In Vitro Fertilization (IVF)
During in vitro fertilization (IVF), eggs and sperm are brought together in a lab to allow the sperm to fertilize an egg. With IVF, you can use any combination of your own eggs and sperm and donor eggs and sperm.
After IVF, one or more fertilized eggs are placed in the uterus.
- Ovarian stimulation and egg retrieval.
To prepare for a procedure using your own eggs, you will likely need hormone treatment to control ovulation and make your ovaries grow multiple eggs at once. This is often done with shots of gonadotropin-releasing hormone analogue (GnRH agonist or GnRH antagonist) and gonadatropins (such as follicle-stimulating hormone (FSH)). You will get these hormone shots every day for about 1 to 2 weeks.
Your doctor will check your blood estrogen levels and will use ultrasound to see how your follicles are developing. Your dose may change based on test results. And you are monitored frequently with transvaginal ultrasound and blood tests. If follicles fully develop, you are given a human chorionic gonadotropin (hCG) injection to stimulate the eggs to mature. The mature eggs are collected 34 to 36 hours later. This is done with needle aspiration guided by ultrasound. Most people have pain medicine and sedation for this procedure.
- Sperm collection.
Sperm are collected by means of masturbation or by taking sperm from a testicle through a small incision. This procedure is done when a blockage prevents sperm from being ejaculated or when there is a problem with sperm development. Sperm may have been collected and frozen at an earlier time. In that case, the sperm are thawed on the day the eggs are collected.
- Fertilization and embryo transfer.
The eggs and sperm are placed in a dish. They are incubated with careful temperature, atmospheric, and infection control for 48 to 120 hours. About 2 to 5 days after fertilization, the best fertilized eggs are selected. One to four are placed in the uterus. This is done with a thin flexible tube (catheter) that is inserted through the cervix. The other eggs may be frozen (cryopreserved) for future attempts.
- Pregnancy and birth.
Any embryos that implant in the uterus may then result in pregnancy and birth of one or more infants.
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.
Birth rates resulting from a single cycle of IVF using a woman's own eggs are about 30% to 40% for women age 34 and younger, then rates decrease steadily after age 35.footnote 1 The aging of the egg supply has a powerful effect on the chances that an assisted reproductive technology (ART) procedure will result in pregnancy and a healthy baby.
- 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.
A woman who has already had a live birth is more likely to have a successful ART procedure than a woman who hasn't given birth before. This "previous birth advantage" gradually narrows as women age from their early 30s to their 40s.
- Own eggs versus donor eggs.
Birth rates are affected by whether ART procedures use a woman's own eggs or donor eggs. Many women over age 40 choose to use donor eggs, which greatly improves their chances of giving birth to healthy babies. For each cycle of in vitro fertilization:footnote 1
- Using her own eggs, a woman's chances of having a live birth decline from around 35% in her late 20s, to around 20% at about age 38, and to 4% by about age 43.
- Live birth rates are about the same among younger and older women using donor eggs. Women in their late 20s through mid-40s average about a 55% birth rate using fresh (not frozen) embryos.
- 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 for a woman, because superovulation and egg retrieval aren't needed.
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 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 the mother 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
For a woman over age 35 to have the best chance of conceiving with her own eggs and carrying a healthy pregnancy, she may choose to have more embryos transferred than a younger woman would. But this increases her risk of multiple pregnancy.
Because of the risks to the babies of multiple pregnancy, experts recommend limiting the number of embryos transferred. Your doctor will recommend a certain number of embryos to be transferred based on your age and specific situation.
Women over 40 have a high rate of embryo loss when using their own eggs. Instead, older women can choose to use more viable donor eggs. If you're using donor eggs, the number of embryos you receive will be based on the age of your donor.
