IVF (In vitro fertilisation) is an assisted reproductive technology in a process by which egg and sperm are fertilized outside the body and then placed in a woman’s uterus after fertilisation. It usually involves the removal of eggs from the woman’s ovary and the collection of sperm from a male. The embryo, which results from fertilisation in the laboratory, is transferred to the woman’s uterus about two to five days later. At this stage, long before any organs have formed, it is still visible to the naked eye and consists of only a few cells.
IVF has had huge publicity and has gained a false reputation as the solution for infertility. In practise, it is one of the most demanding of all procedures in reproductive medicine and is the least successful compared to some alternatives. Strictly speaking, IVF is not even a “treatment” for infertility as it does not alter the underlaying cause of infertility. It is simply an attempt to help someone who is infertile to have a baby, the attempt can be repeated several times, but the basic cause of infertility remains. Although IVF does not change the underlaying cause of fertility, it is best where possible to seek therapy which may improve the chances of becoming pregnant naturally. But there is no doubt that IVF has revolutionized the treatment of infertile people and increased our knowledge about many aspects of what initially causes infertility.
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In vitro fertilisation means literally “fertilisation in glassware” (from the Latin word vitrum), even though glassware is hardly ever used in IVF clinics because of the need for absolute cleanliness and the impossibility of washing glass thoroughly enough. For this reason, doctors prefer to use disposable containers and equipment which are used once and then thrown away.
IVF is often confused with artificial insemination (AI) which is completely different. Artificial insemination refers to conception that does not take place by sexual intercourse. It involves a doctor or nurse placing sperm directly into a woman’s vagina or uterus with a syringe or some other artificial method; fertilisation then occurs in the woman’s fallopian tube in the natural way.
It is important to realize that IVF is not always the ideal treatment for most infertility patients and certainly it should not be the first option to be considered. More that half the women referred to IVF clinics could be better treated by alternatives. Too frequently no systematic assessment of the medical condition of the patient is made in the early stages. There is a real need for referring GP’s to make better judgements as to wether a patient would most benefit from IVF treatment or consider other alternatives. Often patients themselves push for IVF when there may be a more suitable, possibly cheaper, treatment.
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