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In Vitro Fertilization for Infertility
During in vitro fertilization (IVF), eggs and sperm are brought together in a laboratory glass dish to allow the sperm to fertilize an egg. With IVF, you can use any combination of your own eggs and sperm and donor eggs and sperm.
See a picture of the
female reproductive system 
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Ovulation and egg retrieval. To prepare for an assisted reproductive procedure using your own eggs, you will require hormone treatment to control your egg production (ovulation). This is done to prevent unpredictable ovulation, which would make it necessary to cancel that in vitro attempt. This is generally done using one of two similar types of gonadotropin-releasing hormone analogue (GnRH agonist or GnRH antagonist). The following are two examples of how ovulation can be controlled:
- You first receive about 10 days of nasal or injected GnRH agonist that "shuts down" your pituitary. Next, you get daily ovary-stimulating hormone injections and are closely monitored for 2 weeks before egg retrieval. At home, you or your partner injects you with gonadotropin or follicle-stimulating hormone (FSH) to make your ovaries produce multiple eggs (superovulation).
- You start treatment with FSH injections and then add the GnRH antagonist injection after about 5 days, which stops the production of luteinizing hormone (LH) within an hour or two.
After the first week, your doctor checks your blood estrogen levels and uses ultrasound to see whether eggs are maturing in the follicles. During the second week, your dosage may change based on test results. And you are monitored frequently with transvaginal ultrasound and blood tests. If follicles fully develop, you are given a human chorionic gonadotropin (hCG) injection to stimulate the follicles to mature. The mature eggs are collected 34 to 36 hours later by needle aspiration guided by ultrasound. You will usually have pain medicine and sedation for this procedure.
Sperm collection. Sperm are collected by means of masturbation or by taking sperm from a testicle through a small incision. This procedure is performed when a blockage prevents sperm from being ejaculated or when there is a problem with sperm development. Sperm may have been collected and frozen at an earlier time. Then the sperm are thawed on the day the eggs are collected.
Fertilization and embryo transfer. The eggs and sperm are placed in a glass dish and incubated with careful temperature, atmospheric, and infection control for 48 to 120 hours. About 2 to 5 days after fertilization, the best fertilized eggs are selected. One to three are placed in the uterus using a thin flexible tube (catheter) that is inserted through the cervix. Those remaining may be frozen (cryopreserved) for future attempts.
Pregnancy and birth. Any embryos that implant in the uterus may then result in pregnancy and birth of one or more infants.
| By: | Healthwise Staff | Last Revised: March 19, 2010 |
| Medical Review: | Sarah Marshall, MD - Family Medicine Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology | |
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