In vitro fertilization (IVF): MedlinePlus Medical Encyclopedia (2022)

In vitro fertilization (IVF) is the joining of a woman's egg and a man's sperm in a laboratory dish. In vitro means outside the body. Fertilization means the sperm has attached to and entered the egg.

Normally, an egg and sperm are fertilized inside a woman's body. If the fertilized egg attaches to the lining of the womb and continues to grow, a baby is born about 9 months later. This process is called natural or unassisted conception.

IVF is a form of assisted reproductive technology (ART). This means special medical techniques are used to help a woman become pregnant. It is most often tried when other, less expensive fertility techniques have failed.

There are five basic steps to IVF:

Step 1: Stimulation, also called super ovulation

  • Medicines, called fertility drugs, are given to the woman to boost egg production.
  • Normally, a woman produces one egg per month. Fertility drugs tell the ovaries to produce several eggs.
  • During this step, the woman will have regular transvaginal ultrasounds to examine the ovaries and blood tests to check hormone levels.

Step 2: Egg retrieval

  • A minor surgery, called follicular aspiration, is done to remove the eggs from the woman's body.
  • The surgery is done in the doctor's office most of the time. The woman will be given medicines so she does not feel pain during the procedure. Using ultrasound images as a guide, the health care provider inserts a thin needle through the vagina into the ovary and sacs (follicles) containing the eggs. The needle is connected to a suction device, which pulls the eggs and fluid out of each follicle, one at a time.
  • The procedure is repeated for the other ovary. There may be some cramping after the procedure, but it will go away within a day.
  • In rare cases, a pelvic laparoscopy may be needed to remove the eggs. 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. The mixing of the sperm and egg is called insemination.
  • Eggs and sperm are then stored in an environmentally controlled chamber. The sperm most often enters (fertilizes) an egg a few hours after insemination.
  • If the doctor thinks the chance of fertilization is low, the sperm may be directly injected into the egg. This is called intracytoplasmic sperm injection (ICSI).
  • Many fertility programs routinely do ICSI on some of the eggs, even if things appear normal.

In vitro fertilization (IVF): MedlinePlus Medical Encyclopedia (1)Watch this video about:Intracytoplasmic sperm injection

(Video) 시험관 아기, 체외수정(IVF-ET, In Vitro Fertilization-Embryo Transfer) 적응증과 금기

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, a normal embryo has several cells that are actively dividing.
  • Couples who have a high risk of passing a genetic (hereditary) disorder to a child may consider pre-implantation genetic diagnosis (PGD). The procedure is most often done 3 to 5 days after fertilization. Laboratory scientists remove a single cell or cells 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. This 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 to 5 days after egg retrieval and fertilization.
  • The procedure is done 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:

  • Advanced age of the woman (advanced maternal age)
  • Damaged or blocked Fallopian tubes (can be caused by pelvic inflammatory disease or prior reproductive surgery)
  • Endometriosis
  • Male factor infertility, including decreased sperm count and blockage
  • Unexplained infertility

IVF involves large amounts of physical and emotional energy, time, and money. Many couples dealing with infertility suffer stress and depression.

A woman taking fertility medicines may have bloating, abdominal pain, mood swings, headaches, and other side effects. Repeated IVF injections can cause bruising.

In rare cases, fertility drugs may cause ovarian hyperstimulation syndrome (OHSS). This condition causes a buildup of fluid in the abdomen and chest. Symptoms include abdominal pain, bloating, rapid weight gain (10 pounds or 4.5 kilograms within 3 to 5 days), decreased urination despite drinking plenty of fluids, nausea, vomiting, and shortness of breath. Mild cases can be treated with bed rest. More severe cases require draining of the fluid with a needle and possibly hospitalization.

(Video) How egg 🥚 choose sperms||fertilization of baby in women body||abdominal system||science class..

Medical studies have shown so far that fertility drugs are not linked to ovarian cancer.

Risks of egg retrieval include reactions to anesthesia, bleeding, infection, and damage to structures surrounding the ovaries, such as bowel and bladder.

There is a risk of multiple pregnancies when more than one embryo is placed into the womb. Carrying more than one baby at a time increases the risk for premature birth and low birth weight. (However, even a single baby born after IVF is at higher risk for prematurity and low birth weight.)

It is unclear whether IVF increases the risk for birth defects.

