In Vitro Fertilization (IVF)
The term Assisted Reproductive Technologies (ART) is frequently used and simply refers to all fertility treatments involving both the egg and the sperm.
The Missouri Center for Reproductive Medicine and Fertility has expertise in each of the following Assisted Reproductive Technologies: IVF (in vitro fertilization), GIFT (gamete intrafallopian transfer), and ZIFT (zygote intrafallopian transfer). IVF is the most common ART procedure that is used in the United States, as GIFT and ZIFT do not increase pregnancy rates and require a second surgical procedure (laparoscopy).
In Vitro Fertilization (IVF) Success
- Depends primarily on the age of the female partner
- Highest pregnancy and live birth (take-home baby) rates reported in women age
- In 2008, we reported a 60% pregnancy rate and a 40% live birth rate in women age
- Although pregnancy and live birth rates decrease after age 35, IVF remains a viable option for women up until their early 40s.
- Other factors which will affect these rates include the use of fresh or frozen embryos, and the use of donor eggs.
Multiple Pregnancy and IVF
- Increased risk for multiple gestation of about 30%; most multiple pregnancies are twins.
- General guidelines are followed to limit the number of embryos transferred based on the age of the woman, particularly in those age
- The use of blastocyst transfer may also be used to achieve this goal.
- We manage each case individually, and will attempt to be responsive to the needs of the couple, while balancing the number of embryos transferred with the risk of higher order multiple pregnancy.
For more information, see the American Society of Reproductive Medicine (ASRM) fact sheet, Complications and Problems associated with Multiple Births.
The IVF Process
- Ovarian stimulation: Injectable medications are used to stimulate the woman's ovaries to produce multiple oocytes (eggs). In our clinic, most women produce about 8 to 10 oocytes per stimulation attempt. As in nature, oocytes vary in quality. Also after any stimulation procedure, oocytes may vary in maturity at the time of oocyte retrieval. Our clinic typically recovers approximately 80% of high quality, mature oocytes; however, this is highly dependent on the age of the women.
- Patients are closely monitored through ultrasound and blood tests in order to optimize oocyte development while minimizing the incidence of hyperstimulation of the ovaries
- Oocytes are then surgically retrieved from a women’s ovaries during a brief outpatient procedure in which the woman is sedated using medicines given through an intravenous (IV) line.
- Oocytes are inseminated (exposure to sperm) in the laboratory. Not all oocytes will fertilize for a variety of reasons. The fertilization rate in our clinic is around 70% with good quality sperm, which is similar to the National average.
- The fertilized oocytes are then allowed to grow into embryos in culture. Again as in nature, not all fertilized oocytes will develop into embryos.
- Embryos are then transferred into the woman's uterus using a tiny catheter through the vagina and cervix; ultrasound may be used to aid in visualization
- Embryo transfer is very similar to an insemination in that it usually takes less than 5 minutes to perform, and requires no anesthesia
- Embryo transfer is typically performed day 2-3 or day 5-6 following retrieval
Micromanipulation of Embryos
Micromanipulation refers to microscopic procedures using sperm, eggs, and/or embryos that are designed to improve: