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IHR.com - IVF Costs, In Vitro Fertilization Costs, Invitro Fertilization Costs

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Discusses the cost of IVF as well as ways to reduce IVF costs by refund programs, IVF insurance, IVF financing, mini-IVF, etc.

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5 million babies have been born worldwide in the last 6 years. From 1978-1990 there were 90,000 births
2003: 113,000 cycles performed
2012: 12,436 Twin IVF Births
2013: 12,085 (twins), 411-376 (triplets)
2012: 62,000 babies (1.5% of the population)
In 2012 165,000 women used IVF. Overall chance for a baby is 1/3 (mostly depends on the age of a women

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IVF Treatments and Birth's per year summary- ADC

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IVF Treatments and Birth's per year summary- ADC

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Five steps in the IVF and embryo transfer process:
1. Fertility medications and blood tests are taken
2. Eggs are retrieved through a minor surgery
3. Male is asked to produce sperm
4. Process on insemination, sperm and eggs are mixed together and eggs are monitored to confirm fertilization and cell division. Once this occurs fertilized eggs are considered embryos.
5. Embryos are transferred into a woman's uterus 3-5 days following egg retrieval and fertilization. A small tube is inserted into the uterus to transfer embryos.

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Def- The process of fertilization by manually combining an egg an sperm in a laboratory dish and then transferring the embryo to the uterus.
U.S. live birth rate for each IVF cycle started:
women under 35; 41-43%
women 35-37; 33-36%
women 38-40; 23-27%
women 40 and older;13-8%

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The use of a new, high tech embryoscope is now being used in 15 clinics in the United States which has substantially changed the ways of IVF. Doctors constantly have to be checking on the fertilized embryos to make sure they are viable. The new embryos are extremely susceptible to damage or becoming non-viable in an instant, making this new scope very helpful. The embryoscope has the ability to take pictures of the embryo while it is still in the incubator dramatically changing the risks at which poses when doctors have to take the embryos out of its 37 C habitat

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A newly developed technology called the embryoscope is changing the playing field for fertility doctors across the country.

Traditionally, during in-vitro fertilization, doctors will check embryos once a day to determine whether or not they are viable. However, this process is tricky because it must be done in a quick and efficient manner - embryos must be kept at 37 degrees and in an environment with the proper concentration of gases in order to survive.

However, with the embryoscope, a picture can be taken of the embryos every few minutes without disturbing them in their incubators.

Dr. Nina Desai, of the Cleveland Clinic in Ohio, says having the embryoscope in her facility has been helpful.

"Embryos are extremely dynamic for a moment to moment, hour to hour, they will change," Desai said. "And those changes can reflect a lot about the competence of an embryo to implant on the uterine wall."

More than 100 patients at the Cleveland Clinic have been able to start families thanks to this high-tech tool and it is now being used at 14 other medical centers across the country.

"I think for patients it must be an incredible experience to be able to hold a baby in their arms and to then be able to go back and look at this video of their embryos from the very first minutes, first hours of the embryo growing before it even implanted in the uterus," Desai said.

The embryoscope has the power to potentially revolutionize in-vitro fertilization and research is currently being done to determine what role this technology is playing in increasing fertility rates.
Click for more information from the Cleveland Clinic.
Dr. Manny Alvarez serves as Fox News Channel's senior managing health editor. He also serves as chairman of the department of obstetrics/gynecology and reproductive science at Hackensack University Medical Center in New Jersey. For more information on Dr. Manny's work, visit AskDrManny.com.

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A newly developed technology called the embryoscope is changing the playing field for fertility doctors across the country. Traditionally, during in-vitro fertilization, doctors will check embryos once a day to determine whether or not they are viable.

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More couples than ever are turning to in vitro fertilization to help build families.

In 2012, more than 61,000 babies were conceived with the help of IVF, the Society for Assisted Reproductive Technology reported Monday.

