Answers to 10 Common Questions About In Vitro Fertilization (IVF)

When it comes to growing families, no single technology has had more of an impact than IVF. Today there are well over 5 million people in the world who were born using IVF, and that number is expected to grow significantly.

While there is a great deal of helpful information available about IVF, there is also a lot of misinformation and outdated information.

The goal of this guide is to answer some of the most common questions about IVF and provide you with understanding and information that you can use when talking with your doctor or a fertility specialist.

1. What Is IVF?

IVF is a method of assisted reproductive technology (ART) in which eggs and sperm are combined outside the womb (uterus) in a specialized laboratory. If the egg fertilizes and begins cell division, the resulting embryo can be transferred into the woman’s uterus where it will hopefully implant in the uterine lining and further develop to a healthy infant. It can also be frozen and saved for the future.

IVF is currently the most effective form of assisted reproductive technology. The procedure can be done using a woman’s own eggs and a partner’s sperm, or sperm or eggs from a known or anonymous donor. Additionally, a gestational carrier/surrogate may be used to carry the pregnancy.

2. What Other Procedures Can Be Combined with IVF?

While IVF has a long history, dating back to 1978, new techniques and procedures have increased the success rates and lowered the costs.

  • ICSI – Intracytoplasmic Sperm Injection
    This procedure allows a fertility specialist to inject a single sperm into an egg. New screening technologies allow fertility specialists to combine the healthiest sperm and egg. This procedure has improved the chances of an egg being fertilized and resulting in an embryo that can be transferred into the uterus.
  • PGS – Pre-Implantation Genetic Screening / CCS (Comprehensive Chromosome Screening)
    It is possible to analyze biopsied cells from an embryo before implantation to determine whether it has a chromosomal error or genetic mutation present. This helps avoid implanting embryos that will not likely lead to a healthy pregnancy.
  • FET – Frozen Embryo Transfer
    Frozen embryos created during IVF can be used at later time for transfer into the uterus. This procedure has high success rates, allows banking of embryos, and gives patients an opportunity to get pregnant when they choose.

3. Can I Afford IVF?

IVF treatments can be expensive, but that doesn’t mean that they are out of reach. In the U.S., there is a greater understanding of the benefits of IVF, especially as more and more people are waiting until later in life to start their family.

A growing number of U.S. states require some insurance coverage for fertility treatment, and more employers are seeing the value in including fertility coverage as a part of their benefits package.

In addition, other options exist including IVF financing and grants.

Before you make a decision, check with your insurance plan and talk with a fertility specialist. They can often provide advice on how to find a solution that you can afford.

4. Will IVF Become More Affordable?

The global IVF market is expected to grow at a rate of over 11.7% per year between now and 2022. As demand grows and treatments become more efficient, prices will likely decrease, and more businesses and insurance plans are likely to offer full or partial IVF coverage.

Source: Grandview Research: http://www.grandviewresearch.com/industry-analysis/in-vitro-fertilization-market

5. Does IVF Lead to Twins and Multiple Births?

In the past, physicians recommended transferring multiple embryos to improve the chances of fertility since knowing which embryo was viable was hard to determine. This sometimes led to multiple births.

However, new advances like extended blastocyst culture and PGS/CCS have made this less necessary. In fact, due to the potential health risks related to multiple births, most fertility specialists advise against implanting more than one embryo at a time unless indicated. Instead, viable embryos can be frozen and stored for future use.

6. Aren’t Frozen Eggs Less Effective Than Fresh Eggs?

Historically, success rates with fresh embryos were higher than frozen because of the risk of damage in the thawing process. However, vitrification (egg or embryo freezing) technology leads to about 99% embryo survival, which means that success rates with frozen embryos is comparable to fresh embryos.

Also, a pregnancy using frozen embryos may lead to healthier long-term fetal outcomes. This is because freezing allows for Comprehensive Chromosome Screening (CCS) / Preimplantation Genetic Screening (PGS) and Preimplantation Genetic Diagnosis (PGD), which can allow for healthier embryos with a greater chance of leading to a live birth.

Another benefit is that freezing lets a woman’s hormone levels to “cool off” after egg retrieval and stimulation. That means that fertility specialists can transfer embryos at a time when a woman’s hormone levels are stable and may improve implantation of the embryo and pregnancy development.

Vitrification technology has also led to significant improvements in egg freezing outcomes, giving women the chance to preserve fertility for the future.

7. Does IVF Mean That I Need to Take Time Off Work?

Most IVF procedures are minimally invasive and are performed on an outpatient basis. While it is recommended that patients not over-exert themselves, most patients return to work the next day following an egg retrieval and can return to their regular exercise routine by their next menstrual cycle. Following an embryo transfer, most doctors recommend a few days of bed rest.

8. Am I Too Old for IVF?

Among women older than 35, the success of IVF treatments may diminish, since with age comes declining ovarian reserve and egg quality.  However, advanced ART regimes, such as PGS/CCS may expedite treatment and improve the likelihood of a successful pregnancy by identifying and replacing only viable embryos into the uterus. Women who pursue these treatments have implantation rates (pregnancy per embryo transferred) comparable to younger women, since the biggest barrier to success is often the identification of a healthy embryo.

Similarly, if an older woman uses a donor egg, she has a high likelihood of success, since younger eggs are more likely to be viable and the age of the uterus does not significantly alter pregnancy rates. Women can successfully conceive a child through IVF treatment up to age 50 years using donated eggs. They then have the same chances of success as those women younger than 35 years.

9. Do I Need IVF? I’m Not Trying to Get Pregnant Right Now.

A growing number of women are choosing to preserve their fertility for the future. By harvesting eggs when they are still in their early-to-mid thirties, they improve their chances of having a biological child in the future.

10. Can IVF Help Me?

IVF procedures have expanded to help more and more patients to achieve their dream of growing their family.

  • Women with PCOS, endometriosis or other physical issues that impair their ability to get pregnant.
  • Women over age 35 who can get pregnant but suffer recurring loss or miscarriage.
  • Men who may have fertility issues can improve their chances of conceiving
  • LGBT couples who wish to have their own children using a gestational carrier or reciprocal IVF.
  • Men and women whose fertility is at risk due to a diagnosis of cancer or other conditions requiring toxic treatments.
  • Also, many who work in high-risk careers (fields such as chemistry, heavy industry or the military) have turned to IVF as a means of preserving their fertility in case of an unexpected loss of fertility.

Resources:

American Society for Reproductive Medicine
American College of Obstetricians and Gynecologists
Centers for Disease Control and Prevention
Eunice Kennedy Shriver National Institute of Child Health and Human Development
Mayo Clinic
Grandview Research –  Industry Analysis of In Vitro Fertilization Market.
National Institutes of Health – US National Library of Medicine
The National Infertility Association
U.S. Department of Health and Human Services – Office on Women’s Health