IVF is very costly. Some, but not all, states have laws that say health insurance companies must offer some type of coverage. But, many insurance plans do not cover infertility treatment. Fees for a single IVF cycle include costs for medicines, surgery, anesthesia, ultrasounds, blood tests, processing the eggs and sperm, embryo storage, and embryo transfer. The exact total of a single IVF cycle varies, but may cost more than $12,000to $17,000.

After embryo transfer, the woman may be told to rest for the remainder of the day. Complete bed rest is not necessary, unless there is an increased risk for OHSS. Most women return to normal activities the next day.

Women who undergo IVF must take daily shots or pills of the hormone progesterone for 8 to 10 weeks after the embryo transfer. Progesterone is a hormone produced naturally by the ovaries that prepares the lining of the uterus (womb) so that an embryo can attach. Progesterone also helps an implanted embryo grow and become established in the uterus. A woman may continue to take progesterone for 8 to 12 weeks after becoming pregnant. Too little progesterone during the early weeks of pregnancy may lead to miscarriage.

About 12 to 14 days after the embryo transfer, the woman will return to the clinic so that a pregnancy test can be done.

Call your provider right away if you had IVF and have:

(Video) Ovarian Hyperstimulation Syndrome (OHSS)

  • A fever over 100.5°F (38°C)
  • Pelvic pain
  • Heavy bleeding from the vagina
  • Blood in the urine

Statistics vary from one clinic to another and must be looked at carefully. However, patient populations are different in each clinic, so reported pregnancy rates cannot be used as an accurate indication of one clinic being preferable to another.

  • Pregnancy rates reflect the number of women who became pregnant after IVF. But not all pregnancies result in a live birth.
  • Live birth rates reflect the number of women who give birth to a living child.

Outlook of live birth rates depend on certain factors such as mother age, prior live birth, and single embryo transfer during IVF.

According to the Society of Assisted Reproductive Technologies (SART), the approximate chance of giving birth to a live baby after IVF is as follows:

  • 47.8%for women under age 35
  • 38.4% for women age 35 to 37
  • 26% for women ages 38 to 40
  • 13.5% for women age 41 to 42

IVF; Assisted reproductive technology; ART; Test-tube baby procedure; Infertility - in vitro

Catherino WH. Reproductive endocrinology and infertility. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 223.

Choi J, Lobo RA. In vitro fertilization. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 43.

(Video) Šta je hiperstimulacijski sindrom OHSS i prekomjerna stimulacija jajnika?

Practice Committee of the American Society for Reproductive Medicine; Practice Committee of the Society for Assisted Reproductive Technology. Guidance on the limits to the number of embryos to transfer: a committee opinion. Fertil Steril. 2017;107(4):901-903. PMID: 28292618 pubmed.ncbi.nlm.nih.gov/28292618/.

Tsen LC. In vitro fertilization and other assisted reproductive technology. In: Chestnut DH, Wong CA, Tsen LC, et al, eds. Chestnut's Obstetrics Anesthesia. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 15.

Updated by: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Assisted Reproductive TechnologyRead more

NIH MedlinePlus MagazineRead more

FAQs

In vitro fertilization (IVF): MedlinePlus Medical Encyclopedia? ›

In vitro fertilization (IVF) is the joining of a woman's egg and a man's sperm in a laboratory dish. In vitro means outside the body. Fertilization means the sperm has attached to and entered the egg.

What are the 3 types of IVF? ›

The three main approaches to IVF that involve no or fewer drugs are natural cycle IVF, mild stimulation IVF and in vitro maturation (IVM).

What are the 5 steps in in vitro fertilization? ›

IVF involves several steps — ovarian stimulation, egg retrieval, sperm retrieval, fertilization and embryo transfer.

What is a person who does IVF called? ›

A reproductive endocrinologist is a gynecologist who has additional training in infertility and fertility treatment; they treat both male and female fertility issues. 2. Reproductive endocrinologists manage, carry out, and prescribe a variety of fertility tests and treatments, including IUI and IVF.

What is the importance of IVF? ›

The ultimate advantage of IVF is achieving a successful pregnancy and a healthy baby. IVF can make this a reality for people who would be unable to have a baby otherwise: Blocked tubes: For women with blocked or damaged fallopian tubes, IVF provides the best opportunity of having a child using their own eggs.

