In Vitro Fertilization (IVF): What Is It, And How Does It Work?

An illustration depicting intracytoplasmic sperm injection (ICSI), a type of IVF.

As millions of people around the world struggle with conceiving a child due to fertility issues, there is one treatment that gives hope for those people. Created in 1978, in vitro fertilization, commonly known as IVF, is an extremely well-known and successful reproductive treatment that has allowed millions of women to conceive despite health issues. 

What Is IVF?

IVF is a medical procedure that assists in the conception of a child by manually combining eggs and sperm outside of the body, typically in a laboratory. Itʼs part of a broader genre of medicine called assisted reproductive technologies (ART). However, IVF is the most commonly known and used ART. In vitro fertilization got its name because “in vitro” means “in glass” in Latin, which refers to its history of combining the egg and sperm in glass dishes. 

Once the eggs are fertilized with the sperm to form embryos, they are inserted into the uterus of the mother or a surrogate, with the hope of achieving pregnancy.

How Does IVF Work?

The first stage of IVF is known as the Ovarian Stimulation Stage. In order to begin the process of IVF, the woman whose eggs are to be used in the process takes fertility medicine for 8-14 days to stimulate her ovaries into producing multiple eggs instead of the single egg that develops monthly. After that, hormone injections such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are rejected into the woman. This is one of the most crucial steps to ensure success.

After that, when the eggs finally mature, they are collected through a minor, minimally invasive procedure called follicular aspiration. This procedure is relatively simple: a needle is inserted through the vaginal wall and is guided by ultrasound to extract eggs from the ovarian follicles. 

After the eggs are finally extracted, a sperm sample from the father is collected. Then, the sperm and eggs are combined manually on a lab dish to stimulate fertilization. At this stage, different methods are used for fertilization. In some cases, a single sperm is directly injected into the egg through a process called intracytoplasmic sperm injection (ICSI), particularly in cases of male infertility. Other times, the sperm and eggs are left to naturally fertilize. 

Then, the fertilized eggs, now referred to as embryos, are left to culture naturally, as embryologists observe their growth to ensure that the best quality embryos are selected to transfer to the woman. 

After the embryologist determines which embryos have the highest quality and thus the most likely to develop successfully, one or more embryos are transferred into the uterus with a thin catheter. This is where the stage of pregnancy truly begins. This procedure is relatively painless for most women, but some may experience mild cramping afterwards. 

What Is The Purpose of IVF?

IVF is oftentimes a last-case scenario for those struggling with fertility issues. These issues could spring from a couple of reasons, including blocked or damaged fallopian tubes, endometriosis, and low sperm count for the male. Compared to other fertility treatments, IVF has a high success rate. In the United States, the average success rate per IVF cycle for women aged 35 or under is about 40%, but that number decreases to under 10% for women over the age of 42.

The success of an IVF cycle changes based on different factors. First, age is an incredibly important factor. As mentioned earlier, women under 35 have the highest rates of conceiving, but it decreases significantly by the time they reach 40. Second, the cause of infertility is also an important reason, as women with lower egg counts and men with lower sperm counts decrease the chances of success. The quality of eggs and sperm is oftentimes impacted by lifestyle patterns—such as weight, smoking, and drinking—with bad lifestyle habits significantly decreasing quality.

What Are the Barriers of IVF Treatment?

One important barrier of IVF treatment is the risks and side effects that come with it. Sometimes, if the medical procedures of IVF go awry, it can reduce existing fertility and cause intense pain. For example, when a client receives fertility drugs, they might have an excessive bodily reaction to it. This is known as Ovarian Hyperstimulation Syndrome (OHSS), which leads to swollen, painful ovaries that cause severe abdominal pain.

Furthermore, IVF can be a difficult method to pursue with financial constraints. In the U.S., a single IVF cycle costs, on average, between $12,000 and $20,000. Even worse, many American insurance plans donʼt even cover IVF, although some cover the costs partially or even fully, depending on state laws. 

However, this can change overseas. Some countries like Israel and Switzerland, among many others in Europe, cover or subsidize the costs associated with IVF as part of the national healthcare coverage or to increase birth rates in their countries. 

Wrap-Up

IVF has become safer with recent innovations in the field of fertility treatments. These advances include time-lapse embryo monitoring, which allows embryologists to monitor the embryos 24/7 with minimal disruption so that they can select the best ones.

Although IVF is one of the most successful and significant medical advances in the landscape of reproductive issues, there are still many significant challenges, such as cost, that those using IVF have to face. Regardless, from the initial collection of eggs to the final injection, in vitro fertilization has allowed millions of couples to conceive successfully. Hopefully, as science advances through the 21st century, IVF will become more accessible, successful, and efficient for those looking to start a family.