Current as of: April 19, 2023
In vitro fertilization (IVF) ni mchakato wa majaribio ya uzazi wa binadamu ambao hufanyika kwa kutumia yai na manii ili kuwezesha uzazi wa binadamu kufanikiwa. Kwa IVF, unaweza kutumia mchanganyiko wowote wa mayai yako mwenyewe na shahawa na mayai ya wafadhili na shahawa. Baada ya IVF, yai moja au zaidi zilizozaliwa huwekwa ndani ya tumbo la uzazi. - Kuchochea yai na kuchukua yai. Ili kuandaa kwa ajili ya utaratibu kutumia mayai yako mwenyewe, pengine unahitaji matibabu ya homoni kudhibiti ovulation na kufanya ovari yako kukua mayai mengi kwa wakati mmoja. Kwa kawaida, dawa hii hutolewa kwa kutumia dawa za gonadotropin-releasing hormone (GNRH) na gonadotropin (FSH). Hizi ni sindano za homoni ambazo hutolewa kila siku kwa muda wa wiki moja hadi mbili. Daktari wako atachunguza viwango vya estrogen katika damu yako na kutumia ultrasound kuona jinsi follicles yako ni kuendeleza. Kiwango chako cha dawa kinaweza kubadilika kulingana na matokeo ya uchunguzi. Kwa kawaida, uchunguzi wa ultrasound wa transvaginal na uchunguzi wa damu hufanywa. Ikiwa follicles zinaendelea kukua, mgonjwa anapata sindano ya gonadotropin ya chorionic (hCG) ili kuchochea mayai kukomaa. Mayai ya kiume huchukuliwa baada ya masaa 34 hadi 36. Hilo hufanywa kwa kutumia sindano inayoongozwa na ultrasound. Watu wengi wana dawa za kupunguza maumivu na dawa za kutuliza maumivu kwa ajili ya utaratibu huu. - Mkusanyiko wa shahawa. Nyuzinyuzi hukusanywa kwa njia ya kujigamba au kwa kuchukua nyuzinyuzi kutoka kwenye kifua kupitia upasuaji mdogo. Utaratibu huu hufanywa wakati kizuizi kinazuia shahawa kutolewa au wakati kuna tatizo na maendeleo ya shahawa. Huenda shahawa ilikusanywa na kufungia wakati mwingine. Katika hali hiyo, shahawa huyeyushwa siku ya kuchukuliwa kwa mayai. - Uzao na uhamisho wa kiinitete. Mayai na shahawa huwekwa katika bakuli. Mimea hiyo huhifadhiwa kwa muda wa saa 48 hadi 120 kwa kutumia hali ya hewa, joto, na udhibiti wa maambukizi. Baada ya siku mbili hadi tano, mayai bora huchaguliwa. Moja hadi nne huwekwa ndani ya tumbo la uzazi. Hii hufanywa kwa kutumia bomba nyembamba lenye kubadilika-badilika (kateta) ambalo huingizwa kupitia shingo ya tumbo la uzazi. Mayai mengine yanaweza kufungia (cryopreserved) kwa ajili ya majaribio ya baadaye. - ujauzito na kuzaa. Matunda yoyote ambayo huingizwa ndani ya tumbo la uzazi huenda yakawa na matokeo ya mimba na kuzaliwa kwa mtoto mmoja au zaidi. Kwa ujumla, sindano, ufuatiliaji, na taratibu zinazohusiana na utoaji-mimba wa ndani ya mkojo (IVF) zaweza kuwa ngumu kihisia-moyo na kimwili. Kwa sababu ya ovulation ya kawaida, unahitaji uchunguzi wa damu, sindano za kila siku, uchunguzi wa mara kwa mara na daktari wako, na kuvuna mayai. Utaratibu huo hufanywa kwa wagonjwa wa nje. Hahitaji tu muda mfupi wa kupona. Unaweza kushauriwa kuepuka shughuli ngumu kwa siku iliyobaki au kukaa kitandani kwa siku chache. Hii inategemea hali yako na kile daktari wako anapendekeza. Kwa nini IVF inaweza kuwa chaguo la matibabu ikiwa una: - Matumbo ya uterasi yanayokosekana au yaliyofungwa. - Endometriosis kali. - Mshirika mwenye idadi ya chini ya shahawa. - Ukosefu wa uzazi ambao hauwezi kuelezwa na umedumu kwa muda mrefu. - Idadi ndogo ya mayai. - Kipindi cha hedhi kisicho cha kawaida au matatizo ya kutolewa kwa yai (ovulation). "Kama kuna sababu nyingine za kuchagua IVF ni pamoja na: ""Ulikuwa na upasuaji wa kugeuza tubal ligation (""kuwa na tubes yako amefungwa"), na haikufanya kazi." - Ulikuwa na uzazi wa bandia au wa ndani ya tumbo, na haukufanya kazi. - Unataka kupima magonjwa ya urithi kabla ya viini-tete kuhamishwa. - Una mpango wa kutumia