WHAT IS IVF?
In vitro fertilization (IVF) is a process by which an
egg is fertilized by sperm outside the body: in vitro.
IVF is a major treatment for infertility when other
methods of assisted reproductive technology have failed.
The process involves monitoring a woman's ovulatory
process, removing ovum or ova (egg or eggs) from the
woman's ovaries and letting sperm fertilize them in a
fluid medium in a laboratory.
When a woman's natural cycle is monitored to collect a
naturally selected ovum (egg) for fertilization, it is known
as natural cycle IVF.
The fertilized egg (zygote) is then transferred to the
patient's uterus with the intention of establishing a
HISTORY OF IVF
1981 Elizabeth Carr, first IVF baby in USA.
1983 First birth after egg donation.
1985 First birth from cryopreserved embryo.
1985 Transvaginal Ultrasound for follicle monitoring.
1990 First report of egg donation to older mothers.
1992 First human birth after ICSI(Intra cytoplasmic sperm
IVF is used to overcome female infertility in the woman
due to problems of the fallopian tube, making
fertilization in vivo difficult.
It may also assist in male infertility, where there is a
defect in sperm quality, and in such cases intra
cytoplasmic sperm injection (ICSI) may be used, where a
sperm cell is injected directly into the egg cell. This is
used when sperm have difficulty penetrating the egg,
and in these cases the partner's or a donor's sperm may
be used. ICSI is also used when sperm numbers are
Mix in a test tube
Ovarian hyper stimulation
Natural and mild IVF
Final maturation and egg retrieval
Egg and sperm preparation
ALTERNATES OF IVF
Gamete intra fallopian transfer (GIFT):
GIFT is similar to IVF. It is used when a woman has at
least one normal fallopian tube. Eggs are placed in
this tube along with a man’s sperm to fertilize there.
Zygote intra fallopian transfer (ZIFT):
ZIFT is tubal embryo transfer in which a woman’s eggs
are taken from her ovaries, fertilized in the laboratory, and
put back in the fallopian tubes rather than the uterus.
RISKS IN IVF
There may be a failure to recover an egg because:
- follicles that contain mature eggs may not develop in
the treatment cycle
- ovulation has occurred before time of egg recovery
- one or more eggs cannot be recovered
- pre-existing pelvic scarring and/or technical difficulties
prevent safe egg recovery
The eggs that are recovered may not be normal;
There may be insufficient semen to attempt fertilization
of the recovered eggs because the man is unable to
produce a semen specimen, because the specimen
contains an insufficient number of sperm to attempt
fertilization, because the laboratory is unable to
adequately process the specimen provided, or because
the option to use a donor sperm as a "backup" was
Fertilization of the eggs to form embryos may fail even
when the egg(s) and sperm are normal;
The embryos may not develop normally or may not
develop at all. Embryos that display any abnormal
development will not be transferred;
Embryo transfer into the uterus may be
difficult/impossible, or implantation(s) may not occur after
transfer, or the embryo(s) may not grow or develop
normally after implantation;
Any step in the IVF-ET process may be complicated by
unforeseen events, such as hazardous or catastrophic
weather, equipment failure, laboratory conditions,
infection, human error and the like.
Success rates vary widely between clinics and between
physicians performing the procedure and implantation
does not guarantee pregnancy. Therefore, the procedure
may have to be repeated more than once to achieve
pregnancy. However, success rates have improved in
recent years, up from 27% in 2002 to 35% in 2009.
An ectopic or multiple pregnancy may abort
spontaneously or may require termination if the health of
the mother is at risk. The number of multiple pregnancies
has decreased in recent years as technical advances and
professional guidelines have led to implanting of fewer
embryos per attempt.