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In 1977 Lesley Brown got the IVF experimental procedure and in July 25 1978 the first IVF baby or test tube baby was born

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On this day in 1978, Louise Joy Brown, the world's first baby to be conceived via in vitro fertilization (IVF) is born at Oldham and District General Hospital in Manchester, England, to parents Lesley and Peter Brown. The healthy baby was delivered shortly before midnight by caesarean section and weighed in at five pounds, 12 ounces.

Before giving birth to Louise, Lesley Brown had suffered years of infertility due to blocked fallopian tubes. In November 1977, she underwent the then-experimental IVF procedure. A mature egg was removed from one of her ovaries and combined in a laboratory dish with her husband's sperm to form an embryo. The embryo then was implanted into her uterus a few days later. Her IVF doctors, British gynecologist Patrick Steptoe and scientist Robert Edwards, had begun their pioneering collaboration a decade earlier. Once the media learned of the pregnancy, the Browns faced intense public scrutiny. Louise's birth made headlines around the world and raised various legal and ethical questions.

The Browns had a second daughter, Natalie, several years later, also through IVF. In May 1999, Natalie became the first IVF baby to give birth to a child of her own. The child's conception was natural, easing some concerns that female IVF babies would be unable to get pregnant naturally. In December 2006, Louise Brown, the original "test tube baby," gave birth to a boy, Cameron John Mullinder, who also was conceived naturally.

Today, IVF is considered a mainstream medical treatment for infertility. Hundreds of thousands of children around the world have been conceived through the procedure, in some cases with donor eggs and sperm.

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World's First Test Tube Baby Born - Jul 25, 1978 - HISTORY.com

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On this day in 1978, Louise Joy Brown, the world's first baby to be conceived via in vitro fertilization (IVF) is born at Oldham and District General Hospital in Manchester, England, to parents Lesley and Peter Brown. The healthy baby was delivered shortly before midnight by caesarean section and weighed in at five pounds, 12 ounces.

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- people are using IVF to pre-determine the sex of their baby
- people have speculations about it because back in the 70's babies were being born unhealthy

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Almost since its beginning in the 1970s, in vitro fertilization (IVF) has been surrounded by controversy. However, many concerns faded away as more children were born healthy with the help of IVF.

But a new controversy has arisen since model and television host Chrissy Teigen announced that she and her husband, singer John Legend, used IVF to choose the sex of their child.

"Not only am I having a girl," Teigen told People, "but I picked the girl from her little embryo. I picked her and was like, 'Let's put in the girl.'"
Read More: The Basics of In Vitro Fertilization "
How Sex Selection Works

Selecting the sex of a baby is not as difficult as it might seem, especially with recent advances in IVF.

During IVF, several eggs are removed from a woman's body. Then, in a laboratory, the eggs are fertilized with sperm to create embryos that can be implanted into a woman's uterus.

Before the eggs are implanted, a doctor can remove a single cell from the embryo to look at its chromosomes. This is known as preimplantation genetic diagnosis (PGD).

PGD is used to check the embryo for serious or fatal genetic disorders and can also reveal the embryo's sex.

This makes it possible for potential parents to say "boy" or "girl" before an embryo is implanted.
Read More: More Cycles Equals More Success in IVF "
Selection Still Rarely Used

The United States has no restrictions on IVF for sex selection. However, some countries have banned its use except when there is a risk of a sex-linked genetic disorder.

In spite of its availability, the use of sex selection is limited. This might be due to its high price tag - IVF with PGD costs between $15,000 and $25,000 per cycle.

"The number of patients, and particularly the number of offspring that are born following IVF and PGD for nonmedical sex selection, without any other indication, is very, very low," Judith Daar, J.D., a professor of law at Whittier Law School, told Healthline.

Exactly how low is not clear. Clinics are not required to report the reasons couples use IVF.

Then a 2008 study from Johns Hopkins University provided a glimpse of how common IVF with PGD is. Forty-two percent of clinics offering these procedures reported providing sex selection for nonmedical reasons.

