatment (IVF)?

In vitro fertilization treatment (IVF) gives couples facing infertility problems the opportunity to conceive.  Children born through this procedure are commonly known as test tube babies, since the fertilization process occurs in a test tube or Petri dish rather than inside the mother’s womb.   

During in vitro fertilization treatment, the female patient receives fertility medication starting from the third day of menstruation to stimulate the development of follicles in the ovaries.  The use of multiple follicles increases the likelihood of successful conception.  The injected medication typically extends over a period of 10 days.   

When the follicles have matured sufficiently, the reproductive endocrinologist injects the female patient with a hormone that triggers ovulation within 36 hours.  Prior to ovulation, the patient is given general anesthesia to prepare for egg retrieval.  The doctor then pierces the vaginal wall with an ultrasound-guided needle to reach the ovaries and retrieve the follicular fluid containing the eggs.  The procedure takes approximately 20 minutes.   

The ova are separated from the fluid and surrounding cells in the laboratory.  Here, the doctor removes inactive cells and seminal fluid from the semen, which is either taken from the male patient or provided by a sperm donor. 

The sperm and egg are left to incubate together for approximately 18 hours in a culture medium.  This is usually sufficient time for fertilization to take place.  In cases where the sperm count is low, the doctor injects a single sperm into the egg in a procedure known as intracytoplasmic sperm injection (ICSI).  The fertilized egg is left in a special growth medium for 48 hours until the egg matures to the 6–8 cell stage.  Doctors vary in deciding the best time to implant the embryos.   

The embryo transfer is the final stage of in vitro fertilization treatment.  The number of embryos available, the age of the female patient, and various other health factors determine the number of embryos to be transferred.  In most cases, the doctor implants two embryos to strike a balance between the opportunity for successful implantation and the risk of multiple pregnancies.  A thin plastic catheter passed through the vagina and cervix carry the embryos into the uterus.  Any remaining embryos can be frozen for use in the future if the implantation is unsuccessful or if the patient wishes to bear more children.