mayai ya mtoaji au shahawa ya mtoaji. - Una mpango wa kumfanya mtu mwingine (mama wa badala) amchukue mtoto. Kwa kweli, kuna uwezekano mkubwa kwamba mtoto wako atazaliwa baada ya IVF (in vitro fertilization), lakini matokeo ya IVF yanategemea mambo mengi. Karibu matibabu yote ya utoaji-uzazi kwa msaada (ART) hufanywa kwa kutumia IVF. Kiwango cha kuzaliwa kwa wanawake wanaotumia mayai ya mwanamke mwenyewe ni asilimia 30 hadi 40 kwa wanawake wenye umri wa miaka 34 na chini, kisha viwango vinapungua baada ya miaka 35 na zaidi. - Kisababishi cha utasa. Ukosefu wa uzazi waweza kusababishwa na matatizo ya mfumo wa uzazi. Baadhi ya visababishi hivyo vyaweza kutia ndani matatizo ya mirija ya utumbo, ovulation, au shahawa. - Historia ya ujauzito. Mwanamke ambaye amezaliwa na mtoto ana uwezekano mkubwa zaidi wa kufanikiwa katika matibabu ya uzazi kuliko mwanamke ambaye hajazaa. "Uzuri wa kuzaliwa kabla ya kuzaliwa" hupungua hatua kwa hatua kama wanawake wanavyozeeka kutoka miaka yao ya mapema ya 30 hadi miaka yao ya 40. """ - Mayai ya mtu mwenyewe dhidi ya mayai ya mtoaji. Viwango vya kuzaliwa huathiriwa na kama taratibu za ART hutumia mayai ya mwanamke mwenyewe au ya mtoaji. Wanawake wengi wenye umri wa miaka 40 na zaidi huamua kutumia mayai ya wafadhili, ambayo huongeza sana nafasi zao za kuzaa watoto wenye afya. Kwa kila mzunguko wa uzazi wa in vitro, nafasi ya mwanamke ya kuzaa mtoto hai hupungua kutoka asilimia 35 katika miaka yake ya mwisho ya 20, hadi asilimia 20 katika miaka ya 38 na hadi asilimia 4 katika miaka ya 43. - Viwango vya kuzaliwa kwa watoto walio hai ni sawa kati ya wanawake wachanga na wazee wanaotumia mayai ya wafadhili. Wanawake wenye umri wa miaka 20 hadi 40 wana asilimia 55 ya kuzaliwa kwa kutumia viini vya uzazi safi. - Viini-tete vilivyogandishwa dhidi ya viini-tete vipya. Matunda ya IVF ya mchangiaji kutoka kwa mzunguko wa IVF wa awali ambayo huyeyushwa na kuhamishwa kwenye tumbo la uzazi yana uwezekano mdogo wa kusababisha kuzaliwa kwa hai kuliko matumbo ya IVF ya mchangiaji (ya hivi karibuni ya kuzaliwa). Kwa hivyo, kwa sababu ya utando uliohifadhiwa, ni rahisi zaidi kwa mwanamke kupata ovulations na ovulation ya ovuli. In vitro fertilization (IVF) ni njia ya kuimarisha uwezo wa ovari na kuongeza uwezekano wa mimba nyingi. - Superovulation na matibabu ya homoni inaweza kusababisha ugonjwa mbaya wa ovarian hyperstimulation. Daktari wako anaweza kupunguza hatari hii kwa kufuatilia kwa karibu ovari zako na viwango vya homoni wakati wa matibabu. - Hatari ya mimba nyingi inahusiana moja kwa moja na idadi ya viinitete vilivyohamishwa kwenye tumbo la uzazi. Mimba ya wingi ni hatari sana kwa mama na kwa kijusi. Kuna uwezekano mkubwa wa kuambukizwa na kasoro za kuzaliwa kwa watoto waliozaliwa kwa njia fulani za uzazi, kama vile IVF. Zungumza na daktari wako kuhusu hatari hizi zinazowezekana. Uhamisho wa kiinitete: Kwa mwanamke mwenye umri wa miaka 35 na zaidi, nafasi ya kupata mimba na mayai yake mwenyewe na kubeba mimba yenye afya, anaweza kuchagua kuhamisha kiinitete zaidi kuliko mwanamke mchanga. Lakini hilo huongeza hatari ya kupata mimba nyingi. Kwa sababu ya hatari kwa watoto wa mimba nyingi, wataalamu hupendekeza kupunguza idadi ya viinitete vinavyohamishwa. Daktari wako atakupendekeza idadi fulani ya viinitete kuhamishwa kulingana na umri wako na hali maalum. Wanawake wenye umri wa miaka 40 na zaidi wana uwezekano mkubwa wa kupoteza kiinitete chao wenyewe. Badala yake, wanawake wazee wanaweza kuchagua kutumia mayai ya wafadhili yenye uwezo zaidi. Ikiwa utatumia yai la mtoaji, idadi ya viini vilivyopokelewa itategemea umri wa mtoaji. Hivi sasa: Aprili 19, 2023