An earlier survey found that only 8 percent of people who responded said they would use IVF or another technology to choose the sex of the embryo for nonmedical reasons.

IVF sex selection is not free of ethical or moral questions. The American Society for Reproductive Medicine (ASRM) outlined many of these concerns in a 2015 report.

"We thought it was important for clinics to have available the arguments that surround the technology," said Daar, who is a member of the committee, "but we leave it up to the individual providers to make a decision about their practice."
Read More: Lower Birth Rate for Frozen Eggs, Study Says "
Medical Concerns Arise

There is nearly 100 percent accuracy of IVF sex selection, yet this procedure still carries the same risks to women and children as IVF used for medical reasons.

When women choose to have IVF for medical reasons - such as infertility - doctors balance the risks with the benefits of the procedure.

If choosing the sex of the child is the only reason for undergoing IVF, women still need to understand the risks.

Some people are also concerned that nonmedical use of IVF for sex selection may tie up medical resources and prevent couples with infertility from getting the help they need.

This may not be an issue in the United States where IVF sex selection is not that common. However, it could cause problems in countries with more limited resources and a high demand for sex selection.
Read More: U.K. Scientists Given OK to Use Gene Editing on Human Embryos "
Social Concerns Arise

Others see nonmedical IVF sex selection as discriminating against one sex or the other.

To avoid discrimination, some clinics limit the use of nonmedical IVF to parents who already have at least one child. In a Johns Hopkins study, 41 percent of clinics took this approach.

Extensive use of IVF sex selection to choose one sex could also throw off the natural balance between males and females in society.

This effect may be unlikely in the United States. A 2004 survey found that most people who responded did not have a strong preference for having a boy or a girl. Fifty percent wanted a family with an equal number of boys and girls while 27 percent had no preference.

A broader concern over IVF sex selection is that it may open the way for parents to select embryos based on other traits - what the ASRM ethics committee called a slippery slope.

Without laws or guidelines governing this technology in the United States, the question of how it is used and how many problems it creates lies in the hands of the clinics.

"Clinics are in a position to make individualized decisions about the provisions of this type of technology," said Daar.

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should parents be able to choose a baby’s gender

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Almost since its beginning in the 1970s, in vitro fertilization (IVF) has been surrounded by controversy. However, many concerns faded away as more children were born healthy with the help of IVF. But a new controversy has arisen since model and television host Chrissy Teigen announced that she and her husband, singer John Legend, used IVF to choose the sex of their child.

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in areas with few infertility clinics, the price is usually higher.

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1855 Chief Doctor J.Marion Sims injects a males sperm into a female uterus, but the result of the experiment ends in miscarriage

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Purpose for In-Vitro Fertilization (IFV)

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Purpose for In-Vitro Fertilization (IFV)

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As mentioned in my other posts, men and women both have problems related to fertilization or reproduction in general.  In the event of not being able to reproduce naturally, couples resort to IFV so that they can have a child of their own that they can love even though they aren't fertile or able to reproduce.

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a fresh embryo IVF cycle costs on average $8,158 without medications and not including the other process for the male

Medications cost an additional $1,300

Other expenses include the ICSI or the sperm injection which costs $1,544

The PGD or preimplantation genetic process costs $3,550

The total is around $14,000

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IVF stands for In-Vitro Fertilization. This is a process taken when a woman cannot conceive. The process consists of fertilizing the egg. Fertilization is done manually: by combing egg and sperm. After such process is completed it is then inserted into the woman's uterus for the next steps to take place.

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Today, in vitro fertilization (IVF) is practically a household word. But not so long ago, it was a mysterious procedure for infertility that produced what were then known as "test-tube babies." Louise Brown, born in England in 1978, was the first such baby to be conceived outside her mother's womb.

Unlike the simpler process of artificial insemination -- in which sperm is placed in the uterus and conception happens otherwise normally -- IVF involves combining eggs and sperm outside the body in a laboratory. Once an embryo or embryos form, they are then placed in the uterus. IVF is a complex and expensive procedure; only about 5% of couples with infertility seek it out. However, since its introduction in the U.S. in 1981, IVF and other similar techniques have resulted in more than 200,000 babies.

