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Key Features

  • Couples who have not responded to traditional infertility treatments may benefit from in vitro fertilization (IVF)

  • Age is an important determinant of success

    • For couples younger than age 35, the average pregnancy rate is 37% per cycle

    • The rate for women aged 43–44 is 4%

    • About one-quarter of IVF pregnancies have been multiple

  • Current assisted reproductive procedures increase chances of a multiple gestation pregnancy (ie, twins, triplets), imposing the risk of preterm delivery and other pregnancy complications

Clinical Findings

Diagnosis

Treatment

  • All procedures involve ovarian stimulation to produce multiple oocytes, oocyte retrieval by transvaginal sector scan-guided needle aspiration, and handling of the oocytes outside the body

  • With IVF, the eggs are fertilized in vitro and the embryos transferred to the uterus. Extra embryos may be cryopreserved for subsequent cycles

  • Intracytoplasmic sperm injection allows fertilization with a single sperm, which is helpful in the setting of severe oligospermia or obstructive azoospermia

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