Once you have had all the necessary tests, and more specific, potentially more successful treatments have been tried or ruled out, IVF may be useful for the following: Tubal damage (that surgery has failed to treat).
In strict medical terms, IVF is appropriate in the following situations:
If the Fallopian tubes are so badly damaged that surgery has failed to help or if the damage is so severe that surgery is not worth contemplating, then IVF is the only option because it bypasses the tubes. IVF may not be necessary when there is a relatively minor disease of the fallopian tubes. In this case, talk to your GP as tubal surgery might be more justified.
If a man has a low sperm count but produces viable sperm that potentially capable of fertilising an egg, IVF is the ideal course of action. Manipulation of the sperm in the laboratory may make them more likely to be capable of fertilisation. Alternatively, sperm microinjection when a single sperm is injected directly into the egg (see ICSI) may be useful.
IVF may help where a woman’s ovaries produce eggs but do not do so regularly.
For a number of women with endometriosis, IVF is useful. However, the medication required to persuade the ovaries to give up a number of eggs also increases a woman’s own natural oestrogen level, which in turn may stimulate the endometriosis, making it more severe. It is not uncommon for women to find that the symptoms of pain and irregular bleeding increase after unsuccessful IVF treatment. Endometriosis may be treated surgically and by other means, which may be more successful than IVF.
In instances where attempts to diagnose infertility have been unsuccessful and the cause remains unexplained, IVF has good success rates. However, in older women, where unexplained infertility occurs because the ovaries are incapable of producing normal eggs, IVF has a low success rate.
When there is a problem in the cervix or severe scarring of the top of the vagina (usually the following surgery), IVF can help because the embryo is placed directly into the uterine cavity, bypassing the cervix.
If there are multiple factors causing infertility, usually affecting both the man and the woman IVF is generally the most effective treatment. For example, if there is a minor sperm problem combined with a minor scarring of the fallopian tubes, IVF greatly increases the chances of fertilisation and pregnancy.
For couples at high risk of having a genetically abnormal baby can benefit from IVF using preimplantation genetic diagnosis. In this instance, healthy embryos free from certain genetic defects can be selected and placed in the uterus. This treatment is also suitable for some patients with genetic or chromosomal abnormalities that cause repeated miscarriage.
Despite countless breakthroughs in medical science, we still do not understand why some pregnancies will end in tragedy. For most of us, having a child of our own is the most fulfilling experience of our lives. All of us can imagine the desperation and sadness of parents who lose a baby, and the life-shattering impact that a disabled or seriously ill child has on a family.
Professor Robert Winston’s Genesis Research Trust raises money for the largest UK-based collection of scientists and clinicians who are researching the causes and cures for conditions that affect the health of women and babies.
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