What Causes of Infertility Can IVF Treat?

When it comes to infertility, IVF may be an option if you or your partner have been diagnosed with:

Endometriosis

Low sperm counts

Problems with the uterus or fallopian tubes

Problems with ovulation

Antibody problems that harm sperm or eggs

The inability of sperm to penetrate or survive in the cervical mucus

Poor egg quality

Genetic disease of mother or father

An unexplained fertility problem

IVF is never the first step in the treatment of infertility except in cases of complete tubal blockage. Instead, it's reserved for cases in which other methods such as fertility drugs, surgery, and artificial insemination haven't worked.

If you think that IVF might make sense for you, carefully assess any treatment center before undergoing the procedure. Here are some questions to ask the staff at the fertility clinic:

What is your pregnancy ratio per embryo transfer?

What is your pregnancy rate for couples in our age group and with our fertility problem?

What is the live birth rate for all couples who undergo this procedure each year at your facility?

How many of those deliveries are twins or other multiple births?

How much will the procedure cost, including the cost of the hormone treatments?

How much does it cost to store embryos and how long can we store them?

Do you participate in an egg donation program?

Continued

What Can I Expect From IVF?

The first step in IVF involves injecting hormones so you produce multiple eggs each month instead of only one.You will then be tested to determine whether you're ready for egg retrieval.

Prior to the retrieval procedure, you will be given injections of a medication that ripens the developing eggs and starts the process of ovulation. Timing is important; the eggs must be retrieved just before they emerge from the follicles in the ovaries. If the eggs are taken out too early or too late, they won't develop normally. Your doctor may do blood tests or an ultrasound to be sure the eggs are at the right stage of development before retrieving them. The IVF facility will provide you with special instructions to follow the night before and the day of the procedure. Most women are given pain medication and the choice of being mildly sedated or going under full anesthesia.

During the procedure, your doctor will locate follicles in the ovary with ultrasound and remove the eggs with a hollow needle. The procedure usually takes less than 30 minutes, but may take up to an hour.

Immediately following the retrieval, your eggs will be mixed in the laboratory with your partner's sperm, which he will have donated on the same day.

While you and your partner go home, the fertilized eggs are kept in the clinic under observation to ensure optimal growth. Depending on the clinic, you may even wait up to five days until the embryo reaches a more advanced blastocyst stage.

Once the embryos are ready, you will return to the IVF facility so doctors can transfer one or more into your uterus. This procedure is quicker and easier than the retrieval of the egg. The doctor will insert a flexible tube called a catheter through your vagina and cervix and into your uterus, where the embryos will be deposited. To increase the chances of pregnancy, most IVF experts recommend transferring up to three embryos at a time. However, this means you could have a multiple pregnancy, which can increase the health risks for both you and the babies.

Continued

Following the procedure, you would typically stay in bed for several hours and be discharged four to six hours later. Your doctor will probably perform a pregnancy test on you about two weeks after the embryo transfer.

In cases where the man's sperm count is extremely low or there is poor motility (movement of the sperm), doctors may combine IVF with a procedure called intracytoplasmic sperm injection. In this procedure, a sperm is taken from semen -- or in some cases right from the testicles -- and inserted directly into the egg. Once a viable embryo is produced, it is transferred to the uterus using the usual IVF procedure.

What Are the Success Rates for IVF?

Success rates for IVF depend on a number of factors, including the reason for infertility, where you're having the procedure done, and your age. The CDC compiles national statistics for all assisted reproductive technology (ART) procedures performed in the U.S., including IVF, GIFT, and ZIFT, although IVF is by far the most common; it accounts for 99% of the procedures. The most recent report from 2016 found:

Pregnancy was achieved in an average of 27.3% of all cycles (higher or lower depending on the age of the woman).

The percentage of cycles that resulted in live births was 22.2% on average (higher or lower depending on the age of the woman).

