Infertility, Assisted Reproductive Technologies

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 over age 43 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

• See Infertility, Female

Diagnosis

• See Infertility, Female

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