Why is IVF high risk? ›

IVF increases the likelihood of twins, triplets or high-order multiples, with accompanying risk for premature birth, high blood pressure, placenta abnormalities and other challenges. Advanced maternal age (often the reason for IVF) increases risk for miscarriage and birth defects.

How much does IVF cost? ›

According to the N.C.S.L., the average I.V.F. cycle can cost anywhere from $12,000 to $17,000 (not including medication). With medication, the cost can rise to closer to $25,000. Clinics define an I.V.F.

How many eggs are required for IVF? ›

Ovarian stimulation is used to mature multiple eggs for egg retrieval. Even if ovulation is normal, fertility drugs are used to produce more than a single egg because pregnancy rates are higher with more eggs. An average of 10 – 20 eggs are usually retrieved for IVF.

How painful is vitro fertilization? ›

It is similar to a vaginal ultrasound appointment or even a pap smear. In this procedure, one or more embryos are transferred to the uterus using ultrasound guidance and an embryo transfer catheter. You will be able to see the entire procedure take place on an ultrasound screen. This process is not painful.

How many times can you do IVF in a year? ›

The research suggests most couples will need approximately 6 embryo transfers before they achieve a pregnancy! There are no limits to the number of IVF cycles you can have. This decision is entirely up to you and the fertility specialists.

Can you choose gender with IVF? ›

Intended Parents can determine gender through PGD/PGS/PGT-A during an IVF journey. Given a fertility doctor's ability to identify XX or XY chromosomes in the embryo with PGD tests, the gender selection process is almost 100% accurate.

What are the disadvantages of IVF? ›

Disadvantages of IVF

There are side effects form the drugs used, such as hot flushes and severe headaches. There is a possibility of multiple births, which is dangerous for mother and babies. Ovarian hyper-stimulation syndrome (OHS), when too many eggs develop in the ovaries.

What happens to your body after failed IVF? ›

It's important to grieve after a failed IVF. The emotional impact is as overwhelming as the loss of a pregnancy, even if the IVF didn't result in an embryo. You'll experience a profound sadness and depression. It's completely normal, however you will need to speak with your doctor.

Can IVF cause problems? ›

In vitro fertilization (IVF) may significantly increase the risk of birth defects, particularly those of the eyes, heart, reproductive organs and urinary system, according to a UCLA study.

Do IVF babies look like their parents? ›

The Genetics of a Donor Egg

That being said, it's important for couples to understand that nothing is definitive — giving birth to a child naturally doesn't ensure they look like you and using a donor egg doesn't automatically mean your child won't resemble you at all.

What is the success rate of IVF? ›

The latest report, from 2018, shows that 50% of IVF procedures in women ages 35 and under resulted in a live birth. For women ages 42 and older, 3.9% of the egg transfers resulted in a birth.

How old is the oldest IVF baby? ›

It's hard to believe, especially for those who were around when it happened, but the world's first IVF baby – Britain's Louise Brown – just turned 41 years-old!

Do IVF babies look different? ›

Most differences in DNA binding compounds found at birth in children conceived by IVF not seen in early childhood. NIH study results bolster previous studies finding no growth, development differences with IVF.

Are IVF babies normal? ›

IVF is a different way of conception from normal sexual intercourse. But the IVF children are as normal as other children concerning their mental and physical attributes. But people often ask this question if an IVF baby is as normal as other children. A study was conducted in India among ten babies born through IVF.

Will IVF be covered by insurance in 2022? ›

As of June 2022, 20 states have passed fertility insurance coverage laws, 14 of those laws include IVF coverage, and 12 states have fertility preservation laws for iatrogenic (medically-induced) infertility.

Is IVF covered by insurance? ›

No, it does not cover the cost of treating infertility. Any type of sterilisation or contraception, assisted reproduction services, artificial insemination and advanced reproductive treatments such as IUI, IVF, GIFT, ICSI, reversal of sterilisation and gestational surrogacy, etc. are not covered.

Can you pay for IVF to have twins? ›

Yes, a couple can ask for twins, but the clinic will counsel on the risks. The main risk with IVF is pre-term births. Pre-term births account for 60% of twin deliveries and bring a host of complications for the babies.

How long does IVF take to get pregnant? ›

How long does it take to get pregnant with IVF? One cycle of IVF takes about two months. Women younger than age 35 will get pregnant and have a baby with their first IVF egg retrieval and subsequent embryo transfer(s) about half the time.

