In vitro fertilization (IVF) is the most common type of assisted reproductive technology (ART), used to create an embryo by bypassing certain causes of infertility, such as mild sperm abnormalities in men, and fallopian tube or ovulation irregularity in women.

During IVF, a woman’s eggs are surgically retrieved and then fertilized in a laboratory by mixing with a partner (or donor’s) sperm. The fertilized egg, or embryo, is left to grow for two to five days and is then surgically transferred back into the woman’s womb.

In general, patients will seek advice from a fertility doctor after one year of trying unsuccessfully to get pregnant. The chances of a fertile couple conceiving a child in any given month (called the natural pregnancy rate) are around 20%; resulting in roughly ninety percent of couples becoming pregnant after one year of trying to conceive.

It’s recommended that the remaining 10 percent of couples consult a fertility specialist. In particular, women over thirty are encouraged to undergo a fertility treatment evaluation, after six months of attempting to conceive. And it may be beneficial for women over forty to meet with a fertility doctor shortly after deciding to try and have a child.

There are a number of factors involved in determining if a patient is suitable for IVF treatment. Appropriate candidates often include couples who may experience:

Low sperm counts.
Endometriosis.
Problems with the uterus or fallopian tubes.
Ovulation disorders.
Sperm was unable to penetrate or survive in the cervical mucus.
Other health or unexplained reproductive issues.

Because the IVF process bypasses the fallopian tubes (it was originally developed for women with blocked or missing fallopian tubes), it is the procedure of choice for those with fallopian tube issues, as well as for such conditions as endometriosis, male factor infertility, and unexplained infertility. A physician can review a patient’s history and help to guide them to the treatment and diagnostic procedures that are most appropriate for them.

While some research suggests a slightly higher incidence of birth defects in IVF-conceived children compared with the general population (4 – 5% vs. 3%), it is possible that this increase is due to factors other than IVF treatment itself.

It is important to recognize that the rate of birth defects in the general population is about 3% of all births for major malformations and 6% if minor defects are included. Recent studies have suggested that the rate of major birth defects in IVF-conceived children may be on the order of 4 to 5%. This slightly increased rate of defects has also been reported for children born after IUI and for naturally-conceived siblings of IVF children, thus it is possible that the risk factor is inherent in this particular patient population rather than in the technique used to achieve conception.

Research indicates that IVF-conceived children are on par with the general population in academic achievement as well as with regards to behavioral and psychological health. More studies are underway to further investigate this important issue.

Compared with the general population, women who have never conceived appear to have a slightly increased risk of ovarian cancer (about 1.6 times the rate). Because it is thought that many of these women have also used fertility medications, it has been hypothesized that a link might exist between fertility medications and this particular cancer. A number of studies have been conducted since 1992 when this concern was first raised. None have found an association between fertility medications and a higher risk of ovarian or between IVF treatment itself and a higher risk of ovarian cancer. Preliminary results from an ongoing National Institutes of Health study likewise suggest no association between fertility medications and ovarian, uterine or breast cancer.

It is possible that this association is due not to the use of fertility medication, but to the fact that this population of women has never undergone childbirth. Findings from the National Institutes of Health and others suggest that pregnancy or some component of the childbearing process may, in fact, protect directly against ovarian cancer.