IVF (in vitro fertilisation) is a fertility treatment where the eggs are gathered from a woman's ovaries and fertilised with a man's sperm in a laboratory. The fertilised egg (embryo) is then placed back into the woman's womb. In vitro is the latin term for “in glass” which is where the term “test tube” baby derives from. In reality, the fertilisation usually takes place in a culture dish rather than a test tube. The first IVF baby was born in 1978, and since then thousands of babies have been born worldwide following IVF treatment.
The main advantage of IVF is that it gives those who have previously been unable to conceive the opportunity to have a child. IVF can be successful for women who have had fertility problems such as blocked or damaged fallopian tubes, or where there has been a problem with the male's sperm. IVF can also help couples who have not had a problem identified, but have been unable to conceive for three years. IVF may also be successful for couples who have previously been unsuccessful in other fertility treatments.
The success rate for couples conceiving a child by IVF is 25.2%. In 2009, there were 12,714 IVF births and recent figures from the HFEA have shown that one in every eighty births in the UK are IVF babies.
IVF is now more accessible as treatment is available on the NHS and accounts for 25% of IVF treatment. In order to qualify for NHS treatment, women need to be aged between 23 and 39 years of age, have an identified fertility problem, or have been unable to conceive for three years.
IVF can also be beneficial to couples who have a family history of a genetic disease. If one or both of the couple are a carrier for a known disease, screening of the eggs or sperm can be undertaken during the IVF process. At present, there are over 100 known disorders for which screening is available.
Availability of IVF treatment on the NHS varies between NHS primary trusts, and many women may only be eligible for one round of treatment, and it may not be available for others. If undertaken privately, one cycle of IVF treatment can cost from £3,000 - £5,000. In addition to this cost, a couple will also have to pay for tests, medicines and all their consultation costs. There are also other procedures which will be charged for separately such as the freezing and storage of the embryos.
IVF raises the chance of a woman conceiving more than one child in a single pregnancy. The incidence of carrying twins, or triplets or even more is known as a multiple pregnancy and this is a risk which is associated with IVF. The risks associated with multiple births are high, risking the health of both the mother and unborn babies. The Human Fertilisation and Embryology Association (HFEA) have declared these types of pregnancies as a major risk to health associated with IVF treatment. The HFEA have requested that fertility clinics limit the number of embryos used in IVF treatment, recommending that only one embryo should be used for each IVF cycle. On average, the chance of having twins from a natural conception is 1 in 80, compared with 25% of all IVF births. However, following the HFEA recommendations, this figure dropped to 22% in 2009, and a new target of 15% has been set.
Other complications can include increased risk of Ectopic Pregnancy. This is where the embryo implants outside of the uterus and onto the side of the fallopian tube, or occasionally the ovary.
Drugs used in IVF to encourage the creation and growth of eggs can sometimes cause a rare, but critical condition known as Ovarian hyper-stimulation syndrome.(OHSS). This can affect around 5% of IVF patients, with only 1-2% having severe symptoms. The patient is constantly monitored under IVF, so any signs of this condition are likely to be detected at an early stage.