In vitro fertilization (IVF) is so common today that it's amazing to realize the procedure was first introduced when Jimmy Carter was president.

The first so-called "test-tube" baby was born in 1978. Born to a mother whose fallopian tubes were blocked, the baby that resulted from the original procedure was fertilized outside her mother's uterus. The embryo was then placed back into the mother's uterus to grow.

Since then, IVF has become the most common assisted reproductive technology (ART) treatment for infertility in the United States. The procedure has become so popular that more than 99 percent of the ART procedures tracked by the Centers for Disease Control and Prevention (CDC) are IVFs.

IVF involves at least four steps:

1. Stimulating the ovaries with hormones to produce multiple eggs each month

2. Collecting these eggs from the ovaries using a minor surgical procedure called transvaginal ultrasound aspiration. Under some form of anesthesia, your doctor inserts an ultrasound probe into your vagina to locate the mature egg follicles and withdraws them using a needle connected to a suction device. The whole process is usually over in about 30 minutes.

3. Putting sperm and eggs together in a petri dish to encourage fertilization.

4. Placing one or more fertilized embryos back into the uterus so they can grow. This is done using a long thin tube with a syringe at one end, and is usually painless.

Some cases involve additional procedures, such as intracytoplasmic sperm injection (ICSI). This procedure uses a single sperm, which is then injected into the egg. After the egg is fertilized, it's placed into the uterus to grow.

IVF was originally developed for women whose Fallopian tubes were blocked, damaged, or missing for some reason. Today, the treatment is also recommended for those with endometriosis, unexplained infertility, or infertility due to cervical or immune system problems, or for male infertility. It is the last resort treatment for any type of infertility condition that is resistant to treatment.

Rates vary according to region, but most clinics charge about $10,000 for each cycle, excluding medications. However, don't assume that a pregnancy will result from the first cycle. Many women undergo more than one cycle before they give birth. ICSI can add several thousand dollars to the cost of an IVF cycle. For those women who require donor eggs to conceive, the costs of acquiring donor eggs can add another $10,000.

The mounting costs of repeated IVF cycles can lead couples to seek financing by tapping into the equity in their home or other real property. You can ease your financial stress by talking with the clinic or hospital about a payment program to finance several cycles of IVF.

Your success with IVF depends on a number of factors: your age, your or your partner's infertility diagnosis, his sperm quality, the response of your ovaries to medication, and, to some extent, the experience of your physician or fertility clinic.

According to the CDC, women under age 35 have the best chance of a successful pregnancy. About 40 percent of the IVF cycles in women under 35 resulted in live births in 2007. Older women were less successful. Only 11.5 percent of women 41 to 42 years old who underwent IVF procedures had live births that year.

Comparing success rates of different clinics is challenging because reported pregnancy results depends in part on the types of patients the clinic accepts for IVF and the manner in which they conduct their treatments. For example, a clinic that transfers a larger number of embryos per cycle may have a drastically different success rate than a clinic that transfers single embryos. However, along with such an aggressive approach of transferring multiple embryos comes the high risk of a multiple pregnancy, which can have a substantial impact on the health of the pregnant woman and her future children. Also, a clinic's success rate may change considerably over time. If you're older, don't be discouraged by the numbers. It may still be possible to get pregnant through IVF. Talk with your doctor about the factors that may affect your pregnancy.

IVF and other fertility procedures involving ovarian stimulation can increase the risk of ovarian hyperstimulation syndrome, a potentially dangerous complication in which the ovaries become enlarged and, in severe cases, may lead to problems such as respiratory problems, blood clots, or kidney damage. There is also an increased chance of multiple pregnancy when more than one embryo is transferred, which increases the health risks for both the mother and the child. It is unclear whether there is an increased risk of birth defects with IVF. Many studies have not found an increased risk, but several do. A 2008 study conducted by the CDC found an increased risk of some defects including septal heart defects, cleft lip, and gastrointestinal defects. However, researchers emphasize that the risks are still small.

-- Psyche Pascual is a former staff writer with the Los Angeles Times. She is the executive editor of Consumer Health Interactive.

References

Last updated July 27, 2009
Copyright © 2006 Consumer Health Interactive

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