That means IVF babies made up 1.5 percent of the 3.9 million births in the U.S, the agency wrote on its website. And it makes 2012 the biggest year for IVF on record: Doctors performed the most procedures and delivered the most IVF babies.

Over the past decade, the number of IVF treatments has been rising. Doctors performed about 113,000 cycles back in 2003. That number jumped by nearly 50 percent to about 165,000 in 2012.

"A lot of individuals - specifically women - are choosing to develop their careers, and they're having great opportunities, " says Charles Coddington III, an OB-GYN at the Mayo Clinic in Rochester and president of SART. "So a lot of them are getting older before they have children, and they are needing more IVF services."

At the same time, the number of high-risk multiple births from the treatment have been slowly declining, the report found.

"If we dig deeper into the data, there has been a marked reduction in triplets," Coddington tells Shots. "Everyone is really attuned to reducing triplets."

In 2003, women between the ages of 35 and 40 had about a 6 percent chance of having triplets during a successful IVF procedure. Now the odds have dropped to 0.7 percent.

The reason for the decline, Coddington says, is that couples and their doctors are choosing to use fewer embryos during each cycle. "It isn't across the board," Coddington says. "There are still outliers. But the trend is really good. So we've had a better year in terms of triplets."

The chance for twins is also less than it was a decade ago. But the rate is still high, especially for women younger than 40. About a quarter of all successful IVF cycles for women in this age group resulted in twins during 2012, the study reported.

The problem with twins and triplets, Coddington says, is that they raise the health risks for both moms and babies.

Twins are delivered about a month early, on average, he tells Shots. "So about a third of them are going to be in the neonatal nursery. Many will require close observation and have to be put on ventilation."

Mothers pregnant with twins and triplets have higher risks for diabetes, Cesarean sections and a form of hypertension called preeclampsia, Coddington says. "Pregnancy is the toughest elective stress that women will put on their body," he says. "We think it's a simple as, 'Boom! You're pregnant.' But there's a lot of things that can happen."

Between 1971 and 2011, the rate of multiple births doubled in the U.S., from 1.8 to 3.5 percent, a study published in December found. That spike has been almost entirely because of fertility treatments.

In the past, doctors often used three or more embryos during IVF to boost the chance of pregnancy, especially in older moms.

But two years ago, a study in England found that transferring more than two embryos didn't actually increase the odds for a successful live birth. And the average number of embyros transferred per cycle has been steadily declining in all age group groups over the past decade.

For instance, the average number of embryos used for women between the ages of 35 and 37 dropped from 2.9 in 2003 to 2.0 in 2012, the study found.

In fact, IVF is no long the the top culprit for high-risk multiple births. Instead, fertility drugs, such as Clomid, are, a study found.

But IVF does come with other risks. During the procedure, 1 to 5 percent of women suffer from a potentially serious complication, called ovarian hyperstimulation syndrome. IVF babies conceived by a special fertilization technique called ICSI have a small increase in risk for a few rare genetic disorders, including Beckwit-Widemann syndrome and Angelman syndrome.

In the U.S., each IVF cycle costs about $12,400, on average. The overall chance for a baby is about 1 in 3. But the odds depends largely on the age of the women. For those under age 35, success rates are more than 40 percent. Above age 42, chances fall to about 10 percent per cycle.

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IVF Baby Boom: Births From Fertility Procedures Hit New High

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More couples than ever are turning to in vitro fertilization to help build families. In 2012, more than 61,000 babies were conceived with the help of IVF, the Society for Assisted Reproductive Technology reported Monday. That means IVF babies made up 1.5 percent of the 3.9 million births in the U.S, the agency wrote on its website.

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In Vitro Births Continue to Rise in U.S.

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Researchers also report drop in number of multiple embryo transfers, twin and triplet birth rates

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From 1827 to now, IVF has made major medical advances and has improved the technology. By the 2000's IVF had become a mainstream medical procedure causing more than half a million births of "test tube" babies.

