Fertility Infertility Issues

Tens of millions of babies are conceived every year by parents who don’t want them. Thus, it is saddening and frustrating when a couple that is desperate for a child to call their own cannot conceive by nature means. Statistics suggest that roughly 6.1 million people in the United States struggle with infertility. However, advances in medical science that have taken place in the past few decades have made it possible for many of these people to conceive.

Specialists now have methods to restore fertility and various technologies to assist in reproduction. Assisted reproductive technology (ART) has revolutionized the treatment of fertility and is responsible for thousands of births in the United States each year. In vitro fertilization (IVF) is one of the most common and most effective ART techniques.

The first successful IVF birth in the United States was in 1981. Since this initial success, it has been estimated that more than 250,000 babies have been born as a direct result of in vitro fertilization. Louise Brown was the very first baby conceived via IVF. She was born in England and died in 2003 at the tender age of 25.

Children conceived using IVF have often been referred to as “test tube babies” because of the rather clinical way in which they are created. The in vitro process includes harvesting mature eggs from a female and fertilizing them with a man’s sperm in a laboratory dish. The eggs are surgically removed from a woman’s ovary with the guidance of ultrasound (I don’t think I need to explain how the sperm are “harvested”). The eggs will sit for 40 hours before being examined to see if fertilization has taken place and to ensure that they are properly dividing into cells. The eggs, which have now been promoted to embryos, will be incubated and observed for several days.

Three to five days after the embryos are fertilized, they are implanted in the uterus where they will develop naturally as any other fetus would. This technique completely rules out any need for the fallopian tubes where the fertilization process would normally take place. Typically, 2-4 embryos are placed in a woman’s uterus at a time. This increases her chance of becoming impregnated, but also increases the risk of multiple pregnancies, which can result in complications. Of all the women who give birth as a result of in vitro fertilization, 63% are single births, 32% are twins, and 5% are triplets or more. Each attempt at implanting embryos is called a cycle.

IVF is often the first technique that experts suggest, especially if infertility stems from problems with a woman’s fallopian tubes. If the fallopian tubes, which are vital to reproduction, are severely damaged, blocked or entirely absent, in vitro fertilization may be the answer. Endometriosis, cervical factor infertility, male factor infertility, ovulation disorders and unexplained fertility are other instances in which IVF is often used. Only about 5% of infertile couples utilize IVF techniques.

The success rates of this procedure are similar to that of natural pregnancies: 37% among women less than 35 years of age, 28% for women aged 36-39, and roughly 13% in women older than 40. Pregnancy is rare in women over the age of 44. The success rates of individual clinics providing in vitro fertilization are available on the Centers for Disease Control and Prevention web site. Miscarriage rates with IVF are also similar to natural pregnancies (about 20%). A serious condition requiring emergency medical care, called ectopic pregnancy occurs in about 3-5% of IVF patients. In an ectopic pregnancy, the embryo grows outside the uterus and does not survive.

There are some risks to any ART procedure, including multiple pregnancies, ovarian hyperstimulation syndrome, bleeding or infection, low birth weight and birth defects.

Ovarian hyperstimulation, in which the ovaries become swollen and painful, is one of the most commonly cited risks of IVF. Despite it’s common reference, the condition is actually rather rare and the side effects involved are usually mild. Possible side effects are nausea, vomiting, loss of appetite or a bloated sensation. In only 1% of cases, more severe symptoms occur, such as severe abdominal pain, severe nausea or vomiting, decreased urinary frequency, dark colored urine and shortness of breath. Severe cases can also be accompanied by a significant ten- pound weight gain over the course of only 3-5 days.

The process of egg retrieval and the use of laparoscopy that is sometimes involved with in vitro carries the normal risks associated with any anesthesia. Bleeding, infection and damage to the bowel, bladder or blood vessels can also occur during egg retrieval, but are rare. Less than one IVF patient of out 1,000 will need surgery to repair damage that occurred during the egg retrieval process.

Psychological stress and emotional problems are also often cited as a risk of in vitro fertilization. This is especially true in cases where the procedure is unsuccessful. IVF is generally considered to be one of the most stressful infertility treatments. To help avoid stress, patients are encouraged to educated themselves about the process, create a support network of family and friends and seek professional counseling. Other typical stress reducing techniques, such as relaxation and meditation, plenty of rest, exercise and proper nutrition are also advised.

Health risks and disappointment are not the only costs of IVF. Each cycle costs an average of $12,400 and many couples will have to endure more than one cycle in order to conceive.

However, for most in vitro patients, the stress and financial investment are well worth it. Besides the obvious benefit of a woman conceiving a child that is biologically related, there are a few other advantages to IVF. Before the introduction of IVF technologies, many women underwent surgery on their fallopian tubes in an attempt to restore fertility. Thanks to IVF, more invasive surgeries such as these have been cut in half.

If infertility stems from a partner’s inability to produce eggs or sperm, donors or even a frozen embryo can be used. A woman who has a genetic disease which may be passed on to her baby may also choose to utilize donated eggs via in vitro fertilization techniques. IVF also makes it possible for single women to become pregnant with the use of sperm donors.

Studies suggest that in vitro fertilization is a safe procedure, which results in the creation of a child that is as healthy as those conceived naturally. However, some studies have suggested that children conceived through assisted reproduction are at an increased risk for genetic disorders.

Information contained in this article was obtained from the following sources:
The American Pregnancy Association