Infertility and In Vitro FertilizationToday, in vitro fertilization (IVF) is practically a household word. But not so long

ago, it was a mysterious procedure for infertility that produced what were then

known as "test-tube babies." Louise Brown, born in England in 1978, was the

first such baby to be conceived outside her mother's womb.

Unlike the simpler process of artificial insemination -- in which sperm is placed

in the uterus and conception precedes otherwise normally -- IVF involves

combining eggs and sperm outside the body in a laboratory. Once an embryo or

embryos form, they are then placed in the uterus. IVF is a complex and

expensive procedure; only about 5% of couples with infertility seek it out.

However, since its introduction in the U.S. in 1981, IVF and other similar

techniques have resulted in more than 200,000 babies.

What Causes of Infertility Can IVF Treat?

When it comes to infertility, IVF may be an option if you or your partner have

been diagnosed with:

Endometriosis

Low sperm counts

Problems with the uterus or fallopian tubes

Problems with ovulation

Antibody problems that harm sperm or eggs

The inability of sperm to penetrate or survive in the cervical mucus

An unexplained fertility problem

IVF is never the first step in the treatment of infertility. Instead, it's reserved for

cases in which other methods such as fertility drugs, surgery, and artificial

insemination haven't worked.

If you think that IVF might make sense for you, carefully assess any treatment

centre before undergoing the procedure. Here are some questions to ask the

staff at the fertility clinic:

What is your pregnancy ratio per embryo transfer?

What is your pregnancy rate for couples in our age group and with our fertility problem?

What is the live birth rate for all couples who undergo this procedure each year at your

facility?

How many of those deliveries are twins or other multiple births?

How much will the procedure cost, including the cost of the hormone treatments?

How much does it cost to store embryos and how long can we store them?

Do you participate in an egg donation program?

What Can I Expect From IVF?

The first step in IVF involves injecting hormones so you produce multiple eggs

each month instead of only one.You will then be tested to determine whether

you're ready for egg retrieval.

Prior to the retrieval procedure, you will be given injections of a medication that

ripens the developing eggs and starts the process of ovulation. Timing is

important; the eggs must be retrieved just before they emerge from the follicles

in the ovaries. If the eggs are taken out too early or too late, they won't develop

normally. Your doctor may do blood tests or an ultrasound to be sure the eggs

are at the right stage of development before retrieving them. The IVF facility will

provide you with special instructions to follow the night before and the day of the

procedure. Most women are given pain medication and the choice of being

mildly sedated or going under full anesthesia.