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IVF was initially introduced by Patrick Steptoe, and Robert Edwards in the 1970's. The first attempt was performed by an embryologist, Samuel Leopold Schenk, in 1878 on mammalian eggs. In 1976 Edwards and Steptoe began working with an infertile couple, Lesley and John Brown. In the successful attempt, they have transferred a fertilized egg at midnight, the time at which the egg was mature. On July 1978, Leslie gave birth to Louise Brown, the first "test tube baby".

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In Vitro Fertilization

In vitro fertilization (IVF) is an assisted reproductive technology (ART) initially introduced by Patrick Steptoe and Robert Edwards in the 1970s to treat female infertility caused by damaged or blocked fallopian tubes. This major breakthrough in embryo research has provided large numbers of women the possibility of becoming pregnant, and subsequent advances have dramatically increased their chances. IVF is a laboratory procedure in which sperm and egg are fertilized outside the body; the term "in vitro" is Latin for "in glass."

Although the procedure was not successfully established until the last quarter of the twentieth century, the history behind the development of IVF dates back much further. The first attempt at IVF on mammalian eggs was performed by Viennese embryologist Samuel Leopold Schenk in 1878. Working with rabbit and guinea pig ova, Schenk noted that cell division occurred in cultures after sperm were added to ova. In 1934 Gregory Pincus and Ernst Vinzenz Enzmann also attempted fertilization with rabbits. They claimed to have produced the first successful pregnancy using IVF, but later analysis of their study suggests that their fertilization technically occurred , or "in the body," rather than , "in glass." They implanted the eggs into the rabbit's uterus after only twelve hours, before the eggs had fully matured, and fertilization actually occurred inside the body.

The next milestone was in 1951, when two scientists working independently, Colin Russell Austin in Australia and Min Chueh Chang in the United Sates, demonstrated that spermatozoa need to mature through certain stages before they develop the capacity to fertilize. By 1959 Chang was able to successfully use IVF to impregnate a rabbit. Significant progress in developing a successful IVF technique with human embryos, however, would have to wait until the 1970s.

Patrick Steptoe, a practicing gynecologist at Oldam General Hospital who pioneered the use of laparoscopy in gynecology, teamed up with Edwards, a professor of human reproduction at Cambridge University, to try to achieve a successful pregnancy in humans using IVF. Their collaboration started in 1968 when Edwards attended a lecture Steptoe gave on laparoscopy at the Royal Society of Medicine in London. They initially achieved successful fertilization and cell division of eggs (in a petri dish) with freshly extracted semen, but were unable to successfully implant the fertilized egg into the female uterus until 1978. They manipulated hormone levels in the female until the eggs were fully mature and then extracted several eggs from the ovaries through laparoscopy, an invasive technique requiring entry through the navel. The doctors fertilized the eggs , and waited until the fertilized eggs divided into eight cells before implanting them into the female uterus (up until the mid-1970s, they had waited until the fertilized egg divided into 100 cells before implantation).

In 1976 Edwards and Steptoe began working with an infertile couple, Lesley and John Brown. In the successful attempt, Edward and Steptoe transferred a fertilized egg at midnight, the time at which the egg was mature-accidental timing that they later discovered was critical when they realized that diurnal cycles of hormonal levels are crucial to the success of the egg implanting in the wall of the uterus. On 25 July 1978, Leslie gave birth to Louise Brown, the first "test tube baby."

Since the birth of Louise Brown, over three million babies have been born as a result of IVF and other assisted reproductive technologies, and the technique has improved as well. Laparoscopy is no longer used to extract eggs from the ovaries. Instead, physicians use transvaginal oocyte retrieval; that is, with a sonogram to visualize what they are doing, they guide a needle through the vaginal wall, and enter the ovaries to extract the eggs. By using this method, the risks associated with the anesthesia required for laparoscopy as well as the costs of the procedure are considerably reduced.

