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For further information, see CMDT Part 20-09: Infertility
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Assisted reproductive technologies (ART) may benefit
Couples who have not responded to traditional infertility treatments
Those with occlusive tubal disease, severe endometriosis, oligospermia, and immunologic or unexplained infertility
Age is an important determinant of success
In the past, about one-third of IVF pregnancies have been multiple
At present, for women < 35 years old, over 50% of embryo transfers resulted in live births
The rate for women > 40 years old is 7.9%
Current assisted reproductive procedures
Increase chances of a multiple gestation pregnancy (ie, twins, triplets), increasing the risk of preterm delivery and other pregnancy complications
However, the increasing use of single embryo transfer has resulted in far fewer multiple births from ART
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All procedures involve ovarian stimulation to produce multiple oocytes, oocyte retrieval by transvaginal ultrasound-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, which allows fertilization with a single sperm, is used in two-thirds of IVF procedures in the United States