IVF is short for in vitro fertilization. Invented in the 70s, it is becoming increasingly common as couples or single people who want to have a baby, can maximize their chances of becoming pregnant in spite of age or infertility. IVF involves combining sperm of a man with an egg of a woman, in a petri dish.

A sperm sample from the male is frozen and tested for abnormalities. Egg retrieval from the female is the more difficult process. First, the woman will have to take hormones to prevent her from ovulating naturally. Once the menstrual cycle is controlled, the woman will then take hormones to stimulate her ovaries to produce more than one egg during ovulation. The woman will also typically take HCG, a growth hormone that allow the eggs to mature before their retrieval. The eggs are then retrieved by a syringe while the woman is under anesthesia.

The retrieved eggs will then be fertilized by the male’s sperm and become embryos. At three or five days, the embryos will be considered viable and graded based on their shape and the number of cells inside. Embryos can also be tested by extracting a cell and testing it for chromosomal abnormalities. This testing is called Preimplantation Genetic Screening (PGS).

Sometimes the embryos are implanted into the woman after day 3 or 5, sometimes they are frozen. This is called a fresh or frozen embryo transfer. The embryos are transferred by a catheter into the woman’s uterus. If an embryo successfully implants into the uterine wall, a pregnancy will result. However, injectable medicine will be needed to reduce the chance of miscarriage.

For individuals who lack fertile eggs or viable sperm of their own, they can seek out an egg or sperm bank or donor. An egg donor is a woman who undergoes the process of an egg retrieval. A sperm donor simply deposits sperm into a test tube. Despite the name, donors are usually compensated unless they are doing the donation for a friend or family member. Because the egg donor goes through a significant medical procedure requiring injections, hormones, anesthesia, and some risk to her health, the egg donor is well compensated. Ethical guidelines limit compensation to $10,000 per retrieval procedure, however, some egg donors can command much more money on the private market based on their education, height or beauty.

Frozen embryos can also be donated. Sometimes friends or family will donate embryos to someone who is seeking to have a child; other couples will consider placing their embryos for “adoption” to suitable families.

IVF success rate depends on a number of factors: age of the embryo and the woman, causes of infertility, quality of embryos, as well as the skill of the doctor/quality of their lab. As of 2014, the average cycle (when injectable medication starts prior to egg retrieval) result in a live birth about 37% of the time for women under 35 and lower for older women. Frozen embryo transfers have somewhat better success rates. Clinics’ success rates do tend to vary, with some clinics boasting higher success rates than others. Each clinics’ results are posted on the CDC or SART webpage, but they may be 3 years out of date.

For couples where IVF is not likely to succeed, they can seek out a surrogate. A surrogate or gestational surrogate will be the woman who undergoes IVF and the embryo transfer. She will not be genetically related to the embryo. Because a surrogate can be chosen based on age and the fact she has had at least one successful pregnancy, the intended parents who select a surrogate can control factors to increase the chance of a successful embryo transfer.

Future articles will discuss the specifics of egg donors and surrogates in more detail.