Guide to Common Reasons for Choosing IVF

As your fertility journey starts to take shape, it can be very helpful to understand why parents choose IVF. The following guide will give you a rundown on the most common reasons for in vitro fertilization (IVF). 

What is IVF? 

In vitro fertilization (IVF) is one of the most common types of assisted reproductive technology (ART). It involves retrieving viable eggs that are fertilized outside the body, and then implanted into the lining of the uterus. An IVF cycle typically has these 5 steps: 

1. Pre-cycle fertility testing for women  
   Before treatment can begin, an exhaustive battery of testing is done to better understand how infertility is impacting your ability to conceive. 

2. Stimulation of the ovaries to produce several eggs during one menstrual cycle  
   A regimen of injectable medications is administered over a two-week period to induce the production of multiple eggs in one cycle. 

3. Retrieval of the eggs from each ovary  
   An outpatient surgical procedure is performed to extract the mature eggs from your ovaries. 

4. Fertilization of the eggs in a laboratory by either conventional fertilization or intracytoplasmic sperm injection (ICSI)  
   Your eggs will be fertilized by the provided sperm sample, and the resulting embryo watched over by an embryologist for about five days. 

5. Embryo implantation into the uterus  
   Once your embryos have adequately matured in the lab, there is another outpatient procedure to transfer an embryo into your uterus for implantation. 

6. Freeze embryos for future use 
   Embryos can be frozen and stored once they’ve reached adequate maturity. They can then be thawed at any point and used in a frozen embryo transfer (FET) 

How common is IVF? 

According to a report released by the US Society of Assisted Reproductive Technology (SART), one million babies were born between 1987 and 2015 through the use of IVF or other assisted reproductive technologies. It is estimated that births from IVF make up 1-2% of all births in the US annually. 

What are the most common reasons for IVF? 

Human reproduction is an incredibly complex process. There are lots of things that can throw a wrench in the works, medically speaking. As science advances, so does our understanding of the causes of infertility – not to mention our ability to overcome them. The following are some of the most common reasons parents choose IVF treatment. 

Blocked or damaged fallopian tubes 

Sometimes referred to as tubal factor infertility, damaged or blocked fallopian tubes will prevent the ovum from reaching the uterus for fertilization. There are many types of infections and diseases that can cause hydrosalpinx or scarring that can block your fallopian tubes. Among people who have ovaries, up to 30% will experience a blockage that impacts their fertility. Most will be asymptomatic until they try to get pregnant. 

Ovulation disorders 

There are a variety of medical conditions that can impact the production of the hormones necessary for ovulation, which will result in irregular or no ovulation at all. Here are a few of the most common causes of ovulation disorders: 

• Hormone imbalances like PCOS can impact egg production and ovulation. 
• Thyroid conditions impact hormone production, which in turn can impact fertility. 
• A history of eating disorders or substance abuse, chronic severe stress, or similar health problems can impact ovulation. 
• Pituitary adenomas, or benign tumors on your pituitary gland can impact the production of certain hormones necessary for ovulation. 

Endometriosis 

Endometriosis is a condition where tissue similar to that of the lining of the uterus implants or grows outside the uterus. The presence of this tissue can impact the function of your ovaries, uterus and fallopian tubes. Endometriosis can be difficult to diagnose. The most common symptom is much heavier blood flow during menstruation. 

Uterine Fibroids 

Uterine fibroids are benign fibrous growths in the uterus. They are most common in women in their 30s and 40s. Depending on the size and placement of the fibroid, it can interfere with implantation of the fertilized egg. Fibroids will cause more severe menstrual symptoms, especially cramping and heavier blood flow, but otherwise do not have any additional  symptoms. 

Previous tubal sterilization or removal 

Tubal ligation is a form of sterilization where the fallopian tube is cut or blocked. As the ovaries remain intact, it is still possible to conceive with assistance. Tubal ligation reversal surgery can repair the fallopian tube to allow you to get pregnant. However, IVF is an alternative to surgery that many with previous tubal sterilization opt for, as it is less invasive. 

Impaired sperm production or function 

If sperm count or density is low, or sperm movement is weak (poor motility), this will make it very difficult for fertilization to occur. This is often referred to as male factor infertility, and IVF is the best method for overcoming it, as it greatly decreases how far the sperm has to travel to reach the egg. For those experiencing severe male-factor infertility, the availability of intracytoplasmic sperm injection (ICSI) with IVF is a big reason to opt for this treatment method. ICSI is a process where a single, healthy sperm is injected directly into an egg, thus bypassing any issues with sperm quality, quantity, or function. 

Repeated implantation failure or miscarriage 

For women who’ve experienced multiple implantation failures or miscarriages, the issue could stem from a displaced, or non-standard window of implantation (WOI). This can result in a lack of synchrony between embryo and endometrium, which impacts implantation. IVF treatment offers the opportunity for endometrial receptivity tests (ERTs) like MIRA™ to determine your precise WOI and then schedule your embryo transfer accordingly. 

Unexplained infertility 

There are some causes of infertility that won’t show up on standard fertility testing. When that happens, it is called unexplained infertility. This diagnosis doesn’t necessarily mean there is no cause at all, but rather that standard testing methods did not identify a clear cause. It can be due to issues like poor egg quality, problems with cervical mucus, or simply a non-standard WOI, all of which require additional tests to diagnose. 

Genetic disorders 

If there is a genetic disorder in your family that you are concerned about passing on, or you have concerns about a greater risk of aneuploidy, IVF makes it possible to screen your embryos before implantation. Preimplantation genetic testing (PGT) can check for general genetic health and single-gene disorders before you go forward with the embryo transfer. 

Fertility preservation for cancer or other health conditions 

Undergoing cancer treatments like radiation or chemotherapy have a high chance of impacting fertility. IVF allows for the retrieval of multiple eggs that can be frozen directly or fertilized and grown into mature embryos before freezing them. In either case, they can be used at a later date, or even implanted in a surrogate in the cases where pregnancy is no longer a possibility. 

Advanced age 

The unfortunate reality is that it gets harder to get pregnant as you get older. IVF treatments can greatly improve your chances of pregnancy if age is a factor. 

Same-sex couples 

Same-sex couples by necessity must  seek out fertility treatment when they want to have biologic children. In recent years, more couples have been opting for IVF because it offers much better success rates than intrauterine insemination (IUI), and because of the benefits of pre-implantation genetic testing and ICSI. 

When to choose IVF 

Before you commit to IVF, you should consult a fertility specialist. Not only will they provide essential support on your fertility journey, but they will run a series of fertility tests, usually can be done in the same day, to determine if IVF is right for you. Identifying any underlying issues will greatly enhance your chances of getting pregnant.