In vitro fertilization (IVF) is the solution for the millions of people across the country who are affected by infertility. During the procedure, the sperm and egg are mixed and incubated in a lab, and the resultant embryos are then inserted into the woman’s uterus.
At the Arizona Center for Reproductive Endocrinology & Infertility, we don’t usually begin our treatment plan with in vitro. Instead, our approach is to solve the issue and allow the woman to get pregnant, and that sometimes means starting with simpler, low-tech tests and procedures and then move to IVF as needed. However, every person’s pregnancy journey is different, and for some couples and women—depending on the cause of their infertility—it makes more sense to try IVF first.
In vitro fertilization is an effective treatment for a wide variety of infertility problems that can’t be overcome through standard techniques. Here are some instances where IVF might be the most successful solution.
Blocked Fallopian Tubes
When IVF was first developed 20 to 30 years ago, it was primarily used in situations where women had blocked fallopian tubes. This can occur because of surgery, infection, or previous tubal ligation, to name a few examples. With IVF, we’re able to bypass the fallopian tubes by surgically retrieving the eggs and placing the fertilized embryos into the uterus to achieve a pregnancy.
Low Sperm Count
If we determine that the cause of infertility is low sperm count, we might try medical treatments to increase the number of sperm a man produces. However, when the sperm count is extremely low, it is very unlikely that we can get enough sperm to the egg to cause fertilization during situations of timed intercourse or artificial insemination. In those circumstances, IVF can increase the chance of fertilization by bringing the sperm and egg together in our lab.
Low Sperm Motility / Weak Sperm
When sperm have trouble penetrating the egg’s glycol-protein covering, the zona pellucida, we can use IVF in conjunction with ICSI (intracytoplasmic sperm injection) to assist in fertilization. With this method, we are able to take a single sperm and, under a microscope, inject it through an egg’s zona pellucida and directly into the egg to achieve fertilization.
Men who are diagnosed with obstructive azoospermia produce sperm in the testes but have no sperm in their semen. This might happen because of a blockage in the ducts that carry the sperm from the testes into the seminal fluid at the time of ejaculation. Sometimes this is caused by the genetic disorder cystic fibrosis, which is associated with congenital absence of the vas deferens.
A simple way to overcome obstructive azoospermia is through a procedure called testicular sperm extraction (TESE), where we obtain sperm directly from the testes. When we do a biopsy like this, we do it in conjunction with ICSI since we want to make sure the limited amount of sperm that we obtain is able to successfully fertilize the egg.
Late Reproduction Age
Age is a significant factor in ovulation problems; women who are 35 years or older are more likely to have issues with producing healthy, quality eggs. IVF can help with this, in that the woman’s ovaries are stimulated by fertility drugs to produce multiple eggs, which can then be fertilized in the lab. If a woman comes in and is in her mid- to late-30s or early 40s, we often recommend jumping straight into IVF because it is such a successful procedure, and it saves us valuable time in trying other treatments first.
IVF can also be used to circumvent the problem of irregular ovulation. The process begins with hormone injections, which are designed to override the body’s natural hormonal production. We can control ovulation with medication, including helping a patient to ovulate. These medications cause multiple egg follicles to develop while preventing ovulation, so that way multiple eggs can be successfully retrieved for the IVF procedure.
Low Quality Eggs
Unfortunately, when egg quality is extremely low, implantation—even with IVF—may not be successful. However, the option for pregnancy is not closed to them. A woman can still experience the joy that comes with carrying a baby and giving birth through IVF with the use of an egg donor. Once a healthy, donated egg is fertilized, we can place it into a woman’s uterus, and often, a pregnancy will be achieved without any complications.
Screening for Recurring Miscarriage
IVF can be used to screen for genetic problems or recurring miscarriage. When the eggs are retrieved and fertilized, the resulting embryos can be tested to make sure they’re genetically and chromosomally competent, and will have a lower chance of miscarriage.
Fertilization Using Frozen Sperm and/or Eggs
If a woman chose to freeze her eggs at an earlier age, they would be thawed and fertilized with the woman’s partner’s sperm or a donor’s sperm through the standard in vitro process. We perform the same procedure if a man decided to freeze his sperm for medical reasons. While a man might donate two to three samples to freeze, potentially creating multiple vials to use, we are often working with a limited supply of frozen eggs, and in that case, we would opt for IVF, which has a higher success rate than artificial insemination.
Pregnancy for Same-Sex Couples
Male couples require three participants to achieve a pregnancy: the sperm donor, an egg donor, and someone to carry the baby. Fertilization can be achieved through artificial insemination if the egg donor and surrogate are the same woman, but if they are two different women, we would need to perform IVF.
On the other hand, IVF allows both women in a female couple to participate in the pregnancy. One woman would donate the egg to become the biological mother, and the other would carry the baby as the birth mother.
At AZCREI, about 2 of 3 of our patients will get pregnant on the first try using in vitro fertilization; it’s an amazing solution that offers women and couples the chance to finally have a baby. To make an appointment and learn more about in vitro options, visit AZCREI online or call us at 520-326-0001.