In Vitro Fertilization
As of 2014, over 1 million babies have been conceived through in vitro fertilization (IVF). IVF was introduced in the United States in 1981. The pregnancy success rates have climbed to current rates of about 41% for women under 35 years of age.
WHAT IS IVF?
In Vitro Fertilization (IVF) is a type assisted reproductive technology (ART). IVF is generally recommended for couples that have failed to conceive after three unsuccessful intrauterine insemination (IUI) cycles. According to the Society for Assisted Reproductive Technology the IVF success rate in the U.S. for women of all ages is around 30%; however, when women under the age of 35 are taken into account, the IVF success rate is much greater.
IVF is the process of extracting and fertilizing eggs in the laboratory. After fertilization, embryos are then transferred into the uterus. The process occurs in four stages after a comprehensive evaluation and preparation process. The 4 stages are:
- Ovarian Stimulation
- Egg Retrieval
- Embryo Transfer
- A woman is given stimulation medication to encourage multiple eggs to develop in her ovaries
- Once enough mature eggs are identified, she will undergo an outpatient surgical procedure in which eggs are extracted from her ovaries
- In the lab, the eggs are combined with sperm (either from husband or donor sample) for fertilization
- If fertilization occurs, the embryos will be monitored by the lab’s embryologist for development
- Embryos that continue to develop will then be transferred either on day three or day five into the patient’s uterus through a small intrauterine catheter
- If there are extra viable embryos not transferred, they can be frozen for future use
- Two weeks from retrieval the patient will perform a urine pregnancy test
WHY CHOOSE IVF?
IVF is a good option for those who have been unsuccessful with other fertility treatments such as ovulation induction with medications or intrauterine insemination. Additionally, IVF bypasses the fallopian tubes because eggs are directly harvested from the ovaries, eliminating the need for functioning tubes.
IVF should be considered for some conditions, such as:
- Couples who have been unsuccessful with other fertility treatments
- Women who have blocked or damaged tubes
- Women who have had a tubal ligation (“tubes tied”)
- LGBT couples
- Male infertility such as low sperm count
- Women with diminished ovarian reserve or age-related infertility
- Women with conditions such as endometriosis or polycystic ovarian syndrome (PCOS)
WHAT FACTORS DETERMINES IVF SUCCESS RATES?
Considering in vitro fertilization (IVF)? Then it’s important to learn about IVF success factors that can help or hinder your getting pregnant.
Your age and using your own eggs are important IVF success factors to consider. While younger women have higher chances of IVF success, factors that reduce the chances of IVF success include being an older woman with fewer eggs and the lower quality of an older woman’s eggs. Ovarian reserve testing can help to assess the impact of age and estimate pregnancy rates from IVF.
In fact, the live birth IVF success rate for women under 35 who start an IVF cycle is 40%. However, women over age 42 have a 4% success rate.
More IVF success factors to think about include whether or not you were pregnant previously and if it was with the same partner.
If you were pregnant previously with the same partner that’s currently undergoing IVF treatment, there is a greater probability of IVF success. Factors such as a history of recurrent miscarriage or a different partner may reduce the chances of IVF success.
Type of Fertility Problems
While some male infertility problems do impact IVF success, factors like uterine abnormalities, exposure to DES or fibroid tumors also decrease the likelihood of success with IVF.
Very important to know: IVF success factors are dependent on ovulation. Ovarian dysfunction, like high FSH levels which indicate a low ovarian reserve, may reduce the chances of IVF success. Factors that may lower pregnancy rates and reduce success with IVF include needing large amounts of ovulation stimulation drugs.
When both partners are infertile with lower chances for IVF success, factors such as the length of time you have been infertile is important to consider. The chances of IVF success decrease with the amount of time a couple has been infertile.
Use of Donor Eggs
Donor eggs are a significant consideration, especially if you are over 40, as there may be a higher rate of IVF success. Factors such as egg quality and age of donor are important. Using donor eggs from younger women may increase the chances of pregnancy for women over 40. 2011 findings show a 55% live birth success rate with a fresh donor egg/embryo transfer.
Stop smoking if you want to improve your chance of having a baby. In fact, many times the woman is required to stop smoking at least 3 months before starting IVF treatment.
- Smokers require higher dosages of fertility drugs to stimulate their ovaries
- Smokers have lower implantation rates than nonsmokers
- Women who smoke require almost twice as many IVF attempts
- Women who smoke experience more failed fertilization cycles
More IVF success factors to mull over include losing weight if you are overweight or obese. Women who are overweight have an increased risk of infertility as well as miscarriage. Overweight women also have less IVF success with fertility treatments than women of normal weight. Underweight women are also at greater risk of having success with IVF. Bottom line: aim to stay within a healthy weight range.
The center you choose to perform the IVF treatment can greatly affect your IVF success. Factors to think about when reviewing the success rate of fertility centers include:
- The training and experience of the IVF clinic and staff
- The live birth rate per IVF cycles started
- The rate of patients pregnant with multiples (twins, triplets or more)
- The laboratory used by the clinic and the qualifications of their staff
- The types of patients accepted at the clinic, more specifically their age and fertility problem
Keep in mind that some clinics are more willing to accept patients with a lower chance of IVF success or they may specialize in particular treatments.
Know your IVF success factors as you plan to get pregnant
Remember, just as with any chronic illness, knowledge is power with infertility. The more you learn about specific IVF success factors, the more control you will feel about high-tech treatments that help you get pregnant and start a family.
IVF can be emotional challenging. It requires financial and personal commitment that affects both partners. The schedule is an unpredictable and demanding one. It is important to address stress related to the process and outcome. Stress reduction can be improved by eating healthy, exercising and getting plenty of sleep. Yoga, meditation, tai chi and aromatherapy are great ways of reducing stress. Acupuncture has been shown to increase the number of eggs retrieved per IVF cycle with stress reduction. We have a number of counselors we work with as well. In your IVF material, names and contact information for counselors are provided.
Dr. Richard-Davis has over 25 years of experience and is board certified in both reproductive endocrinology and infertility (REI) andobstetrics and gynecology. Board certification is a specialized examination conducted by the American College of Obstetrics and Gynecology (ABOG) determining qualifications have been met by the physician that meet the required standards of care set by ABOG. A nationally-known fertility expert and thought leader, she is the only female fertility specialist in Arkansas. Dr. Richard-Davis is an active member of the American Society of Reproductive Medicine (ASRM) and Society of Reproductive Endocrinology and Infertility (SREI) organizations, which are the recognized and respected national and international organization of fertility and reproductive medicine. She has served in numerous leadership positions in both organizations and is a professor of the Department of Obstetrics and Gynecology for UAMS. She has trained numerous OB/GYN doctors and reproductive endocrinology and infertility specialists in the U.S. and other countries. Her women’s health research has been presented at national conferences and published in peer review journals. She is the author of Planning Parenthood: Strategies for Success in Fertility Assistance, Adoption, and Surrogacy.
To schedule a consult to learn more about your treatment options, or if you would be a candidate for IVF, call 501-526-7425.
Learn more about the Fertility Clinic at UAMS.
Use the Society of Assisted Reproductive Technology tool to calculate your success rate after a complete evaluation has been done.