2. WHAT IS IVF?
In vitro fertilization (IVF) is a process by which egg cells are manually fertilized by sperm outside of the womb. IVF is a major treatment in infertility when other methods of assisted reproductive technology (ART) have failed. With IVF, you can use any combination of your own eggs and sperm and donor eggs and sperm. The first test tube baby, Louise Brown, was born in

3. Why It Is Done In vitro fertilization may be a treatment option if:
A woman's fallopian tubes are missing or blocked.
A man has low sperm counts.
Unexplained infertility has continued for a long time.
A couple wants to test for inherited disorders before embryos are transferred.

4. What is involved with in vitro fertilization?
There are 5 basic steps in the IVF and embryo transfer process which include the following:
Monitor and stimulate the development of healthy egg(s) in the ovaries.
Collect the eggs.
Secure the sperm.
Combine the eggs and sperm together in the laboratory and provide the appropriate environment for fertilization and early embryo growth.
Transfer embryos into the uterus.

5. STEP 1
Step 1: Fertility medications are used to control the timing of the egg ripening and to increase the chance of collecting multiple eggs during one of the woman's cycles (referred to as ovulation induction). Multiple eggs are collected because some eggs mightn't be developed or are unable to fertilize. Egg development and hormone levels are monitored using ultrasounds and blood tests.

6. STEP 2
Step 2: Through a minor surgical procedure using ultrasound, a hollow needle is guided through the pelvic cavity to retrieve the eggs. Sedation and local anesthesia are provided to remove any discomfort during the experience. The eggs are removed from the ovaries using the hollow needle, which is called follicular aspiration.

7. STEPS 3 & 4
Step 3: Sperms, usually obtained by ejaculation are prepared to be combined with the eggs.
Step 4: The sperm and eggs are placed in laboratory incubators which enable fertilization to occur. This process is called insemination. In cases where fertilization is suspected to be low, intracytoplasmic sperm injection (ICSI) may be used. In this procedure, a single sperm is injected directly into the egg in an attempt to achieve fertilization. Once fertilization and cell division occurs, the fertilized eggs are considered embryos.

8. STEP 5
Step 5: The embryos are transferred into the woman's uterus anywhere from one to six days later (usually 2- 3 days following egg retrieval). At this point, the fertilized egg has divided to become a two-to-four cell embryo. The transfer process involves a speculum which is inserted into the vagina to expose the cervix. A number of embryos are suspended in fluid and placed through a catheter into the womb. This process is often guided by ultrasound.

9. Are there variations of in vitro fertilization?
1) Gamete intrafallopian transfer (GIFT) is similar to IVF, but the gametes (egg and sperm) are transferred to the fallopian tubes rather than the uterus, and fertilization takes place in the tubes rather than in the laboratory. GIFT also involves a laparoscopic surgical procedure to transfer the sperm and egg into the tubes.
2) In zygote intrafallopian transfer (ZIFT) the fertilization process still takes place in the laboratory. It is similar to GIFT in that the fertilized egg is transferred into fallopian tubes, and it involves a laparoscopic surgical procedure.

10. How successful is in vitro fertilization?
The success rate of IVF clinics depends on a number of factors including patient characteristics and treatment approaches. In the United States, the live birth rate for each IVF cycle started is approximately:
30 to 35% for women under age 35
25% for women ages 35 to 37
15 to 20% for women ages 38 to 40
6 to 10% for women ages over 40
*NOTE* : that pregnancy rates do not equate to live birth rates.

11. What are the risks associated with in vitro fertilization?
The risks of in vitro fertilization depend upon each specific step of the procedure.
Ovary stimulation carries the risk of hyperstimulation, where the ovaries become swollen and painful. This condition, "Ovarian Hyper stimulation Syndrome", is usually rare, mild, and involves the following potential side affects: nausea, vomiting, lack of appetite, or a feeling of being bloated. More severe symptoms which occur in 1% of cases, include the following:
Severe abdominal pain
Severe nausea or vomiting
Decreased urinary frequency
Dark-colored urine
Shortness of breath
Ten pound weight gain within three to five days

12. What are the risks associated with in vitro fertilization?
Egg retrieval and the use of laparoscopy carry the typical risks related to anesthesia. There is also a slight risk of bleeding, infection, and damage to the bowel, bladder, or a blood vessel. A very small percent of patients would require surgery to repair these damages.
The chance of a multiples pregnancy is increased in all assisted reproductive procedures. This also increases the risk of premature delivery.
Assisted reproductive technology (ART) involves a significant physical, financial, and emotional commitment on the part of the couple, causing psychological stress.

13. Ethics
Issues
In a few cases, laboratory mix-ups (misidentified gametes, transfer of wrong embryos) have occurred, leading to legal action against the IVF provider and complex paternity suits.
Pregnancy past menopause
Although menopause is a natural barrier to further conception, IVF has allowed women to be pregnant in their fifties and sixties. Therefore, they have an emotional link with the child through pregnancy and childbirth.
Religious objections

14. THANK YOU