Are There Other Issues With IVF to Consider?

Any embryos that you do not use in your first IVF attempt can be frozen for later use. This will save you money if you undergo IVF a second or third time. If you do not want your leftover embryos, you may donate them to another infertile couple, or you and your partner can ask the clinic to destroy the embryos. Both you and your partner must agree before the clinic will destroy or donate your embryos.

A woman's age is a major factor in the success of IVF for any couple. For instance, a woman who is under age 35 and undergoes IVF has a 39.6% chance of having a baby, while a woman over age 40 has an 11.5% chance. However, the CDC recently found that the success rate is increasing in every age group as the techniques are refined and doctors become more experienced.

Continued

What Are The Costs of IVF?

The average cost of an IVF cycle in the U.S. is $12,400, according to the American Society of Reproductive Medicine. This price will vary depending on where you live, the amount of medications you're required to take, the number of IVF cycles you undergo, and the amount your insurance company will pay toward the procedure. You should thoroughly investigate your insurance company's coverage of IVF and ask for a written statement of your benefits. Although some states have enacted laws requiring insurance companies to cover at least some of the costs of infertility treatment, many states haven't.

Also be aware that some carriers will pay for infertility drugs and monitoring, but not for the cost of IVF or other artificial reproductive technology. Resolve: The National Infertility Association publishes a booklet called the "Infertility Insurance Advisor," which provides tips on reviewing your insurance benefits contract.

Sources

SOURCES: American Society for Reproductive Medicine web site. American College of Obstetricians and Gynecologists web site.
Human Reproduction Update , July-August 2002.
The Infertility Workup and Understanding Treatment Options , RESOLVE online.
The Merck Manual , Seventeenth Edition, 2000.
The Fertility Handbook: A Guide to Getting Pregnant , Addicus Books, 2002. CDC: "2016 Assisted Reproductive Technology Success Rates National Summary Report." " Assisted Reproductive Technology Success Rates 2009."

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Today, in vitro fertilization (IVF) is practically a household word. But not so long ago, it was a mysterious procedure for infertility that produced what were then known as "test-tube babies." Louise Brown, born in England in 1978, was the first such baby to be conceived outside her mother's womb.

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Reasons why Men require In-Vitro Fertilization (IFV)

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Reasons why Men require In-Vitro Fertilization (IFV)

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Men:
-Impaired sperm production or function
-Unexplained infertility
-Genetic disorder
-fertility preservation for cancer or other health conditions

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In 1827 scientists first discovered that women contained eggs. Scientists later learn that the eggs need sperm to be fertilized in 1843.

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Reasons why Women require In-Vitro Fertilization (IFV)

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Reasons why Women require In-Vitro Fertilization (IFV)

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Women:
-Fallopian tube damage or blockage
-Ovulation disorders
-Pre-mature ovarian failure
-Endometriosis
-Uterine fibroids
-Previous tubal sterilization or removal.

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Overview

In vitro fertilization (IVF) is a complex series of procedures used to help with fertility or prevent genetic problems and assist with the conception of a child.

During IVF, mature eggs are collected (retrieved) from ovaries and fertilized by sperm in a lab. Then the fertilized egg (embryo) or eggs (embryos) are transferred to a uterus. One full cycle of IVF takes about three weeks. Sometimes these steps are split into different parts and the process can take longer.

IVF is the most effective form of assisted reproductive technology. The procedure can be done using a couple's own eggs and sperm. Or IVF may involve eggs, sperm or embryos from a known or anonymous donor. In some cases, a gestational carrier - someone who has an embryo implanted in the uterus - might be used.

Your chances of having a healthy baby using IVF depend on many factors, such as your age and the cause of infertility. In addition, IVF can be time-consuming, expensive and invasive. If more than one embryo is transferred to the uterus, IVF can result in a pregnancy with more than one fetus (multiple pregnancy).

Your doctor can help you understand how IVF works, the potential risks and whether this method of treating infertility is right for you.