Physicians now begin giving women hormone therapy two weeks prior to retrieving the eggs to increase the chance of recovering several healthy, mature eggs. Hormone therapies are usually administered through oral medications such as clomiphene citrate, also known as Clomid. Ultrasounds and blood tests are used to determine the optimal time for egg retrieval (when the eggs are almost ready for fertilization). Once physicians obtain the eggs, they then place them in a petri dish with sperm for fertilization. Usually about seven to nine eggs are fertilized. If a male fertility problem exists such as sperm immotility or a low sperm count, intracytoplasmic sperm injection (ICSI) is commonly used to combat the problem. With ICSI, the physician manually injects a sperm into an egg with a needle to fertilize it.

The number of fertilized eggs physicians place in the uterus in hopes that at least one will implant varies with the physician conducting the procedure. Physicians consider different factors with each couple, such as the number of trials the couple can afford to attempt. The remaining embryos are preserved through cryopreservation, frozen for future use in case the first few embryos fail to implant in the uterus wall on the initial attempt. Once the fertilized eggs each divide into eight cells, they are placed in a catheter and inserted through the cervix into the uterus (this usually occurs from two to three days after retrieving the eggs and follows the same timeline as if the eggs were fertilized naturally).

When Edwards and Steptoe successfully helped the Browns give birth to Louise, the first "test tube baby," many ethical debates arose. Many of these issues still surround embryo research today, and they include who essentially "owns" the embryos as well as whether scientists should be allowed to perform experiments for stem cell research with the extra cryopreserved embryos that are not implanted. Many religious groups, the Roman Catholic Church being the most prominent, are strongly against IVF because it is not considered natural conception.

IVF has greatly advanced embryo research as well as helped many infertile couples conceive when adoption was once their only option for children. Though there are other similar assisted reproductive technologies (ART) such as gamete intrafallopian transfer (GIFT) and zygote intrafallopian transfer (ZIFT), IVF is currently the most popular. The development of intracytoplasmic sperm injection (ICSI) has improved success rates.

Sources

1. Fishel, S., and E. Malcolm Symonds, eds. In Vitro Fertilisation: Past-Present-Future. Oxford: IRL Press, 1986.

2. "In Vitro Fertilization (IVF-ET)." Georgia Reproductive Specialists. http://www.ivf.com/ivffaq.html (Accessed August 4, 2008).

3. Marrs, Richard P., ed. Assisted Reproductive Technologies. Boston: Blackwell Scientific Publications, 1993.

4. Maienschein, Jane. Whose View of Life? Cambridge, MA: Harvard University Press, 2003.

5. Trounson, Alan, and Carl Wood. In Vitro Fertilization and Embryo Transfer. Edinburgh, UK: Churchill Livingstone, 1984.

Zhu, Tian, "In Vitro Fertilization". Embryo Project Encyclopedia (2009-07-22). ISSN: 1940-5030 http://embryo.asu.edu/handle/10776/1665.

Arizona State University. School of Life Sciences. Center for Biology and Society. Embryo Project Encyclopedia.

© Arizona Board of Regents Licensed as Creative Commons Attribution-NonCommercial-Share Alike 3.0 Unported (CC BY-NC-SA 3.0) http://creativecommons.org/licenses/by-nc-sa/3.0/

Fertilization in Vitro; Fertilization in vitro; Technology

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In Vitro Fertilization In vitro fertilization (IVF) is an assisted reproductive technology (ART) initially introduced by Patrick Steptoe and Robert Edwards in the 1970s to treat female infertility caused by damaged or blocked fallopian tubes. This major breakthrough in embryo research has provided large numbers of women the possibility of becoming pregnant, and subsequent advances have dramatically increased their chances.

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IVF is a procedure in which the egg from a woman's ovary is removed and fertilized by sperm in a laboratory procedure. Once they're done doing that the fertilized egg is implanted to the woman's uterus.

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In vitro fertilization (IVF) - Mayo Clinic

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In vitro fertilization (IVF) - Learn about the IVF process and what to expect from this assisted reproductive technology to treat infertility.

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In Vitro Fertilization (IVF): What is it?

