IVF stands for In Vitro Fertilization and is the treatment of choice in those cases in which infertility results from blocked fallopian tubes. Remember, in order for a pregnancy to result, the egg has to travel through the fallopian tube towards the uterus. On its way there it is met by the sperm and if fertilization occurs, the fertilized egg will implant in the uterus. Obviously, blocked fallopian tubes will stop this from happening.
For IVF the eggs are taken directly from the ovaries and are then put into a petri dish together with the sperm. After the sperm has fertilized the eggs, the eggs are kept for about days in sterile conditions and are then returned to the womb. The challenge is now for the tiny embryo to implant inside the womb.
IVF is usually performed on an outpatient basis, using partial sedation or general anaesthesia for the egg retrieval process. In order to ensure that there will be several eggs that can be fertilized, the woman is usually given fertility medications to stimulate the ovaries. Gonadotropins, which are usually injected over a period of around 10 days, are the most common drugs used. When eggs approach maturity, a shot of human chorionic gonadotropin is usually administered. However, before ovulation occurs, a needle is used to “harvest” the eggs. The needle is introduced through the vagina and guided by ultrasound until it pierces the vaginal wall to reach the ovaries. The follicular fluid that is aspirated usually contains between ten and thirty eggs which are then further handled in the IVF laboratory.
After the eggs are fertilized with a semen sample in the lab, they are kept in a growth medium for two to five days. One or more of the embryos are then returned to the uterus via a catheter. No sedation is necessary for this part of the procedure. Now comes the most difficult time for most – the waiting. After approximately two weeks an ultrasound is performed to see whether one or more of the eggs has successfully implanted.
Though IVF is mainly used to circumvent blocked tubes, it is also often attempted with other fertility issues. Because the sperm does not have to travel long distances or survive an extended period of time inside the woman’s body, IVF can be a good option if poor sperm quality is an issue. Due to the fact that several eggs are harvested and fertilized at one time, it is also an option if egg quality is marginal and time is running out for the woman. Endometriosis and unexplained fertility are other indications that are often treated with IVF.
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