Why it's done

In vitro fertilization (IVF) is a treatment for infertility or genetic problems. If IVF is performed to treat infertility, you and your partner might be able to try less-invasive treatment options before attempting IVF, including fertility drugs to increase production of eggs or intrauterine insemination - a procedure in which sperm are placed directly in the uterus near the time of ovulation.

Sometimes, IVF is offered as a primary treatment for infertility in women over age 40. IVF can also be done if you have certain health conditions. For example, IVF may be an option if you or your partner has:

Fallopian tube damage or blockage. Fallopian tube damage or blockage makes it difficult for an egg to be fertilized or for an embryo to travel to the uterus.

Ovulation disorders. If ovulation is infrequent or absent, fewer eggs are available for fertilization.

Endometriosis. Endometriosis occurs when tissue similar to the lining of the uterus implants and grows outside of the uterus - often affecting the function of the ovaries, uterus and fallopian tubes.

Uterine fibroids. Fibroids are benign tumors in the uterus. They are common in women in their 30s and 40s. Fibroids can interfere with implantation of the fertilized egg.

Previous tubal sterilization or removal. Tubal ligation is a type of sterilization in which the fallopian tubes are cut or blocked to permanently prevent pregnancy. If you wish to conceive after tubal ligation, IVF may be an alternative to tubal ligation reversal surgery.

Impaired sperm production or function. Below-average sperm concentration, weak movement of sperm (poor mobility), or abnormalities in sperm size and shape can make it difficult for sperm to fertilize an egg. If semen abnormalities are found, a visit to an infertility specialist might be needed to see if there are correctable problems or underlying health concerns.

Unexplained infertility. Unexplained infertility means no cause of infertility has been found despite evaluation for common causes.

A genetic disorder. If you or your partner is at risk of passing on a genetic disorder to your child, you may be candidates for preimplantation genetic testing - a procedure that involves IVF. After the eggs are harvested and fertilized, they're screened for certain genetic problems, although not all genetic problems can be found. Embryos that don't contain identified problems can be transferred to the uterus.

Fertility preservation for cancer or other health conditions. If you're about to start cancer treatment - such as radiation or chemotherapy - that could harm your fertility, IVF for fertility preservation may be an option. Women can have eggs harvested from their ovaries and frozen in an unfertilized state for later use. Or the eggs can be fertilized and frozen as embryos for future use.

Women who don't have a functional uterus or for whom pregnancy poses a serious health risk might choose IVF using another person to carry the pregnancy (gestational carrier). In this case, the woman's eggs are fertilized with sperm, but the resulting embryos are placed in the gestational carrier's uterus.

Risks

Risks of IVF include:

Multiple births. IVF increases the risk of multiple births if more than one embryo is transferred to your uterus. A pregnancy with multiple fetuses carries a higher risk of early labor and low birth weight than pregnancy with a single fetus does.

Premature delivery and low birth weight. Research suggests that IVF slightly increases the risk that the baby will be born early or with a low birth weight.

Ovarian hyperstimulation syndrome. Use of injectable fertility drugs, such as human chorionic gonadotropin (HCG), to induce ovulation can cause ovarian hyperstimulation syndrome, in which your ovaries become swollen and painful.

Symptoms typically last a week and include mild abdominal pain, bloating, nausea, vomiting and diarrhea. If you become pregnant, however, your symptoms might last several weeks. Rarely, it's possible to develop a more severe form of ovarian hyperstimulation syndrome that can also cause rapid weight gain and shortness of breath.

Miscarriage. The rate of miscarriage for women who conceive using IVF with fresh embryos is similar to that of women who conceive naturally - about 15% to 25% - but the rate increases with maternal age.

Egg-retrieval procedure complications. Use of an aspirating needle to collect eggs could possibly cause bleeding, infection or damage to the bowel, bladder or a blood vessel. Risks are also associated with sedation and general anesthesia, if used.

Ectopic pregnancy. About 2% to 5% of women who use IVF will have an ectopic pregnancy - when the fertilized egg implants outside the uterus, usually in a fallopian tube. The fertilized egg can't survive outside the uterus, and there's no way to continue the pregnancy.

