In vitro fertilization (IVF)

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If a woman does not or cannot produce any eggs, donated eggs may be used.

Step 3: Insemination and Fertilization.

The man’s sperm is placed together with the best quality eggs and stored in an environmentally controlled chamber. The mixing of the sperm and egg is called insemination. The sperm usually enters (fertilizes) an egg a few hours after insemination. If the doctor thinks the chance of fertilization is low, the laboratory staff may directly inject the sperm into the egg. This is called intracytoplasmic sperm injection (ICSI). Many fertility programs routinely do ICSI on some of the eggs even if everything is normal.

Step 4: Embryo culture

When the fertilized egg divides, it becomes an embryo. Laboratory staff will regularly check the embryo to make sure it is growing properly. Within about 5 days, the embryo has several cells that are actively dividing.

Couple who have a high risk of passing a genetic (hereditary) disorder to a child may consider pre-implantation genetic diagnosis (PGD). The procedure is done about 3 -4 days after fertilization. Laboratory scientists remove a single cell from each embryo and screen the material for specific genetic disorders. According to the American Society for Reproductive Medicine, PGD can help parents decide which embryos to implant, which decreases the chance of passing a disorder onto a child. The technique is controversial and not offered at all centers.

Step 5: Embryo transfer

Embryos are placed into the woman’s womb 3 - 5 days after egg retrieval. The procedure is performed in the doctor’s office while the woman is awake. The doctor inserts a thin tube (catheter) containing the embryos into the woman’s vagina, through the cervix, and up into the womb. If an embryo sticks to (implants) in the lining of the womb and grows, pregnancy results.

More than one embryo may be placed into the womb at the same time, which can lead to twins, triplets, or more. The exact number of embryos transferred is a complex issue that depends on many factors, especially the woman’s age. Unused embryos may be frozen and implanted or donated at a later date.

IVF is done to help a woman become pregnant. It is used to treat many causes of infertility, including:

• Damaged or blocked fallopian tubes (can be caused by pelvic inflammatory disease)
• Endometriosis
• Male factor infertility, including decreased sperm count and blockage
• Unexplained infertility

Review Date: 01/31/2007
Reviewed By: Bryan R. Hecht, MD, Department of Obstetrics and Gynecology, Cleveland Clinic, Canfield, OH. Review provided by VeriMed Healthcare Network.