In Vitro Fertilization (Glossary)

In Vitro Fertilization: In Vitro Fertilization, or IVF, is one of several types of Assisted Reproductive Technology that are in wide use today to assist in the creation of a family for couples who are experiencing difficulty in conceiving a child, or in carrying the child through a full term pregnancy. advertisement

To begin the procedure, the woman must undergo about two weeks of intensive preparation in order to prepare a proper environment in the woman to increase the chances of recovering several healthy and mature eggs. This preparation includes hormonal therapy with fertility drugs, in order to induce superovulation, which is designed to produce multiple eggs. Blood tests and ultrasound scans of the woman's ovaries are used to determine the optimal time to retrieve the eggs from the ovary. The optimal time will generally be just before ovulation when the eggs are almost ready for fertilization.

Because of significant improvements in ultrasound imaging technology, surgery is no longer required for most In Vitro Fertilization patients. At the optimum time, the woman is placed under local anesthesia in an outpatient facility, and a sonographically-guided needle is used to recover the eggs from her ovary. This procedure does not require either hospitalization or the use of general anesthesia. The mild discomfort that the woman will experience during this procedure has been described as being similar to what she would experience during a Pap smear or an endometrial biopsy. Because of the non-invasive nature of this procedure, in most cases, after only a short rest, the woman will be able to return home and resume her normal activities.

The removed eggs are then fertilized in a laboratory environment (in a culture dish and not in a test tube, as is commonly thought), where they will be maintained at normal body temperature inside an incubator. The fertilization can be accomplished with the sperm of the intended father or with sperm from a donor. The eggs are then maintained in a laboratory dish in a nutrient mixture that serves as a substitute for the environment of the fallopian tubes. Here the fertilized eggs are allowed to develop into cleaving pre-embryos, whose cells divide 2 or 3 times to become pre-implantation embryos, or pre-embryos.

A little over two days after fertilization, by the use a special catheter, the pre-embryos are passed through the vagina and into a healthy uterus. This delivery of the pre-embryos approximates the time that they would have reached the uterus after normal ovulation and fertilization. If the pre-embryos successfully implant into the uterus, the pregnancy will progress in the same way as any other pregnancy. The host for the implantation of the pre-embryos can be either the woman from whom the eggs were harvested, or a surrogate mother. After the pre-embryo placement in the uterus, the patient will only be required to lie quietly in a bed for about an hour, and will then be allowed to return home.

Although the possibility of a continuing pregnancy being achieved through the use of In Vitro Fertilization has improved to the point where between 15% and 25% of the procedures are successful, the possibility of a pregnancy being achieved for any single patient cannot be predicted, primarily because there are so many variables and possible complications.