In Vitro Fertilization is an assisted reproductive technology (ART) commonly referred to as IVF. IVF is the process of fertilization by extracting eggs, retrieving a sperm sample, and then manually combining an egg and sperm in a laboratory dish. The embryo(s) is then transferred to the uterus. Other forms of ART include gamete intrafallopian transfer (GIFT) and zygote intrafallopian transfer (ZIFT).

Why is IVF used?
IVF can be used to treat infertility in the following patients:
What is involved with in vitro fertilization?
There are five basic steps in the IVF and embryo transfer process:
Step 1: Fertility medications are prescribed to stimulate egg production. Multiple eggs are desired because some eggs will not develop or fertilize after retrieval. A transvaginal ultrasound is used to examine the ovaries, and blood test samples are taken to check hormone levels.

Step 2: Eggs are retrieved through a minor surgical procedure that uses ultrasound imaging to guide a hollow needle through the pelvic cavity to remove the eggs. Medication is provided to reduce and remove potential discomfort.

Step 3: The male is asked to produce a sample of sperm, which is prepared for combining with the eggs.

Step 4: In a process called insemination, the sperm and eggs are mixed together and stored in a laboratory dish to encourage fertilization. In some cases where there is a lower probability of fertilization, intracytoplasmic sperm injection (ICSI) may be used. Through this procedure, a single sperm is injected directly into the egg in an attempt to achieve fertilization. The eggs are monitored to confirm that fertilization and cell division are taking place. Once this occurs, the fertilized eggs are considered embryos.

Step 5: The embryos are usually transferred into the woman's uterus three to five days following egg retrieval and fertilization. A catheter or small tube is inserted into the uterus to transfer the embryos. This procedure is painless for most women, although some may experience mild cramping. If the procedure is successful, implantation typically occurs around six to ten days following egg retrieval.

Side effects of in vitro fertilization

Although you may need to take it easy after the procedure, most women can resume normal activities the following day.
Some side effects after IVF may include:

Passing a small amount of fluid (may be clear or blood-tinged) after the procedure

Mild cramping

Mild bloating

Constipation

Breast tenderness

If you experience any of the following symptoms, call your doctor immediately: Some side effects of fertility medications may include:

Headaches

Mood swings

Abdominal pain

Hot flashes

Abdominal bloating

RARE: Ovarian hyper-stimulation syndrome (OHSS)

What are the risks associated with in vitro fertilization?

As with most medical procedures, there are potential risks. More severe symptoms, typically from OHSS, include the following:

Decreased urinary frequency

Shortness of breath

Faintness

Severe stomach pains and bloating

Ten-pound weight gain within three to five days

If you experience any of these symptoms above, contact your doctor right away.
Additional risks of IVF include the following:

Egg retrieval carries risks of bleeding, infection, and damage to the bowel or bladder.

The chance of a multiples pregnancy is increased with the use of fertility treatment. There are additional risks and concerns related to multiples during pregnancy including the increased risk of premature delivery and low birth weight.

Though the rates of miscarriage are similar to unassisted conception, the risk does increase with maternal age.

The Mayo Clinic reports that the risk of ectopic pregnancy with IVF are 2-5%. An ectopic pregnancy is when a fertilized egg implants anywhere outside the uterus and is not viable.

Assisted reproductive technology (ART) involves a significant physical, financial, and emotional commitment on the part of a couple. Psychological stress and emotional problems are common, especially if in vitro fertilization (IVF) is unsuccessful.

IVF is expensive, and many insurance plans do not provide coverage for fertility treatment. The cost for a single IVF cycle can range from at least $12,000-$17,000.

How successful is in vitro fertilization?

The success rate of IVF clinics depends on a number of factors including reproductive history, maternal age, the cause of infertility, and lifestyle factors. It is also important to understand that pregnancy rates are not the same as live birth rates.
In the United States, the live birth rate for each IVF cycle started is approximately:
What if I don't produce healthy eggs or my husband is sterile?

You may choose to use donor eggs, sperm, or embryos. However, make sure to talk with a counselor experienced with donor issues. You will want to be informed about various legal issues related to gamete donation including the legal rights of the donor.

