What is In Vitro Fertilization (IVF)

In vitro fertilization is a series of procedures that are used to help with getting pregnant (conceiving). It can be used to help treat problems with fertility or genetics.

IVF is a type of assisted reproductive technology (ART). ART refers to all treatments and procedures that combine eggs and sperm outside of the body to try to help a couple conceive.

During IVF, eggs are retrieved from the ovaries and combined with sperm in a lab to fertilize the eggs. One or more of the fertilized eggs (embryos) are inserted into the uterus through the cervix. Candidates for IVF include:

• People who are infertile. Infertility is when you are unable to conceive after a year of having sex regularly without using birth control. Infertility can also mean that a woman is not able to carry a pregnancy to full term.
• Women who have undergone early (premature) menopause or ovarian failure.
• Women who had both ovaries removed. In this case, donor eggs must be used.
• Women who have damaged or blocked fallopian tubes.

There is no age limit for having IVF, but it is not recommended for women who have gone through menopause (postmenopausal women). The ideal age for IVF is age 35 or younger. Women age 41 or older are often counseled to consider using donor eggs during IVF to increase the chances of success.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Previous pregnancies you have had.
• Any history of drug use, smoking, or excessive alcohol use.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to other structures or organs.
• Blood clots.
• The procedure not working.
• Having twins or multiples.
• Increased risk of early delivery.

What happens before the procedure?

Before beginning a cycle of IVF, you and the sperm donor may need various tests (screenings) to make sure that IVF is right for you. You and the donor:

• Must provide a complete medical history and the medical history of your families.
• Will have a physical exam.
• May need blood tests to check for infectious diseases, including HIV (human immunodeficiency virus).

You may have other tests, such as:

• Testing of your ovaries to determine the quality and quantity of your eggs.
• Hormone tests and ovulation testing.
• An exam of your uterus. This may be done with:
  • Sonohysterogram. This exam uses sound waves sent to a computer to make real-time images of the inside of your uterus. To get the best images, a germ-free salt-water solution (sterile saline) is injected into your uterus through your vagina.
  • Hysteroscopy. In this procedure, a thin, flexible tube with a tiny light and camera on the end of it (hysteroscope) is inserted through your vagina and into your uterus.

The donor sperm will be taken and analyzed to check whether:

• The sperm are normal.
• There are enough sperm to fertilize the egg.
• The sperm act normally after sexual intercourse (postcoital exam).

What happens during the procedure?

IVF involves several procedures. One cycle of IVF can take about 2 weeks, and more than one cycle may be required. The steps of IVF are:

• Ovarian stimulation.
  • If you use your own eggs during IVF, you will begin treatment with artificial (synthetic) hormones at the start of a cycle. This treatment stimulates your ovaries to produce multiple eggs, rather than the single egg that normally develops each month.
  • Multiple eggs are needed because some eggs will not fertilize or will not develop normally after fertilization.
• Egg retrieval.
  • Using ultrasound images as a guide, a thin needle will be inserted through your vagina and into the ovary and sacs (follicles) that contain the eggs.
  • The needle is connected to a suction device, which will pull the eggs and fluid out of each follicle, one at a time.
  • The procedure will be repeated for the other ovary.
• Insemination and fertilization.
  • The sperm will be mixed together with your eggs (insemination) and stored in an environmentally controlled chamber.
  • The sperm usually enters (fertilizes) an egg a few hours after insemination.
• Embryo transfer. This usually takes place 2–6 days after the egg retrieval.
  • The fertilized eggs (embryos) will be placed into your uterus using a thin tube (catheter). The catheter will be inserted into your vagina, through your cervix, and into your uterus.
  • If successful, the embryo will stick to the lining of your uterus (implant) about 6–10 days after egg retrieval. If an embryo implants in the lining of the uterus and grows, pregnancy will result.

These procedures may vary among health care providers and hospitals.

What happens after the procedure?

• You may need to lie down and rest for a short time.
• You may continue to take hormone therapy. You may take hormone therapy for up to 3 months, as instructed by your health care provider.

Summary

• In vitro fertilization (IVF) is a series of procedures that are used to help with getting pregnant (conceiving).
• Before beginning a cycle of IVF, you and the sperm donor may need various tests (screenings) to make sure that IVF is right for you.
• IVF involves several procedures. One cycle of IVF can take about 2 weeks, and more than one cycle may be required.

In Vitro Fertilization, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After your procedures, it is common to have:

• Cramping.
• Light vaginal bleeding or spotting.
• Vaginal discharge.

Follow these instructions at home:

• Continue to take hormone therapy as instructed by your health care provider. You may need to continue taking hormone therapy for 3 months.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you become pregnant, begin routine pre-birth (prenatal) care. If you have a high-risk pregnancy, you may need to have more tests or more visits to your health care provider.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you. Avoid sexual intercourse for 5–10 days after embryo transfer, or as long as directed.
• Do not smoke.
• Do not use alcohol.
• Keep all of your follow-up visits as told by your health care provider. If you become pregnant, this includes prenatal visits. This is important.

Contact a health care provider if:

• You develop new or unusual vaginal discharge.
• You have nausea or vomiting for more than 2 days.
• You develop a rash.
• You become light-headed or feel faint.
• You have pain that gets worse.

Get help right away if:

• You have:
  • Vaginal bleeding.
  • Difficulty breathing.
  • Swelling in your abdomen.
  • Moderate to severe pain in your abdomen.
  • A fever that lasts for more than 3 days.
  • Symptoms that last for more than 3 days.
  • A fever, and your symptoms suddenly get worse.
• You are urinating less than usual.
• You gain more than 3 lb (1.4 kg) in 2 days.
• You faint.