In-vitro fertilization (IFV) is a form of assisted reproductive technology that involves combining eggs and sperm in the laboratory and transferring the fertilized eggs (embryos) into the uterus.

Since the first birth from IVF in 1978 in England, this procedure has become an integral part of infertility treatments.

IVF is a complex process lasting seven weeks. The first five weeks are dedicated to ovarian suppression. In week six, ovarian stimulation with fertility injections takes place. The last week involves surgical retrieval of eggs from the ovary and, three to five days later, transfer of embryos into the uterus. Ovarian stimulation during week six entails daily injections and regular visits for ultrasounds and blood hormone levels.

Egg retrieval is a 30 to 45 minute procedure performed under intravenous sedation in the Bennett Fertility Institute (BFI) operating suite. Under ultrasound guidance, a needle is inserted vaginally into the ovaries, and follicular fluid, which contains eggs, is aspirated. Several hours later, sperm and eggs are combined in the laboratory. Incubation in the laboratory lasts three to five days.

Embryo transfer, a procedure lasting 10 to 15 minutes requiring no anesthesia, is performed then. Two weeks later, a pregnancy test is performed.

Indications:

• Blockage or absence of Fallopian tubes, sperm abnormalities, severe endometriosis or pelvic scarring, and unexplained infertility are the most common indications for IVF.

Contraindications, complications, adverse effects:

• Surgical risks such as bleeding, infection, injury to vital organs, or anesthesia complications are very uncommon.
• Multiple births and ovarian hyperstimulation syndrome are possible complications of fertility medications.
• Approximately five percent of patients will have some degree of hyperstimulation syndrome, a condition in which the ovaries enlarge and produce excess fluid in the abdomen.
• Nausea, vomiting, breathing difficulties, abdominal swelling and weight gain may result. Approximately one percent of patients undergoing IVF will be hospitalized with this condition, usually for several days of observation, IV fluids, and occasionally drainage of excess abdominal fluid.
• Twins occur in approximately 30 percent of all IVF pregnancy.
• Triplets occur in five percent of all IVF pregnancies.
• Quadruplets rarely occur nowadays.
• During the IVF cycle, common adverse effects are abdominal tenderness, cramps, emotional changes, and discomfort at the injection sites.
• IVF is contraindicated in patients with serious medical illnesses or in patients in whom pregnancy is dangerous.

The Bennett Fertility Institute at INTEGRIS Baptist Medical Center, Oklahoma City, Oklahoma provides advanced infertility diagnostic studies and treatment to patients who fail to conceive by less extensive means. The Institute offers assisted reproductive technology (ART) procedures such as in-vitro fertilization (IVF), micromanipulation, embryo and sperm cryopreservation (freezing and banking), and egg and embryo donation.