In Vitro Fertilization
In vitro fertilization (IVF) involves fertilization outside the body in a laboratory environment. To date, thousands of babies have bee delivered worldwide as a result of IVF treatment. Over the years, the procedures to achieve IVF pregnancy have become increasingly simpler, safer, and more successful.
To accomplish pregnancy as a result of IVF, several steps are involved:
- Stimulation of the ovary to produce several fertilizable oocytes (eggs)
- Retrieval of the oocytes from the ovary
- Fertilization of the oocytes and culture of the embryos in the IVF Laboratory
- Placement of the embryos into the uterus for implantation (embryo transfer or ET)
What Type of Infertility Might Be Helped by IVF?
- Absent fallopian tubes or tubal disease that cannot be treated successfully by surgery
- Endometriosis that has not responded to surgical or medical treatment
- A male factor contributing to infertility, in which sperm counts, motility or morphology are low but enough sperm can be produced or retrieved by surgical means to allow fertilization in the laboratory
- Unexplained infertility that has not responded to other treatments
Intracytoplasmic Sperm Injection (ICSI)
Intracytoplasmic sperm injection is a micromanipulation technique developed to help achieve fertilization for couples with severe male factor infertility or couples who have had failure to fertilize in a previous in vitro fertilization attempt. The procedure overcomes many of the barriers to fertilization and allows couples with little hope of achieving successful pregnancy to obtain fertilized embryos.
The technique involves very precise maneuvers to pick up a single, live sperm and inject it directly into the center of a human egg.
ICSI Process
The ICSI procedure requires that the woman’s partner undergo ovarian stimulation with fertility medications so that several mature eggs develop. These eggs are then aspirated, using vaginal ultrasound, and incubated under precise conditions in the Embryology Laboratory. The semen sample is prepared by centrifuging (spinning the sperm cells through special solution). This solution separates live sperm from debris and most of the dead sperm. The micromanipulation specialist picks up the single live sperm in a glass needle and injects it directly into the egg.
Through the ICSI procedure, many couples with difficult male factor infertility problems have achieved pregnancy. Fertilization rates of 50-70% (of all eggs injected) are achieved, and pregnancy rates are comparable to those seen with IVF in couples with no male factor infertility.
Embryo Cryopreservation
Embryo cryopreservation is a method used to preserve embryos by cooling and storing them at low temperatures. They can then be thawed at a future date and transferred to the uterus, providing additional opportunity for achieving conception.
As a part of the usual process of in vitro fertilization, multiple eggs may be stimulated to grow, recovered from the ovaries with ultrasound guidance, and fertilized. This may result in additional embryos in excess of the number that a couple would desire to have transferred back to the uterus. If the additional embryos are of sufficiently good quality to undergo the process of cryopreservation, this can be preformed in order to provide another opportunity for embryo transfer. That is if the IVF fresh embryo transfer does not result in pregnancy, the frozen embryos can be subsequently thawed and transferred to the uterus in a hormonally controlled cycle. Alternatively, if the cycle is successful, the embryos can be stored for several years should the couple decide to attempt to have more children later on.
Worldwide, cryopreservation of human embryos has been shown to be a successful procedure and there are no reports of increased birth defects in pregnancies achieved through this process.
