What is IVF?
IVF stands for In Vitro (= Latin for ”in glass”) Fertilization. What that means is you take sperm from a man, and put them in a petri dish with eggs from a woman, and the sperm fertilize the eggs. The fertilized eggs are called zygotes, and then they become embryos. The embryos are usually cultured (= keeping them warm in a dish) for a few days, and evaluated by an embryologist (who is a PhD, not an MD). In a typical IVF cycle, one (sometimes more than one) embryo is transferred back into the woman’s uterus. This usually happens around day 2-3, or day 5-6. The embryos that are not transferred can be vitrified, which basically means freezing really quickly to a really cold temperature, and then transferred back at a later date.
An IVF cycle starts out by stimulating the woman’s ovaries to produce a lot of follicles (little bubbles of fluid that house an egg). Most cycles, a woman only produces one follicle, but for this, you want lots. To do that, the woman is treated with a cocktail of medicines that is very variable. Usually, though, it consists of something to stimulate follicle growth (sometimes FSH, or follicle-stimulating hormone, which is what your pituitary gland produces normally) plus something that keeps her from ovulating too soon.
During stimulation, the woman gets frequent ultrasounds, and sometimes bloodwork, to monitor the process. It’s important that she doesn’t produce too many follicles, because that can lead to Ovarian Hyperstimulation Syndrome (OHSS), which results in fluid accumulation in the body and can be dangerous and even fatal. When the ovaries have a sufficient number of good-sized follicles (this number varies a lot, but approximately 10-20), she is given a medicine that induces ovulation. But before she ovulates, she is sedated and the eggs are removed using an ultrasound-guided needle that goes through the vaginal wall into the ovaries and retrieves the eggs from the follicles. The eggs are then put into a dish with the man’s sperm, unless the couple is doing ICSI (Intracytoplasmic Sperm Injection). ICSI means that the best-looking sperm are identified, and one sperm is injected into each mature egg.
In some cases, the embryos can be tested for a specific known genetic mutation, or screened for genetic abnormalities. It’s also possible to use donor eggs, donor sperm, or even donor embryos. These techniques are not legal in all countries, however.
IVF is emotionally demanding for both partners, and physically demanding for the woman. It can also be very expensive. And unfortunately, IVF does not protect against ectopic pregnancy or miscarriage. Statistics and success rates are hard to define, since every clinic is different, and there are so many techniques being used. But the success rate is somewhere around 30% after one IVF cycle. Since the first IVF baby was born in 1979, it’s been a quickly developing field that has helped countless couples have children, and it’s a great option for couples struggling with infertility.