What To Expect

Overall, in vitro fertilization (IVF)-related injections, monitoring, and procedures can be emotionally and physically demanding. Superovulation with hormones requires regular blood tests, daily injections, frequent monitoring by your doctor, and harvesting of eggs.

These procedures are done on an outpatient basis. They require only a short recovery time. You may be advised to avoid strenuous activities for the rest of the day or to be on bed rest for a few days. This depends on your condition and what your doctor recommends.

Why It Is Done

IVF may be a treatment choice if you have:

• Missing or blocked fallopian tubes.
• Severe endometriosis.
• A partner with low sperm counts.
• Infertility that can't be explained and has lasted a long time.
• A low number of eggs.
• Irregular menstrual periods or problems with releasing an egg (ovulation).

Other reasons you may choose IVF include:

• You had surgery to reverse a tubal ligation ("having your tubes tied"), and it didn't work.
• You had artificial or intrauterine insemination, and it didn't work.
• You want to test for inherited disorders before embryos are transferred.
• You plan to use donor eggs or donor sperm.
• You plan to have someone else (a surrogate) carry the baby.

How Well It Works

While many people have babies after in vitro fertilization (IVF), success depends on many different things. Almost all assisted reproductive technology (ART) procedures are done using IVF.

• Age. The age of the egg supply affects the chances that an assisted reproductive technology (ART) procedure will result in pregnancy and a healthy baby. Birth rates from IVF steadily decrease if you are using your own eggs after age 35.
• Cause of infertility. Infertility can be caused by problems with the reproductive system. Some of these causes can include problems with the fallopian tubes, with ovulation, or with the sperm.
• Pregnancy history. If you have already been pregnant and had a live birth, you are more likely to have a successful ART procedure than someone who hasn't given birth before.
• Own eggs versus donor eggs. Birth rates are affected by whether ART procedures use your own eggs or donor eggs. For those over age 40, using donor eggs instead of your own eggs can greatly improve the chances of giving birth to healthy babies.
• Frozen embryos versus fresh embryos. Donor-frozen IVF embryos from a previous IVF cycle that are thawed and transferred to the uterus are less likely to result in a live birth than are donor-fresh (newly fertilized) IVF embryos. But frozen embryos are less expensive and less invasive, because superovulation and egg retrieval aren't needed.

Risks

In vitro fertilization (IVF) increases the risks of ovarian hyperstimulation syndrome and multiple pregnancy.

• Superovulation with hormone treatment can cause severe ovarian hyperstimulation syndrome. Your doctor can reduce this risk by closely monitoring your ovaries and hormone levels during your treatment.
• The risk of a multiple pregnancy is directly related to the number of embryos transferred to the uterus. Multiple pregnancies are high-risk for both you and the fetuses.

There may be a higher risk of birth defects for babies conceived by certain assisted reproductive techniques, such as IVF. Talk with your doctor about these possible risks.

Embryo transfer success versus the risk of multiple pregnancy

If you are older than 35, you may choose to have more embryos transferred than someone who is younger. This will give you the best chance of getting pregnant using your own eggs and having a healthy pregnancy. But this increases your risk of multiple pregnancy.

Because of the risks with multiple pregnancy, experts recommend that you limit the number of embryos transferred. Your doctor will recommend a certain number of embryos. This number is based on your age and other factors.

If you are older than 40, there is a high rate of embryo loss when using your own eggs. Donor eggs may work better for you.