In Vitro Fertilisation(IVF)
In vitro fertilisation (IVF) is the most well-known of all assisted conception methods. With IVF, egg cells are fertilised by sperm 'in vitro,' meaning 'in glass' outside the female's body. The technique was pioneered in the 1970s, with the first successful human birth taking place in 1978.
How does IVF work?
Eggs are extracted from the woman's ovaries and combined with male sperm in a laboratory. The woman is regularly prescribed fertility drugs to increase ovulation and the chances of producing multiple mature eggs for fertilisation. This seeks to create more than the standard one egg per month. The doctors can tell when the eggs are mature by checking blood hormone levels and using an ultrasound. With the woman drowsy under sedation, a fine needle is used to remove the eggs.
The male provides a fresh sample of sperm. Alternatively a donor sperm sample is removed from the freezer (if the quality of the male's sperm is inadequate for fertilisation). The sperm is washed and mixed with the eggs, usually in a form of petri dish containing a nutrient. This is placed in an incubator in order to maintain the best, cleanest and most stable environment for the eggs and sperm. For the next 2 to 4 days, the dish is checked for fertilisation, with the healthiest embryos chosen to be inserted into the uterus. If the procedure is successful, an embryo will implant into the uterine wall and lead to pregnancy.
Who can benefit from IVF?
IVF can be a viable option when one or both partners have been diagnosed with an infertility problem, particularly those which significantly reduce the chances of conception in the long term; for instance, dysfunctional sperm in the male or blocked or damaged fallopian tubes in the female. Couples with no discernible cause for their infertility, who nevertheless have been unable to conceive for more than 3 years, are also ideal candidates.
Methods of assisted conception such as IVF are usually looked upon by doctors as a 'last resort' and they are likely to recommend other, non-invasive techniques beforehand. Candidates for IVF may therefore have previously attempted changes to diet or general health, or using fertility drugs. Some couples who try alternative methods of assisted conception without success, such as intrauterine insemination (IUI), progress to IVF.
Advantages
IVF treatment has been used for longer than many other forms of assisted conception, which means that a number of studies have been conducted on children conceived through IVF. Such studies show that a majority of these children have no long term health problems. In addition, IVF allows women with damaged or even missing fallopian tubes the possibility of having a baby. Women below the age of 30 have approximately a one in four chance of IVF conception for each cycle of treatment. Those who have conceived in the past have greater chances.
Disadvantages
The probability of multiple pregnancies (e.g. twins) is increased due to the method of placing more than one embryo in the uterus. This may not be a problem at all, but it can also increase the risk of complications or miscarriage. Certain studies claim that IVF children are likelier to use hospitals or have surgery more often than naturally conceived children. Fertility drugs can lead to side effects in the female. An ectopic pregnancy, where the embryo implants into the wrong place, is also a possibility. The success rate for IVF is around 20% per cycle, and the treatment can be expensive.