In vitro fertilization (IVF) is a technique of medically assisted procreation. It is aimed at parents who have lived together for at least two years and fail to conceive despite regular sexual activity. It consists of artificial fertilization performed in a test tube by combining a sperm (male gamete) and egg (female gamete). The embryo, at a minimum of stage 4 or 8, is then implanted in the uterine cavity. The success rate of this procedure is about 25%. This technique is used after the identification of the cause of infertility in case there are problems in the fallopian tubes in women, or sperm abnormalities in men. The technique may also be used after several failed attempts at intrauterine inseminations.
Infertility manifests itself by difficulties or the inability of a couple to conceive a child.
The diagnosis of infertility for a couple is necessarily made before considering this kind of medical assisted reproduction technique. Tests to investigate the cause of the failure are done: hormonal balance, examination of the female genital tract by pelvic ultrasound or hysterosalpingography (study of the uterus and fallopian tubes), and a study of sperm in men.
In vitro fertilization is performed in three stages, namely:
- stimulation of the ovaries by hormone treatment. This allows multiple ovarian follicles to grow and, after the use of a drug triggering ovulation, to retrieve oocytes by follicular puncture under general anesthesia;
- an insemination test: semen is collected by masturbation and kept, and the most mobile sperm are collected and placed in contact with the oocyte;
- the placement of one or two embryos into the uterus through the vagina.
Upon approval of the parents, the unused embryos are frozen. They may, if necessary, be implated later into the mother's womb.
In some cases, the direct implantation of sperm into the oocyte is performed: this is in case attempts at conventional IVF have failed, or if there is a case of azoospermia
(the near complete absence of sperm in a puncture sample of the testis).
To increase their chance of getting pregnant, a couple should have regular sexual intercourse around the time of ovulation, an average of 14 days before the beginning of the next menstrual cycle. Stopping the use toxic substances such as tobacco, alcohol or drugs is also recommended as they have adverse effects on fertility.