In vitro fertilization (or fertilization; IVF) is a process by which an egg is fertilized by sperm outside the body: in vitro (“in glass”). The process involves monitoring and stimulating a woman’s ovulatory process, removing an ovum or ova (egg or eggs) from the woman’s ovaries and letting sperm fertilise them in a liquid in a laboratory. The fertilised egg (zygote) is cultured for 2–6 days in a growth medium and is then implanted in the same or another woman’s uterus, with the intention of establishing a successful pregnancy.
The first successful birth of a "test tube baby", Louise Brown, occurred in 1978. Louise Brown was born as a result of natural cycle IVF where no stimulation was made. Robert G. Edwards, the physiologist who developed the treatment, was awarded the Nobel Prize in Physiology or Medicine in 2010.
IVF may be used to overcome female infertility where it is due to problems with the fallopian tubes, making fertilisation in vivo difficult. It can also assist in male infertility, in those cases where there is a defect in sperm quality; in such situations intracytoplasmic sperm injection (ICSI) may be used, where a sperm cell is injected directly into the egg cell. This is used when sperm has difficulty penetrating the egg, and in these cases the partner’s or a donor’s sperm may be used. ICSI is also used when sperm numbers are very low. When indicated, the use of ICSI has been found to increase the success rates of IVF.
IVF success rates are the percentage of all IVF procedures which result in a favourable outcome. Depending on the type of calculation used, this outcome may represent the number of confirmed pregnancies, called the pregnancy rate, or the number of live births, called the live birth rate. The success rate depends on variable factors such as maternal age, cause of infertility, embryo status, reproductive history and lifestyle factors. Maternal age: Younger candidates of IVF are more likely to get pregnant. Women older than 41 are more likely to get pregnant with a donor egg. Reproductive history: Women who have been previously pregnant are in many cases more successful with IVF treatments then those who have never been pregnant. Due to advances in reproductive technology, IVF success rates are substantially higher today than they were just a few years ago.
The live birth rate is the percentage of all IVF cycles that lead to a live birth. This rate does not include miscarriage or stillbirth and multiple-order births such as twins and triplets are counted as one pregnancy. A 2012 summary compiled by the Society for Reproductive Medicine which reports the average IVF success rates in the United States per age group using non-donor eggs compiled the following data.
The major complication of IVF is the risk of multiple births. A risk of ovarian stimulation is the development of ovarian hyper-stimulation syndrome, particularly if hCG is used for inducing final oocyte maturation. This results in swollen, painful ovaries. Ectopic pregnancy may also occur if a fertilised egg develops outside the uterus, usually in the fallopian tubes and requires immediate destruction of the foetus.
The answer is no. There has been a lot of research and no significant birth defects have been seen in children born using IVF compared to normal unassisted pregnancy.
The main potential factors that influence pregnancy (and live birth) rates in IVF have been suggested to be maternal age, duration of infertility or subfertility, bFSH and number of oocytes, all reflecting ovarian function. Optimal woman’s age is 23–39 years at time of treatment. A triple-line endometrium is associated with better IVF outcomes. Biomarkers that affect the pregnancy chances of IVF include: