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In Vitro Fertilization (cont.)

Success Rate

Techniques for assessing the viability of an embryo when genetic issues are present are cell biopsy and evaluation and pronuclear biopsy and evaluation.

The pregnancy rate by age is similar to that of normally conceived pregnancies: 37% among women younger than 35 years and 28% for those aged 36-39 years. The success rate is about 13% in those older than 40 years. Pregnancy in women older than 44 years is rare.

The rate of miscarriages with IVF pregnancies is the same as that with normally conceived pregnancies. Ectopic pregnancy occurs in about 3-5% of cases. An ectopic pregnancy is a serious condition that requires emergency medical care. The embryo is growing outside the uterus and does not survive.

Egg and sperm donors

Donors may contribute the egg or the sperm (or even a frozen embryo) to an IVF program when a partner is not able to produce the egg or sperm.

  • Egg donation: Sometimes eggs are used from another woman if the recipient has impaired ovaries or has a genetic disease that could be passed on to her baby. The egg donor may be anonymous or known (such as a younger relative for an older woman or a designated donor). Ideally, the donor should be aged 21-30 years. The donor's eggs are removed the same way they are with IVF. The recipient takes increasing doses of estrogen to synchronize her hormone levels in preparation for the embryo transfer. Both the donor and recipient should talk with a counselor about the psychological aspects of this procedure. Everyone signs a consent form to cover the legal issues of such a donation. Success rates for this type of donation are higher than the rates with conventional IVF. The rate of multiple pregnancy is high, so doctors try to transfer only 2 embryos at one time.

  • Sperm donation: This can be routinely done for women whose male partners have impaired sperm or low sperm counts. Donation may be anonymous from a sperm bank. In some cases, a male partner may "bank" sperm if he anticipates problems with chemotherapy or other medical conditions that may affect his sperm later in life.

  • Embryo donation: Receiving a donor embryo (usually from a frozen embryo created in the laboratory from another couple) is the earliest form of adoption. The donor couple must sign an advance directive regarding embryo ownership and disposition. Those directives should include statements regarding (1) embryo donation to another couple, (2) donation of the embryos for research, or (3) disposition of the embryos after thawing.


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