How many embryos should be created or transferred?

The number of embryos transferred typically depends on the number of eggs collected and maternal age. As the rate of implantation decreases as women age, more eggs may be implanted depending on age to increase the likelihood of implantation. However, a greater number of eggs transferred increases the chances of having a multiples pregnancy. Make sure to talk with your doctor before the procedure so you both agree on how many embryos to implant.

How do I choose an infertility clinic?

There are a number of questions to ask regarding the cost and details of specific centers and fertility programs. Some suggested questions are available online in Selecting Your ART Program.

Some couples want to explore more traditional or over the counter efforts before exploring infertility procedures. If you are trying to get pregnant and looking for resources to support your efforts, we invite you to check out the fertility product and resource guide provided by our corporate sponsor. Review resource guide here.

However, if you are looking for testing or options to increase your fertility chances of conception, you can find a fertility specialist with the search tool below:

For more information:
American Society of Reproductive Medicine
Compiled using information from the following sources:

1. American Society for Reproductive Medicine. (2014). Gamete and embryo donation: Deciding whether to tell.
https://www.asrm.org/FACTSHEET_Gamete_Donation_Deciding_Whether_To_Tell/
2. Human Fertilisation & Embryology Authority. (2014). IVF - What is in vitro fertilisation (IVF) and how does it work?
http://www.hfea.gov.uk/IVF.html
3. Human Fertilisation & Embryology Authority. (2014). Risks of fertility treatment.
http://www.hfea.gov.uk/fertility-treatment-risks.html
4. MedlinePlus. (2014). In vitro fertilization (IVF).
http://www.nlm.nih.gov/medlineplus/ency/article/007279.htm
5. Mayo Clinic. (2013, June 27). In vitro fertilization (IVF).
http://www.mayoclinic.org/tests-procedures/in-vitro-fertilization/basics/definition/prc-20018905
6. RESOLVE: The National Infertility Association. (n.d.) IVF/ART.
http://www.resolve.org/family-building-options/ivf-art/

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In Vitro Fertilization (IVF): Side Effects and Risks

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In Vitro Fertilization is an assisted reproductive technology (ART) commonly referred to as IVF. IVF is the process of fertilization by extracting eggs, retrieving a sperm sample, and then manually combining an egg and sperm in a laboratory dish. The embryo(s) is then transferred to the uterus.

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Average cost for a IVF cycle: $12,00+
Medications: $3,000+
Average cost using fresh embryos without medications: $8,158
Average cost of frozen embryo: $3,000 - 5,000
Covered by insurance in 15 states.
Discounted cycles and Multi cycle programs are offered.
Refund programs are available for a set fee.
Refund programs only provide a partially refund.

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When I found out that I was a carrier for the single-gene genetic disorder Tay-Sachs, a degenerative neurological condition that is fatal for children born with it, there was absolutely nothing to worry about...unless my husband was also a carrier.

The odds of that in my case, I had been told, were "one in a million," so I wasn't terribly concerned.

So my heart skipped a beat when I saw I had a missed call on my cell phone from my reproductive endocrinologist two weeks after my husband had finally gotten tested.

"You can imagine my surprise," she began, "when Matt's test results came across my desk this morning ... and he's a Tay-Sachs carrier."

That's when I found out I would be one of more than 85,000 women in the U.S. annually who undergo in-vitro fertilization, or IVF, as a way to create a family. Utilizing IVF and pre-implantation genetic diagnosis or PGD, the team of doctors and embryologists at our infertility practice would be able to create embryos, and then biopsy those embryos to ensure that only those not affected by Tay-Sachs were among those selected to create a pregnancy.

As I began researching IVF, I also dove into the financial details of the treatment.

Unraveling the seemingly foreign language of clinical terminology and insurance verbiage can be a heavy added stress on a patient struggling with infertility; I offer the below as an introduction to anyone also beginning this process. Here are four things I learned in our journey thus far.

