In Vitro Fertilisation (IVF)

	Male Problems
	Female Problems
	Treating Infertility
	Artificial Insemination
	IVF

This method first came into practice in 1977, when two doctors, one a leading obstetrician and gynaecologist and the other a physiologist achieved the first successful 'test-tube' implantation. Louise Brown, the result of this extensive procedure, was born nine months later after a normal, healthy pregnancy with the treatment of infertility being radically revolutionised.
This procedure normally has a good success rate, but shouldn't be viewed as a 'cure-all' for infertility.

What is involved in the process of IVF?

The woman concerned is given drugs to stimulate her ovaries, in order to achieve multiple ovulation. After establishing the precise date of ripening, the eggs are then removed, via the abdomen using a laparoscope. Another method, would be to approach the ovary from the inside of the pelvis, thus avoiding the necessity for an abdominal incision and general anaesthetic.

During this procedure, usually more than one egg is removed for fertilisation, to save repeating the operation in the case of failure. However it is best to bear in mind that the procedure may have to be repeated for a few cycles before the 'healthiest' of eggs are gathered, therefore the latter technique would also have the advantage of fewer surgical incisions to the abdomen.

The ripe eggs are then placed in a flat container, where they are incubated for up to 24 hours and continuously checked to ensure that they are healthy and fully-developed. After the given time, sperm which has been 'washed' to remove any traces of degenerating produce, is then introduced. If the conditions are favourable, fertilisation will then take place. However, if fertilisation does not occur, the egg will be studied, and wherever possible an explanation is offered to the couple concerned. Sometimes the cause will be evident, and further steps will be taken to overcome the problem during the next treatment attempt.

Embryo transfer

While this is taking place, the women concerned will lie on her back with her feet placed in stirrups. The doctor will then insert a speculum so as to expose the cervix, and check the position and size of the uterus, so as to establish the best method for passing the tube, containing the embryo into it. Any excess fluid surrounding the cervix will also be removed, so as to ensure that none will stick to the embryo, thus preventing implantation.
The tube containing the embryo will then be passed through the vagina, cervix and a short distance into the uterus, where it will be released. The exact measurement of placement will be established during an ultrasound scan done during a prior visit. Once this is complete, the catheter is gently withdrawn, and inspected in the laboratory to ensure that the embryo has indeed been 'placed' into the patient.

What is the success rate, and how safe is IVF?

It must be considered that there is a high failure rate with success being achieved in less than one-third of couples who become involved in the treatment and less so in women who are over the age of 38 years. Multiple pregnancy is yet another area that should be taken into account, as it is common practice for three fertilised cells to be inserted at one given time in order to be sure of at least one success.

The potential misfortune of babies being born with certain birth defects, arising from embryo handling is highly unlikely, as of the several thousand IVF pregnancies, only two abnormal cases have been reported, and it is expected that even this incidence will be reduced as embryo and foetal monitoring techniques improve.