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In vitro fertilization

Author
Richard Paulson, MD
Section Editor
Robert L Barbieri, MD
Deputy Editor
Kristen Eckler, MD, FACOG

INTRODUCTION

In vitro fertilization (IVF) refers to a procedure designed to overcome infertility and produce a pregnancy as a direct result of the intervention. In general, the ovaries are stimulated by a combination of fertility medications and then one or more oocyte(s) are aspirated from ovarian follicles. These are fertilized in the laboratory ("in vitro"), after which, one or more embryo(s) are transferred into the uterine cavity. These steps occur over about a two-week interval of time, which is called an IVF cycle.

The first pregnancy after the fertilization of a human egg in vitro and the first birth from an in vitro-fertilized embryo were reported in 1976 and 1978 [1,2]. Since then, more than five million pregnancies have been achieved worldwide by IVF and its modifications (table 1), known generically as assisted reproductive technologies (ARTs). As experience has accumulated, success rates have increased, and the indications for these procedures have expanded, ART now accounts for 1 to 3 percent of live births in the United States and Europe.

PATIENT SELECTION

Fertility issues — A complete infertility evaluation should be performed on both partners prior to embarking on IVF. (See "Causes of female infertility" and "Evaluation of female infertility" and "Evaluation of male infertility".)

The initial experience with IVF involved women with tubal disease that could not be surgically corrected. With its efficacy established, IVF has been made available to women with other causes of infertility, including one or more of the following:

Tubal factor (IVF is primary therapy if tubes are completely blocked)

                                                   

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Literature review current through: Nov 2016. | This topic last updated: Sun Dec 04 00:00:00 GMT+00:00 2016.
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References
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