In vitro fertilization indications

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

• Initially IVF was developed to overcome infertility due to problems of the fallopian tube, but it turned out that it was successful in many other infertility situations as well. The introduction of intracytoplasmic sperm injection (ICSI) addresses the problem of male infertility to a large extent. Thus, for IVF to be successful it may be easier to say that it requires healthy ova, sperm that can fertilize, and a uterus that can maintain a pregnancy. Cost considerations generally place IVF as a treatment when other less expensive options have failed.
• This means that IVF can be used for females who have already gone through pregnancy. The donated oocyte can be fertilised in a crucible. If the fertilization is successful, the fertilized egg will be transferred into the uterus, within which it will develop into an embryo.
• According to NICE guidelines, IVF is indicated in unexplained infertility for women that have not conceived after 2 years of regular unprotected sexual intercourse.^[1]

It should be considered as a treatment option for infertility in patients with following risk factors:

• Advanced age of the woman (advanced maternal age)
• Damaged or blocked fallopian tubes (can be caused by pelvic inflammatory disease or prior reproductive surgery)
• Endometriosis
• Male factor infertility, including decreased sperm count and blockage
• Unexplained infertility