Birth defects. The age of the mother is the primary risk factor in the development of birth defects, no matter how the child is conceived. More research is needed to determine whether babies conceived using IVF might be at increased risk of certain birth defects.

Cancer. Although some early studies suggested there may be a link between certain medications used to stimulate egg growth and the development of a specific type of ovarian tumor, more-recent studies do not support these findings. There does not appear to be a significantly increased risk of breast, endometrial, cervical or ovarian cancer after IVF.

Stress. Use of IVF can be financially, physically and emotionally draining. Support from counselors, family and friends can help you and your partner through the ups and downs of infertility treatment.

How you prepare

The Centers for Disease Control and Prevention and the Society for Assisted Reproductive Technology provide information online about U.S. clinics' individual pregnancy and live birth rates.

A clinic's success rate depends on many factors. These include patients' ages and medical issues, as well as the clinic's treatment population and treatment approaches. Ask for detailed information about the costs associated with each step of the procedure.

Before beginning a cycle of IVF using your own eggs and sperm, you and your partner will likely need various screenings, including:

Ovarian reserve testing. To determine the quantity and quality of your eggs, your doctor might test the concentration of follicle-stimulating hormone (FSH), estradiol (estrogen) and anti-mullerian hormone in your blood during the first few days of your menstrual cycle. Test results, often used together with an ultrasound of your ovaries, can help predict how your ovaries will respond to fertility medication.

Semen analysis. If not done as part of your initial fertility evaluation, your doctor will conduct a semen analysis shortly before the start of an IVF treatment cycle.

Infectious disease screening. You and your partner will both be screened for infectious diseases, including HIV.

Practice (mock) embryo transfer. Your doctor might conduct a mock embryo transfer to determine the depth of your uterine cavity and the technique most likely to successfully place the embryos into your uterus.

Uterine exam. Your doctor will examine the inside lining of the uterus before you start IVF. This might involve a sonohysterography - in which fluid is injected through the cervix into your uterus - and an ultrasound to create images of your uterine cavity. Or it might include a hysteroscopy - in which a thin, flexible, lighted telescope (hysteroscope) is inserted through your vagina and cervix into your uterus.

Before beginning a cycle of IVF, consider important questions, including:

How many embryos will be transferred? The number of embryos transferred is typically based on age and number of eggs retrieved. Since the rate of implantation is lower for older women, more embryos are usually transferred - except for women using donor eggs or genetically tested embryos.

Most doctors follow specific guidelines to prevent a higher order multiple pregnancy, such as triplets or more. In some countries, legislation limits the number of embryos that can be transferred. Make sure you and your doctor agree on the number of embryos that will be transferred before the transfer procedure.

What will you do with any extra embryos? Extra embryos can be frozen and stored for future use for several years. Not all embryos will survive the freezing and thawing process, although most will.

Having frozen embryos can make future cycles of IVF less expensive and less invasive. Or, you might be able to donate unused frozen embryos to another couple or a research facility. You might also choose to discard unused embryos.

How will you handle a multiple pregnancy? If more than one embryo is transferred to your uterus, IVF can result in a multiple pregnancy - which poses health risks for you and your babies. In some cases, fetal reduction can be used to help a woman deliver fewer babies with lower health risks. Pursuing fetal reduction, however, is a major decision with ethical, emotional and psychological consequences.

Have you considered the potential complications associated with using donor eggs, sperm or embryos, or a gestational carrier? A trained counselor with expertise in donor issues can help you understand the concerns, such as the legal rights of the donor. You may also need an attorney to file court papers to help you become legal parents of an implanted embryo.

What you can expect

IVF involves several steps - ovarian stimulation, egg retrieval, sperm retrieval, fertilization and embryo transfer. One cycle of IVF can take about two to three weeks. More than one cycle may be needed.

Ovulation induction

The start of an IVF cycle begins by using synthetic hormones to stimulate the ovaries to produce multiple eggs - rather than the single egg that typically develops each month. Multiple eggs are needed because some eggs won't fertilize or develop normally after fertilization.