What are signs of poor egg quality? ›

There aren't many obvious symptoms of low egg reserve, so our fertility experts ask you about:
  • Absent or late periods.
  • Shorter-than-average menstrual cycles.
  • Irregular periods with a heavy or light flow.
  • History of miscarriage.

How long is the IVF process? ›

As you can see, each IVF cycle takes about 28-40 days (or even longer), or about the length of a normal ovulation cycle. Unfortunately, there are no guarantees when it comes to IVF, some people may need to undergo a number of cycles before being successful.

Is IVF hard on your body? ›

Fertility treatments will test your marriage. As I mentioned, IVF is stressful. It's hard on your body, but even more so, it's a mentally and emotionally draining process.

What's the most painful part of IVF? ›

The most potentially painful part of undergoing IVF is the procedure to implant the fertilized eggs back into the uterus. Done a few days after egg retrieval, this feels like a smear test; not pleasant by any means, but nothing to be scared of.

Is IVF 100 percent successful? ›

The most important fact to know about IVF is it's not 100 percent successful—the process can take time, money, and even an emotional toll on your life. "There's a significant emotional drain on the couple and the relationship," says Dr.

What causes failed IVF? ›

IVF can fail due to embryos that have chromosomal abnormalities. This means that the embryo has a missing, extra, or irregular portion of chromosomal DNA. The body then rejects the embryo and this results in IVF failure.

How do you know if IVF failed? ›

The only reliable diagnostic test to establish the success or failure of assisted reproduction treatment is the pregnancy test. It can be done either in urine or through a blood test to determine the level of β-hCG hormone (“beta”).

How many tries does it take for IVF to work? ›

“For most couples – and certainly those where the woman is younger than 40 and those of any age using donor eggs – two-thirds will achieve a live birth after five or six treatment cycles. This will take, on average, two years and is similar to rates that couples conceiving naturally take in one year.”

Can IVF prevent Down syndrome? ›

Drugs used in IVF for older women may increase their risk of having a baby with Down's syndrome, experts say. Doctors already know that the chance of having a baby with the genetic condition goes up with the age of the mother, especially for those over 35.

Can you bleed during IVF treatment? ›

Implantation spotting is one possible cause of spotting during an IVF cycle. This refers to the two-week period after embryo transfer. During this time, the embryo is in the process of attaching itself to the lining of the uterine wall. Some of the lining may shed, causing spotting to occur.

How many rounds of IVF is normal? ›

The Greatest Percentage of IVF Success Occurs in Six Cycles

From that comprehensive analysis, which included results from both fresh and frozen embryo transfers, researchers found that the average live birth rate for couples participating in six IVF cycles was 65.3%.

How can I make my first IVF successful? ›

How to Increase Your Chances of IVF Success
  1. Maintain a healthy weight. ...
  2. Optimize sperm health. ...
  3. Partner with an excellent doctor and embryology laboratory. ...
  4. Reduce your stress. ...
  5. Quit smoking. ...
  6. Look into taking supplements. ...
  7. Ensure you have adequate levels of vitamin D. ...
  8. Focus on persistence and patience.
Aug 16, 2022

Can I get pregnant naturally after failed IVF? ›

While uncommon, natural conception after IVF can occur. One study found that out of 2,134 couples who attempted ART, about 20% became pregnant on their own after treatment. Many couples that present for fertility care are subfertile, not infertile.

Can IVF babies have autism? ›

Results Of the more than 2.5 million infants born, 30 959 (1.2%) were conceived by IVF and were followed up for a mean 10 (SD, 6) years. Overall, 103 of 6959 children (1.5%) with autistic disorder and 180 of 15 830 (1.1%) with mental retardation were conceived by IVF.

Can IVF damage your ovaries? ›

Ovarian hyperstimulation syndrome (OHSS), is a possible complication of in vitro fertilization (IVF). In this condition, the ovaries swell and fluid leaks into the body. This condition is more common in women with polycystic ovarian syndrome who are going through fertility treatments.

How can I clean my body after IVF? ›

Drink plenty of fluids – aim for 1 litre (35fl oz) of filtered water daily and also include a variety of herbal teas. Each day of the detox starts with a glass of hot water with a little lemon or lime juice added. This combination is very alkalizing and supports liver cleansing.

