IVF
Overview from Huntington Reproductive Center, Southern
California
IVF Web Site Topics
IVF is an important
component of assisted reproductive technologies and
has been offered by Huntington's Southern California IVF clinics since 1988. In vitro fertilization has enabled thousands
of otherwise infertile couples to create a genetically
related child.
We have a separate Web site devoted to IVF where you will find extensive information on ICSI, Donor Egg, Assisted Hatching, embryo cryopreservation, the potential for egg freezing, and more. Information ranges from its
historical development to advanced procedures such as
ICSI, assisted hatching,cost of treatment, success rates, and other topics.
 IVF has received extensive media
coverage over the last several years and many people
believe that infertility specialists prescribe in vitro
fertilization as "a first line procedure".
However, the majority of couples become
pregnant using technologies such as intrauterine insemination
(IUI), medications,
and/or surgery.
IVF is sometimes the first line treatment for conditions
such as severely damaged fallopian tubes, moderate to severe male factor infertility, advanced female age,
and others.
Some couples delay
seeing an infertility specialist because of cost concerns. While some treatments can be expensive, many
studies demonstrate that specialist care is more economical,
and more likely to result in pregnancy than non specialist
care.
A specialist will likely
move a patient who has failed three IUI
cycles to in vitro fertilization, whereas a non-specialist
may attempt additional IUI cycles. Another example is
Clomid therapy,
where some generalists prescribe the drug for 6 or more
cycles. The literature does not recommend continued
use of Clomid beyond 3-6 ovulatory cycles and most fertility specialists rapidly move patients to the next treatments. If insurance coverage is available, it should
not be wasted on treatments that are unlikely to work.
IVF gets its
name from where the eggs are fertilized, "in vitro"
meaning outside of the body. In the early days, babies
were referred to as "test tube babies". This
is not accurate, as fertilization occurs in a Petri
dish not a test tube.
IVF technology has advanced remarkably
over the last ten years and physicians have developed
treatment protocols, which vary by each patient's response
to treatment. These protocols help to insure the development
of sufficient eggs while monitoring the patient's response
to medications thus improving safety and efficacy.
IVF patients receive ovulation-inducing
drugs (FSH) such as Gonal-F, Follistim, Repronex, or
Bravelle. These drugs cause the development of multiple
eggs, which are needed for the process. Patients are
monitored carefully by ultrasound and estradiol hormone
measurements. Dosages of FSH are individualized according
to each patient's response. Once the eggs mature, they
are retrieved using transvaginal ultrasound retrieval.
The patient receives "light" general anesthesia
and a small "needle" is passed through the
back of the vagina and inserted into the follicle to remove the egg.
Once the eggs are retrieved, they
are combined with sperm in a Petri dish where fertilization
takes place. ICSI is sometimes required to insure fertilization.
In ICSI, a single sperm is inserted directly into the
egg. The resultant embryos are incubated until they
are ready for transfer to the uterus. The transfer is
painless and requires less than 5 minutes.
IVF and PGD, Preimplantation Genetic Diagnosis
In some IVF cases, embryos will undergo the PGD procedure. PGD is performed for couples at risk of transmitting certain genetic diseases, to verify the correct number of chromosomes, or for gender selection. Please see the PGD section of our Web site.
The "IVF section" of
our Web site includes our IVF
success rates, information on egg donation and the
donor egg program, a description of male procedures such as PESA,
TESA, and MESA and other relevant information.
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