Several different medications may be used, such as:

Medications for ovarian stimulation. To stimulate your ovaries, you might receive an injectable medication containing a follicle-stimulating hormone (FSH), a luteinizing hormone (LH) or a combination of both. These medications stimulate more than one egg to develop at a time.

Medications for oocyte maturation. When the follicles are ready for egg retrieval - generally after eight to 14 days - you will take human chorionic gonadotropin (HCG) or other medications to help the eggs mature.

Medications to prevent premature ovulation. These medications prevent your body from releasing the developing eggs too soon.

Medications to prepare the lining of your uterus. On the day of egg retrieval or at the time of embryo transfer, your doctor might recommend that you begin taking progesterone supplements to make the lining of your uterus more receptive to implantation.

Your doctor will work with you to determine which medications to use and when to use them.

Typically, you'll need one to two weeks of ovarian stimulation before your eggs are ready for retrieval. To determine when the eggs are ready for collection, you may have:

Vaginal ultrasound, an imaging exam of your ovaries to monitor the development of follicles - fluid-filled ovarian sacs where eggs mature

Blood tests, to measure your response to ovarian stimulation medications - estrogen levels typically increase as follicles develop, and progesterone levels remain low until after ovulation

Sometimes IVF cycles need to be canceled before egg retrieval for one of these reasons:

Inadequate number of follicles developing

Premature ovulation

Too many follicles developing, creating a risk of ovarian hyperstimulation syndrome

Other medical issues

If your cycle is canceled, your doctor might recommend changing medications or their doses to promote a better response during future IVF cycles. Or you may be advised that you need an egg donor.

Egg retrieval

Egg retrieval can be done in your doctor's office or a clinic 34 to 36 hours after the final injection and before ovulation.

During egg retrieval, you'll be sedated and given pain medication.

Transvaginal ultrasound aspiration is the usual retrieval method. An ultrasound probe is inserted into your vagina to identify follicles. Then a thin needle is inserted into an ultrasound guide to go through the vagina and into the follicles to retrieve the eggs.

If your ovaries aren't accessible through transvaginal ultrasound, an abdominal ultrasound may be used to guide the needle.

The eggs are removed from the follicles through a needle connected to a suction device. Multiple eggs can be removed in about 20 minutes.

After egg retrieval, you may experience cramping and feelings of fullness or pressure.

Mature eggs are placed in a nutritive liquid (culture medium) and incubated. Eggs that appear healthy and mature will be mixed with sperm to attempt to create embryos. However, not all eggs may be successfully fertilized.

Sperm retrieval

If you're using your partner's sperm, a semen sample needs to be provided at your doctor's office or clinic the morning of egg retrieval. Typically, the semen sample is collected through masturbation. Other methods, such as testicular aspiration - the use of a needle or surgical procedure to extract sperm directly from the testicle - are sometimes required. Donor sperm also can be used. Sperm are separated from the semen fluid in the lab.

Fertilization

Fertilization can be attempted using two common methods:

Conventional insemination. During conventional insemination, healthy sperm and mature eggs are mixed and incubated overnight.

Intracytoplasmic sperm injection (ICSI). In ICSI, a single healthy sperm is injected directly into each mature egg. ICSI is often used when semen quality or number is a problem or if fertilization attempts during prior IVF cycles failed.

In certain situations, your doctor may recommend other procedures before embryo transfer.

Assisted hatching. About five to six days after fertilization, an embryo "hatches" from its surrounding membrane (zona pellucida), allowing it to implant into the lining of the uterus. If you're an older woman, or if you have had multiple failed IVF attempts, your doctor might recommend assisted hatching - a technique in which a hole is made in the zona pellucida just before transfer to help the embryo hatch and implant. Assisted hatching is also useful for eggs or embryos that have been previously frozen as the process can harden the zona pellucida.

