Clinical Evaluation For The Use Of In Vitro Fertilization (IVF) In Infertile Patients Indications, Methods, and Results

Abstract

In vitro fertilization is often the only successfuf treatment. IVF treatment comprises s•everal key procedures. After assessment and pretreatment, if necessary, the woman is given a course of hom10ne therapy designed to • stimulate the development of multiple follicles in her ovaries. The eggs which ripen (ideally at least three) are removed from the follicle by aspiration at laparoscopy, or nori-laparoscopically using ultrasound control. They are then fertilized in a test-tube or dish using her husband's sperm. The embryo that develops from each egg is cu.ltured for 1-2 days in culture medium at 37C. Those embryos whose cells appear to divide normally are replaced into the uterus. When possible, three embryos are replaced simultaneously(26).

The number ofripe eggs which can be recovered from the ovaries is a major factor limiting the outcome of IVF. Success rates increase dramatically if multiple embryos are replaced in the uterus. Since either ovary produces only one ripe egg in a s'pontaneous menstrual cycle, the follicular phase before IVF must be supplemented . with exogenous hormones in order to stimulate the number of eggs which develop for collection. To appreciate the underling strategies involved in successful "superovulation", it is necessary _first to consider how preovulatory follicular development is regulated in a spontaneous ovarian cycle(26).