Can in vitro babies reproduce? ›

Currently, the first IVF-conceived people are now more than 30 years old, and some of them have conceived children.

Can I use my sister's eggs for IVF? ›

Relatives Have the Same Genes

If you're considering asking a sister to be an egg donor, she will provide the same assortment of genes as you because you have the same parents. This way, you can be sure that your child will share some of the same characteristics that are prominent in your family.

Does a fertilized egg have a soul? ›

From the Christian view, a soul comes into being at the moment of conception. A single fertilized egg cell, if it divides into two cells, can be said to have had a soul. So do the cells that form after. Soul-ness is thus innate to the process of growth, the sustenance of life.

What are the 5 stages of IVF? ›

The process consists of five steps:
  • Step 1: Medication. The woman is given injection hormones to stimulate healthy egg development. ...
  • Step 2: Harvest the eggs. ...
  • Step 3: Fertilization. ...
  • Step 4: Embryo culture. ...
  • Step 5: Embryo transfer. ...
  • Delivering the good news.

Is 42 too old for IVF? ›

Women over the age of 50 are generally not considered candidates for IVF. However, women of any age with access to viable eggs or embryos (her own or from a donor) and a receptive uterus (her own or with a gestational surrogate) is capable of achieving motherhood through IVF.

How many injections do you need for IVF treatment? ›

Medications for IVF treatment are often administered subcutaneously (straight into the fat immediately beneath the skin) or intramuscularly (directly into the muscle). Depending on the individual therapy and cycle, a patient might receive 1–2 injections daily, approximately 90 injections each cycle for 9 to 14 days.

What is the difference between ICSI and IVF? ›

What are IVF and ICSI? IVF and ICSI are forms of assisted reproductive treatment (ART) in which eggs are fertilised with sperm outside the body. IVF is used for female infertility and unexplained infertility, and ICSI is used when there is a male cause of infertility.

What is natural and mild IVF? ›

Mild or Modified Natural Cycle IVF is conducted during a woman's natural menstrual cycle, with a later addition of fertility medication to help stimulate her ovaries into producing a number of eggs ready for collection. This treatment is sometimes also referred to as Mini IVF.

What are the disadvantages of IVF? ›

Disadvantages of IVF

There are side effects form the drugs used, such as hot flushes and severe headaches. There is a possibility of multiple births, which is dangerous for mother and babies. Ovarian hyper-stimulation syndrome (OHS), when too many eggs develop in the ovaries.

Is IVF hard on the body? ›

Fertility treatments will test your marriage. As I mentioned, IVF is stressful. It's hard on your body, but even more so, it's a mentally and emotionally draining process.

Is IVF painful process? ›

It is similar to a vaginal ultrasound appointment or even a pap smear. In this procedure, one or more embryos are transferred to the uterus using ultrasound guidance and an embryo transfer catheter. You will be able to see the entire procedure take place on an ultrasound screen. This process is not painful.

How long does IVF take to get pregnant? ›

How long does it take to get pregnant with IVF? One cycle of IVF takes about two months. Women younger than age 35 will get pregnant and have a baby with their first IVF egg retrieval and subsequent embryo transfer(s) about half the time.

Can you mix sperm for IVF? ›

A single sperm is used to fertilize a single egg. The question that often comes up is, can both guys from a gay male couple mix their sperm together? The simple answer is no. The IVF lab will not mix the sperm together.

How do they take sperm for IVF? ›

Testicular sperm aspiration (TESA)

TESA is a procedure performed for men who are having sperm retrieved for IVF/ICSI. It is done with local anesthesia in the operating room or office and is coordinated with their female partner's egg retrieval. A needle is inserted in the testicle and tissue/sperm are aspirated.

How many sperm are needed for IVF? ›

In theory, one sperm is all that is needed to fertilise an egg and achieve a successful pregnancy using ICSI technique. For most (moderate) oligozoospermic patients, sperm are retrieved successfully from their ejaculated samples collected on the day of egg retrieval.

Videos

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2. B+ IVF - aplikacija Menopur
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3. Patient Education Video: Intrauterine Device (IUD)
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4. Pap and HPV Testing | Nucleus Health
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5. Dangers of Diabetes, High Blood Pressure and Obesity
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6. In-vitro-Fertilisation (IVF) – Chancen, Risiken, Ablauf
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