1. How Much IVF Actually Costs

My husband and I were back at our reproductive endocrinologist's office a week after that first phone call, to learn more about the process ... and its costs.

On average, nationally, a "fresh" IVF cycle costs $12,000, before medications, which typically run another $3,000 to $5,000. In a "fresh" IVF cycle, eggs are harvested transvaginally after a closely monitored period of ovulation-inducing medications and then "mixed" with fresh sperm. One or two of the best-looking of the resulting embryos are then transferred to the uterus via a thin catheter.

The PGD step of the process meant we were looking at another $3,000 to $6,000. Altogether, conservatively speaking, about $20,000 ... for each attempt to have a healthy child utilizing a procedure that is successful (most optimistically) about 40% of the time, depending upon factors such as maternal age and the specific medical circumstances of the parents.

One of the most complex aspects of an infertility diagnosis is that for a patient to have her best chances for conception with IVF, she needs to act as quickly (to ensure that her eggs are as young and thus as viable as possible) as she can upon diagnosis. This biological urgency doesn't exactly complement the equally pragmatic need to invest in the time to budget and save for treatment.

RELATED: What It's Really Like Financially to Have Your First Child

For some individuals undergoing IVF, if a fresh cycle doesn't result in a pregnancy, and the remaining embryos from this fresh cycle can subsequently be used during a "frozen" cycle. "Frozen" cycles, often abbreviated as FET or Frozen Embryo Transfer, are much more economical, as they use "frozen" (technically, vitrified) embryos stored for future use. FET averages anywhere from $3,000 to $5,000 per cycle and annual storage fees for frozen embryos are typically an additional few hundred for each year.

Many practices offer "refund" and "discounted multi-cycle" programs. Practices with these kinds of programs offer various plans that provide patients with multiple IVF cycles for a single, discounted fee that costs about 30% to 40% less than the same exact treatment plan if you were to pay for it on a cycle-by-cycle basis.

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The Cost of IVF: 4 Things I Learned While Battling Infertility

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When I found out that I was a carrier for the single-gene genetic disorder Tay-Sachs, a degenerative neurological condition that is fatal for children born with it, there was absolutely nothing to worry about...unless my husband was also a carrier.

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In-Vitro Fertilization has been a very controversial topic since the 1980's. Moral, ethical and religious issues have become relevant due mostly to the Roman Catholic Church. The Catholic Church argued against IVF in 1987 particularly for the belief that the unused embryos from a planned implantation were to be disposed of. They also had contempt against possibly that the male donor to the embryo could not be the husband in the relationship. Besides the Catholic Church, many people protest IVF, now particularly the freezing of embryos, and chose to believe that it is wrong even though lives are being made due to infertility.

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Table of Contents

Read a brief summary of this topic

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in vitro fertilization (IVF), also called test-tube conception, medical procedure in which mature egg cells are removed from a woman, fertilized with male sperm outside the body, and inserted into the uterus of the same or another woman for normal gestation. Although IVF with reimplantation of fertilized eggs (ova) has long been widely used in animal breeding, the first successful birth of a human child from IVF, carried out by British gynecologist Patrick Steptoe and British medical researcher Robert Edwards, did not take place until 1978.

Evaluation and technique

In vitro fertilization is generally undertaken only after an exhaustive evaluation of infertility has been made. A number of the candidates for IVF are women who suffer from blocked or absent fallopian tubes; others are couples in which the male partner has a low sperm count or couples whose infertility is unexplained. The IVF procedure includes the recovery (by needle aspiration) of mature eggs and the incubation of the eggs in a culture medium, as well as the collection and preparation of sperm and its addition to the medium. In certain cases (e.g., low sperm count) intracytoplasmic sperm injection (ICSI) may be necessary. In this technique deoxyribonucleic acid ( DNA) from sperm is injected via a needle into an egg. Fertilization generally occurs within 12 to 48 hours. The potential embryo is then placed in a growth medium, where it is observed periodically for division into two-cell, four-cell, and eight-cell stages. During this period the mother receives progesterone to prepare her uterine lining for implantation of the embryo. The embryo, which at this point is known as a blastocyst, is introduced through the cervix into the uterus, in which the blastocyst seems to float free for about three-and-a-half days. If the procedure is successful, the embryo implants itself in the uterine wall, and pregnancy begins.

