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In vitro fertilization (IVF) has become a common procedure that is performed in hundreds of clinics around the world. IVF involves removing eggs from a woman, fertilizing them in a laboratory, and then returning the fertilized eggs to the woman's womb.

Before the actual IVF procedure can be performed the woman will be given a series of hormone shots and will be required to take a variety of fertility drugs. This will encourage multiple eggs to be produced. These drugs often need to be taken for several months before the eggs are to be harvested. The more eggs that can be harvested at one time, the greater the chances of a successful outcome.

The Eggs are usually harvested via a laparoscopic incision or via transvaginal ultrasound-guided egg retrieval.

• During a laparoscopy, an incision is made in the abdomen and a needle is inserted to retrieve the eggs. This is a surgical procedure, and as such there is the risk of surgical complications.
• In a transvaginal ultrasound procedure, the woman is given intravenous sedatives or will be put under general anesthesia. After which, a needle that is attached to an ultrasound wand is inserted into the vagina. Using the ultrasound as a guide, the doctor directs the needle to the ovaries and pushes the needle through the follicles and aspirates follicular fluid into the needle. The needle is removed and the fluid is taken to the lab where the eggs are extracted.

Sperm can be provided by the woman's mate or by a donor.

• The sperm is collected by having the man ejaculate into a sterile container. The only advance preparation that he must take is that he should refrain from ejaculating for a couple of days before he makes his donation.
• In cases where the male can not ejaculate sperm due to a blockage (such as from a vasectomy), the sperm can be surgically removed. Sperm aspiration is a microsurgical technique. A needle is inserted through a small incision in the scrotum and immature sperm is aspirated from the epididymis. The immature sperm is then treated with enzymes that will allow it to mature before being introduced to the eggs.

The egg is then placed in a petri or culture dish and the sperm is introduced into the dish and allowed to fertilize the egg.

• The procedure takes place inside an incubator.
• If multiple eggs are fertilized, it is possible to have the additional embryos frozen for later implantation.

When the cells begin to divide, one or more fertilized eggs are then planted in the woman's womb.

• The eggs (usually 3-4) are ejected into the uterus via a thin catheter that is inserted through the vagina.

• The woman will be required to take additional hormonal treatments for a couple of weeks to help enhance the chances of successful implantation.

• If one or more of the eggs successfully attach themselves to the womb, the woman can expect to experience a normal pregnancy.

• When three or more eggs are successfully implanted, there may be a need for a pregnancy reduction to be performed. This will help minimize the risks, to both mother and fetuses, that a high number multiple pregnancy can cause.

Each couple needs to be evaluated individually to gage their candidacy for IVF. However, on average:

• The woman should be under 35 years old. The younger the woman, the greater the chances of success.
• She should have a regular menstrual cycle.
• She should respond well to egg stimulating hormones
• The male needs to have good sperm volume and mobility.
• The couple also needs a good funding source, especially if the procedure is not covered by their insurance. According to the American Society For Reproductive Medicine, in 1993 one cycle of IVF treatments cost about $8,000!

The success of an IVF procedure depends upon a number of factors, as well the rates vary from clinic to clinic.

• Approximately 10-20% of all infertile women are unable to produce harvestable eggs.
• When eggs can be harvested, about 60-80% of them will be successfully fertilized. Of those, only about 30-35% will be successfully implanted, resulting in a pregnancy.
• When a pregnancy does occur, there is still a possibility of a miscarriage or an etopic pregnancy occurring.
• If the procedure fails, it can be repeated.