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The use of assistive reproductive technologies is more than just a question of medical treatment and conception. There are also ethical and moral dilemmas that can be a part of this process, which can include, but are not limited to:
As with any medical treatment or procedure, there are potential risks and complications. This is true for in vitro fertilization, which has its own special risks that can include:
When a woman, or couple, and the Fertility Specialist determine that in vitro fertilization is the treatment of choice, there are several steps that must be taken to promote the greatest chance of success.
The primary steps in in vitro fertilization include:
1. Counseling - you will discuss the IVF process, risks and benefits, and outcome goals. Treatment consents will be signed, which may include consents for IVF and embryo transfer, micro-insemination, cryopreservation of resultant embryos and psychological treatment/evaluation.
2. Semen analysis - semen samples will be analyzed for: volume and consistently, sperm count, motility, structure and survivability
3. Testing - including ultrasound and hormone levels to establish baseline uterine and hormonal status, for the syncing of your IVF cycle
4. Fertility drugs - hormones will be provided to the woman, to stimulate egg production, including superovulation, where the ovaries produce more than one egg during a cycle. A greater number of eggs increases the chances for a successful IVF. Drugs will be added at different times during the IVF cycle, to prepare the uterus for implantation, promote egg and follicle development, and aid in egg retrieval or harvesting.
5. Egg Retrieval - eat or drink nothing 8 hours prior to your retrieval. Ultrasound is used to guide the needle as it enters the ovary for harvest, through the vaginal wall.
6. Fertilization - concentrated sperm is introduced to your eggs, in a petri dish or test tube
7. Transfer - with the use of a speculum, the procedure is similar to a Pap smear. An ultrasound guides placement of the embryos inside the uteris.
The steps related to IVF are fairly consistent, regardless of the Fertility Clinic that you use, due to the sequential nature of the human body in terms of fertility. Following the guidelines and instructions of your Fertility Specialist, will help to promote positive outcomes following IVF.
The process of In Vitro Fertilization was initially brought to fame by the creation of the world's first "test tube baby" - a breakthrough in assistive reproductive technology, also called ART, that has helped many people achieve pregnancy and childbirth, when other fertility treatment options proved ineffective.
The IVF was first pioneered by Embryologist, Dr. Edwards, and Gynecologist, Dr. Steptoe, in England in 1978, to help couples who were unable to have children, by natural conception, due to fertility problems that could not be overcome with traditional treatments.
The term "in vitro" means, "outside the living body," and was initially referred to as in vitro fertilization - pre-embryonic transfer, or IVF-ET, to refer to the stage of cell development at the time of the implantation into the woman's uterus.
There are many causes of infertility, including hormonal problems, structural or mechanical issues and medical conditions. There are also many different treatments available, to address the specific causes of infertility, such as hormone treatments or surgical correction of structural anomalies.
In vitro fertilization - IVF - is one type of infertility treatment, however it is not a first line treatment. Your Fertility Specialist will try other less invasive and less expensive options before choosing IVF, since many causes of infertility can be overcome with other treatment options.
IVF is best used for those situations in which a woman is trying to conceive and intrauterine insemination is not possible or effective, or in which donation of eggs or sperm is necessary to complete the process due to either male or female fertility problems within a couple.
Since IVF is not the first line treatment for infertility, there are other available options. Some of these options include:
In vitro fertilization is dependent on several factors, including:
In order for in vitro fertilization to be successful, assistance must be provided in the form of fertility drugs. These drugs are designed to stimulate and emulate hormones which normally regulate reproductive activities, to control the reproductive cycle and promote success with IVF. The primary drugs used in IVF include
- Gonadotropin (go-nad-oh-trow-pin) Releasing Hormone (GnRH) AgonistsAntagonistsGonadotropinshCGSolu-MedrolDoxycyclineProgesterone
- Progesterone is taken daily beginning two days after egg retrieval to support the embryo in the uterus until the placenta is able to make enough progesterone. This takes about 2 months.
- Doxycycline is given to the male partner during the woman's stimulation cycle to reduce bacteria that may be present in the sperm.
- Medrol is a steroid hormone given daily, for up to four days, to assist pre-embryo implantation in the uterine wall, following embryo transfer.
- Pregnyl, Profasi or Novarel is taken to help maturate the eggs and prepare them for retrieval. Gonal F, Bravelle, Follistim, Pergonal and Repronex are the most commonly used gonadotropins and they stimulate the egg follicle to ripen during inadequate follicular development.
|Jennifer Mathes, Ph.D.|