In Vitro Fertilization
ROBERT GORE-LANGTON AND SUSAN DANIEL
In vitro fertilization (IVF) is a female reproductive technology and involves several steps. First, women normally undergo controlled hyperovulation, which produces more than the usual single mature egg per menstrual cycle. Up to twenty eggs per ovary can result from this procedure. The ova (eggs) are then retrieved and inseminated with sperm. Within forty-eight hours fertilization and cell division, or cleavage, occur, generating a number of embryos ranging from zero to twenty. After the quality of the embryos has been checked, several of the most acceptable are implanted in the woman's womb or are frozen for future implantations and for embryo research.
IVF was developed to treat infertility due to blocked fallopian tubes, but it is now also used to overcome male-factor and idiopathic (undetermined) infertility as well as infertility related to endometriosis. Attention to patient selection is important to ensure that treatment is offered to those who will benefit from the technology and that the appropriate technology is used.
Patients with tubal or idiopathic infertility have the best prognosis after IVF. Some studies indicate that women with endometriosis have a poorer