Preimplantation genetic testing. Embryos are allowed to develop in the incubator until they reach a stage where a small sample can be removed and tested for specific genetic diseases or the correct number of chromosomes, typically after five to six days of development. Embryos that don't contain affected genes or chromosomes can be transferred to your uterus. While preimplantation genetic testing can reduce the likelihood that a parent will pass on a genetic problem, it can't eliminate the risk. Prenatal testing may still be recommended.

Embryo transfer

Embryo transfer is done at your doctor's office or a clinic and usually takes place two to five days after egg retrieval.

You might be given a mild sedative. The procedure is usually painless, although you might experience mild cramping.

The doctor will insert a long, thin, flexible tube called a catheter into your vagina, through your cervix and into your uterus.

A syringe containing one or more embryos suspended in a small amount of fluid is attached to the end of the catheter.

Using the syringe, the doctor places the embryo or embryos into your uterus.

If successful, an embryo will implant in the lining of your uterus about six to 10 days after egg retrieval.

After the procedure

After the embryo transfer, you can resume your usual daily activities. However, your ovaries may still be enlarged. Consider avoiding vigorous activity, which could cause discomfort.

Typical side effects include:

Passing a small amount of clear or bloody fluid shortly after the procedure - due to the swabbing of the cervix before the embryo transfer

Breast tenderness due to high estrogen levels

Mild bloating

Mild cramping

Constipation

If you develop moderate or severe pain after the embryo transfer, contact your doctor. He or she will evaluate you for complications such as infection, twisting of an ovary (ovarian torsion) and severe ovarian hyperstimulation syndrome.

Results

About 12 days to two weeks after egg retrieval, your doctor will test a sample of your blood to detect whether you're pregnant.

If you're pregnant, your doctor will refer you to an obstetrician or other pregnancy specialist for prenatal care.

If you're not pregnant, you'll stop taking progesterone and likely get your period within a week. If you don't get your period or you have unusual bleeding, contact your doctor. If you're interested in attempting another cycle of in vitro fertilization (IVF), your doctor might suggest steps you can take to improve your chances of getting pregnant through IVF.

The chances of giving birth to a healthy baby after using IVF depend on various factors, including:

Maternal age. The younger you are, the more likely you are to get pregnant and give birth to a healthy baby using your own eggs during IVF. Women age 41 and older are often counseled to consider using donor eggs during IVF to increase the chances of success.

Embryo status. Transfer of embryos that are more developed is associated with higher pregnancy rates compared with less-developed embryos (day two or three). However, not all embryos survive the development process. Talk with your doctor or other care provider about your specific situation.

Reproductive history. Women who've previously given birth are more likely to be able to get pregnant using IVF than are women who've never given birth. Success rates are lower for women who've previously used IVF multiple times but didn't get pregnant.

Cause of infertility. Having a normal supply of eggs increases your chances of being able to get pregnant using IVF. Women who have severe endometriosis are less likely to be able to get pregnant using IVF than are women who have unexplained infertility.

Lifestyle factors. Women who smoke typically have fewer eggs retrieved during IVF and may miscarry more often. Smoking can lower a woman's chance of success using IVF by 50%. Obesity can decrease your chances of getting pregnant and having a baby. Use of alcohol, recreational drugs, excessive caffeine and certain medications also can be harmful.

Talk with your doctor about any factors that apply to you and how they may affect your chances of a successful pregnancy.

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In vitro fertilization (IVF) is a complex series of procedures used to help with fertility or prevent genetic problems and assist with the conception of a child. During IVF, mature eggs are collected (retrieved) from ovaries and fertilized by sperm in a lab. Then the fertilized egg (embryo) or eggs (embryos) are transferred to a uterus.

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Step 1: Fertility medications are given to the carrier, to increase egg simulation.
Step 2:  Eggs are removed by surgical procedure using a hollow needle.
Step 3: Male provides sperm
Step 4: Mixture of sperm and eggs in a dish occurs, otherwise sperm may be injected into egg itself on low probabilities of insemination.
Step 5: Eggs are placed into the carriers uterus 3-5 days after egg insemination.
Hopefully from there everything goes well.

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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.