In Vitro Fertilization (IVF) typically begins with ovarian stimulation. The patient’s ovaries are stimulated with drugs that cause many follicles to develop. The eggs in these follicles are then matured, removed, and fertilized with sperm in the laboratory.
Next, the fertilized embryos are grown in carefully controlled laboratory conditions until they are ready to be returned to the woman’s uterus.
At that time, the embryos are evaluated under a microscope, and the best embryo is carefully transferred to the uterus.
Any remaining viable embryos may be frozen for later use.
In Vitro Fertilization is a very versatile procedure. The eggs may come from the intended parent or an egg donor. The sperm may come from an intended parent or a sperm donor. The embryos may be transferred to the uterus of an intended parent or a gestational carrier who carries the pregnancy for the parent(s), if necessary.
IVF can be attempted using either fresh or frozen embryos. IVF has successfully been used to provide children to women with no male partner, men with no female partner and same-sex couples.
IVF also allows the option of pre-implantation genetic diagnosis (PGD) in order to reduce the risk of having children with genetic diseases or PGT-A, a testing procedure which looks for abnormalities in the chromosomes’ number and position.
About Maternal and Paternal Age Infertility
When the clock starts running
Maternal Age and Infertility
Over the past several decades, social and demographic trends have led to an increased tendency for women to delay childbearing. In women between the ages of 35 and 39 the number of first births increased by over 35% between 1991 and 2001; the rate among women 40 to 44 years of age rose by 70%. Due primarily to abnormalities in the oocyte and resulting embryonic chromosomal anomalies, implantation, clinical pregnancy, and live birth rates decline sharply during the third and fourth decades.
As a result, the incidence of age-related infertility has increased. Improved awareness of the effects of aging on fertility combined with ovarian reserve assessment, patient education, and early infertility evaluation and intervention are important elements in appropriate family planning and prevention of age-related infertility. However, women older than 35 now have many new options available, including advances in fertility treatments such as in vitro fertilization, oocyte donation, oocyte freezing, embryo adoption and gestational surrogacy.
Comprehensive chromosomal screening of blastocysts can help to decrease the risk of the most common chromosomal abnormalities. Women interested in pursuing fertility later in life may benefit from the care of a fertility physician who can provide the most advanced treatment options to result in the highest pregnancy rates; lowest waiting time to pregnancy; as well as to address important issues such as chromosomal anomalies.
Paternal Age and Infertility
Although delaying fatherhood has become somewhat more popular, the heritable sequelae of this practice are not well understood. Advancing paternal age has, however, been implicated in numerous abnormal reproductive outcomes, including poorer semen quality, reduced fertility, and more frequent spontaneous abortions.
Men who choose to delay fatherhood may be less likely to experience a successful pregnancy.
Unlike older women, however, older men do not seem to be at increased risk of trisomy 21 (e.g., Down’s syndrome). Semen quality does not reflect the presence of genomic damage to sperm. Comprehensive chromosomal screening of blastocysts can help to decrease the risk of the most common chromosomal abnormalities.
Men interested in pursuing fertility later in life may benefit from the care of a fertility physician who can provide the most advanced treatment options to result in the highest pregnancy rates; lowest waiting time to pregnancy; as well as to address important issues such as chromosomal anomalies of sperm.
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