Why consider IVF?

Infertility and genetic concerns are the primary reasons IVF is offered as a treatment method for conception. There are a variety of associated health conditions which may carry lower odds of fertility or higher risk, which may serve as reasons why you (or your partner) may consider this procedure as an option.

For women, these include:

• Damage (or blockages) to the fallopian tubes: It can become difficult to conceive when there is a blockage or tissue damage in the fallopian tubes. This can hinder the fertilisation process, or prevent an embryo from being able to travel to the uterus (its implantation destination).
• Premature ovarian failure: This refers to the lack or loss of normal ovarian function in a woman younger than 40 years of age. This affects a woman’s menstrual cycle, and by extension her chances of conceiving, by producing abnormal amounts of oestrogen hormones, or preventing the release of regular eggs. Problems with ovarian cysts (polycystic ovary syndrome / PCOS) can also lead to fertility complications.
• Ovulation disorders: Infrequent or absent ovulation (known as anovulation) results in fewer or no eggs being made available for fertilisation. This can hamper a woman’s chances of being able to conceive (i.e. achieving implantation of a fertilised embryo).
• Uterine fibroids: Benign tumours located in the wall lining of the uterus can also interfere with the fertilisation and implantation process, especially in women who are 30 and 40-something.
• Endometriosis: With this condition, the function of a woman’s uterus, ovaries and fallopian tubes become compromised when uterine tissue implants and then grows outside of the uterus.
• Tubal ligation (sterilisation or removal): A sterilisation procedure for women, tubal ligation is performed when the fallopian tubes are cut or blocked as a means to permanently prevent the occurrence of pregnancy. Many women opt for this procedure as a means of birth control to prevent a pregnancy. In the event that a woman changes her mind after having this procedure done, IVF can still be performed as an alternative to a tubal ligation reversal procedure with some degree of success.
• Gestational carrier (or surrogate): If a woman’s uterus isn’t functioning as it should or if pregnancy poses a threat to her overall health, a gestational carrier may be an option. In this way, IVF can be performed using another woman to carry the pregnancy using fertilised embryos (made up of male and female biological components – sperm and eggs) from the parents wishing to conceive.

For men, these include:

• Compromised sperm function or impaired sperm production: Men may encounter fertility problems when their sperm concentration is below average, or there are abnormalities in the size and shape of sperm, as well mobility problems (weak movement). These compromised functions all contribute to difficulties in fertilisation. Semen abnormalities, some of which may be correctible, can also be problematic and are commonly a sign of an underlying medical concern.

For men and women, these include:

• Unexplained infertility issues: Sometimes extensive testing and evaluation does not turn up a reason for infertility in both women and men. If a cause of infertility cannot be determined, a specialist may conclude a person’s infertility as ‘unexplained’.
• Genetic disorders: Disorders which comprise of genetic causing factors can sometimes be passed on to a child. If genetic disorders are a concern, a fertility specialist may recommend a ‘pre-implantation genetic’ procedure that involves the IVF process. Eggs are harvested from a woman’s ovaries and then fertilised. From there they are screened for a variety of genetic problems. There is a degree of risk in that not all genetic factors are currently identifiable, but if no known concerns are found, fertilised embryos can be implanted in a woman’s uterus. No embryos with genetic defects are normally implanted.
• Fertility preservation: Conditions such as cancer sometimes involve treatment methods that can affect fertility. Treatments such chemotherapy or radiation can harm a person’s ability to naturally conceive. Those about to begin treatment may consider the IVF process as a fertility preservation option. Women can opt to have healthy eggs harvested and frozen in a fertilised (with sperm to form an embryo) or unfertilised state for later use.

IVF may also be considered if other fertility techniques have been unsuccessful. These can include the taking of fertility medications to stimulate ovulation and the fertilisation process, as well as other techniques such as intrauterine insemination (IUI) or intra-cystoplasmic sperm injections (ICSI).