Failure of IVF is typically the result of unsuccessful implantation or miscarriage. Possible explanations for failed implantation are immune rejection by the woman; an embryo with an abnormally thick outer membrane (zona pellucida) that prevents embryo hatching once inside the uterine cavity; lack of synchronization between embryonic stage and endometrial development at the time of embryo introduction into the uterus; and embryonic aneuploidy (abnormal chromosome number). Aneuploidy is a central cause of miscarriage in IVF.

In women who have had repeated IVF failures or who are over 38 years old, the success of IVF may be improved by preimplantation genetic diagnosis (PGD). PGD is used to detect the presence of embryonic genetic abnormalities that have a high likelihood of causing implantation failure or miscarriage. In PGD a single cell is extracted from the embryo once the embryo has divided to produce more than five cells (this step-the extraction of a cell-is an inherent risk of PGD because it sometimes damages the embryo). The cell is then analyzed by fluorescence in situ hybridization (FISH), a technique capable of detecting structural abnormalities in chromosomes that standard tests such as karyotyping cannot detect. In some cases DNA is isolated from the cell and analyzed by polymerase chain reaction (PCR) for the detection of gene mutations that can give rise to certain disorders such as Tay-Sachs disease or cystic fibrosis. Another technique, known as comparative genomic hybridization (CGH), may be used in conjunction with PGD to identify chromosomal abnormalities. CGH is more sensitive than FISH and is capable of detecting a variety of small chromosomal rearrangements, deletions, and duplications. It may also be useful in reducing the chance of multiple births (multiple embryos implanted and carried to term simultaneously) by identifying a single healthy embryo with the best chance for successful implantation. The success of IVF can also be improved through assisted hatching, a technique used to thin the outer membrane of an embryo in order to facilitate implantation.

Ethical issues

In vitro fertilization has been a source of moral, ethical, and religious controversy since its development. Although members of all religious groups can be found on both sides of the issues, the major opposition has come from the Roman Catholic church, which in 1987 issued a doctrinal statement opposing IVF on three grounds: the destruction of human embryos not used for implantation; the possibility of in vitro fertilization by a donor other than the husband, thus removing reproduction from the marital context; and the severing of an essential connection between the conjugal act and procreation.

Other ethical questions raised have involved the unusually high rate of multiple births ( twins, triplets, etc.) associated with IVF. This issue is being addressed primarily through the development of better techniques aimed at using fewer fertilized embryos to achieve pregnancy. For example, in the 1980s and 1990s an average of four fertilized embryos were transferred into a woman's uterus to increase the chance of implantation and pregnancy. However, in the early 2000s, following the implementation of improved methods, just two embryos were transferred, while the same rate of success as with four embryos was maintained. The technique of single embryo transfer (SET) is available, though less than 10 percent of women opt for SET because it has a lower rate of success relative to multiple embryo transfer-in many cases at least two cycles of SET are necessary for success. Furthermore, many women are unable to afford additional cycles of IVF using SET and therefore are more likely to choose multiple embryo transfer, even though a multiple birth may be less desirous than a single birth. Thus, the incidence of twins has continued to rise, especially in the United States, where the rate of twin births has increased 70 percent since the 1980s.

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IVF has also raised a number of unresolved moral issues concerning the freezing ( cryopreservation) of ovaries, eggs, sperm, or embryos for future pregnancies.

Kara Rogers.

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in vitro fertilization | medical technology

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in vitro fertilization (IVF), also called test-tube conception, medical procedure in which mature egg cells are removed from a woman, fertilized with male sperm outside the body, and inserted into the uterus of the same or another woman for normal gestation.