Shore Institute for Reproductive Medicine. In-Vitro Fertilization

Infertility is diagnosed when a woman is unable to become pregnant or bring a pregnancy to term after a full year's attempt. As Americans delay the age at which they begin to have children, the rate of infertility has gradually risen. In fact, statistics show that 20% of all American couples are infertile (whether due to the man, woman, or both). In vitro fertilization is a wonderful option for these couples, affording them an excellent opportunity to have children.

Pregnancy occurs when an egg is released from the ovary into the fallopian tube, where it is fertilized by a sperm. There are numerous reasons why this may not occur. One of them is severe endometriosis, a condition in which the lining of the uterus leaks into the abdominal region during menstruation. (Low to mild levels of endometriosis typically do not cause infertility.) Other common causes of infertility are a low sperm count or a damaged fallopian tube.

Infertility may also be the result of a previously performed medical "sterilization" procedure such as a vasectomy or tubal ligation. In some cases, previous vasectomy reversals or tubal ligation reversals may not have been successful, thereby requiring a second operation by a qualified and highly skilled surgeon.

IVF begins with the prescription of fertility drugs in order to increase the number of ovarian eggs that will develop. With the help of these fertility drugs, the ovaries typically produce between 2 and 25 eggs. The growth of the eggs is monitored through ultrasound, and hormone levels are monitored through blood or urine samples. Once the eggs are at the proper stage (usually 10-12 days after the ovarian stimulation drugs have been taken), they are extracted through a process known as follicular aspiration. This is performed at the clinic under mild sedation and local anesthesia. This step is non-invasive and involves very little or no pain. The patient then leaves the physician's office and returns once the embryos are ready for reinsertion.

Once the eggs are taken from the ovaries, they are brought to the laboratory and placed into an incubator dish. The man's sperm, which is collected several hours before, is placed with the female's eggs. The sperm enters the egg and an embryo is formed. The cells of the fertilized egg then begin to divide and grow. Embryos continue to grow in the laboratory for approximately two to three days.

Once the embryos have developed sufficiently, the patient returns to the office where the embryos are reinserted into the woman's uterus. To facilitate this process, the embryos are placed in a small amount of fluid, inserted through the cervix, and then placed into the uterus.

After a few days, the woman is given blood tests, urine tests, and ultrasound exams to monitor whether or not a pregnancy has occurred.

The odds of becoming pregnant depend on a number of factors, including genetic or hormonal problems, mechanical obstructions, the number of eggs extracted, the age of the female patient, and the male sperm count. According the Centers for Disease Control and Prevention (CDC) on Assisted Reproductive Technologies (ART), there were 64,036 cycles of or attempts at ART in 1996 that resulted in 20,659 babies born. These figures compare favorably to those of a fertile couple trying to achieve pregnancy.