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In vitro fertilization (IVF) is a process by which egg cells are fertilised by sperm outside the womb, in vitro. IVF is a major treatment in infertility when other methods of assisted reproductive technology have failed. The process involves hormonally controlling the ovulatory process, removing ova (eggs) from the woman's ovaries and letting sperm fertilise them in a fluid medium. The fertilised egg (zygote) is then transferred to the patient's uterus with the intent to establish a successful pregnancy.
IVF may be used to overcome female infertility in the woman due to problems of the fallopian tube, making fertilisation in vivo difficult. It may also assist in male infertility, where there is defect sperm quality, and in such cases intracytoplasmic sperm injection ( ICSI) may be used, where a sperm cell is injected directly into the egg cell. This is used when sperm have difficulty penetrating the egg, and in these cases the partner's or a donor's sperm may be used. ICSI is also used when sperm numbers are very low. ICSI results in success rates equal to those of IVF fertilisation.
For IVF to be successful it may be easier to say that it requires healthy ova, sperm that can fertilise, and a uterus that can maintain a pregnancy. Due to the costs of the procedure, IVF is generally attempted only after less expensive options have failed.
This also avails for egg donation or surrogacy where the woman providing the egg isn't the same who will carry the pregnancy to term. This means that IVF can be used for females who have already gone through menopause. The donated oocyte can be fertilised in a crucible. If the fertilisation is successful, the zygote will be transferred into the uterus, within which it will develop into an embryo.
IVF can also be combined with preimplantation genetic diagnosis (PGD) to rule out presence of genetic disorders. A similar but more general test has been developed called Preimplantation Genetic Haplotyping (PGH).
Infertility primarily refers to the biological inability of a person to contribute to conception. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term. There are many biological causes of infertility, some which may be bypassed with medical intervention
Women who are fertile experience a natural period of fertility before and during ovulation, and they are naturally infertile during the rest of the menstrual cycle. Fertility awareness methods are used to discern when these changes occur by tracking changes in cervical mucus or basal body temperature.
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In order to perform IVF, only 3 things are required - eggs, sperm and a uterus, and before starting the IVF cycle, the doctor will check these.
First, a sperm survival test is carried out This is a "trial" sperm wash, using exactly the same method as will be actually used in IVF, to assess whether an adequate number of sperm can be recovered in order to do IVF. This test will also help the laboratory to decide which method of sperm processing should be used during IVF.
A blood FSH level will provide an idea of the "ovarian reserve", and provide information on whether or not the woman will produce enough eggs after superovulation. For older women, some clinics do a clomiphene citrate challenge test. If the FSH level is very high, this suggests early ovarian failure, and it may be a better idea to consider donor eggs.
To gain a better understanding of the procedure, though, you may want to read our more detailed descriptions of each stage of the IVF procedure, including retrieval, embryo culture, and transfering of the embryo. Our Timetable & Embryo Grading guide will help you understand just how your embryo develops before it is transfered back to you. Embryo Development will give you a detailed look at how a fertilized egg divides before being trasnfered.
It is important to note that there are two types of transfers that can occur in an IVF procedure: the standard 3-day transfer or a blastocyst transfer. Both types of transfer have advantages and disadvantages, as outlined in 3 Day Transfer vs. Blastocyst Transfers.
While your embryos are still in the lab, there are a number of techniques that IVF specialists can perform to improve the health your embryos. One such technique is assisted hatching, which may improve your embryos ability to implant in your uterus. Some couples also ask that their embryos receive a preimplantation genetic diagnosis before being transfered. This diagnositic test allows specialists to transfer only those embryos which are healthiest.
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