IVF Decisions

Louise Brown, was the first in vitro fertilization (IVF) baby in the world, born in England in 1978. Her birth created fear that science has outpaced morality, that humankind has exceeded forbidden boundaries. Yet now, 30 years later, IVF is part of the treatment options offered by most full-service infertility programs. Thousands of babies have been born following IVF. In the U.S. alone in 2006, more than 100,000 IVF procedures were performed, resulting in more than 30,000 babies .

Eggs are retrieved from a woman's ovaries by the reproductive endocrinologist. In a sterile laboratory, he/she will observe each egg, or oocyte, under a microscope and determines if it is mature enough for fertilization. If the patient has chosen intracytoplasmic sperm injection, (ICSI) a procedure designed to overcome male infertility, they will carefully remove the cloudy masses of nurse cells surrounding each mature oocyte, and will inject the oocyte with a single sperm selected for optimum morphology and motility.

 If the oocyte is fertilized, they will see the formation of two pronuclei, then the fusion of the diploid cell, or zygote. Over the next few days, as the zygote is incubated at 98.6 degrees, they will track its development in the lab. Ideally, the zygote will form four even, smooth cells, then eight (and so on), before transferring the embryo to the woman's uterus.

This same development process that happens in the laboratory is a lot like what happens in the woman's body, we just get to see each stage.

The day of transfer they will give a set of images of their embryo or embryos, plus a description of the embryos' condition and likelihood of implantation. There are plenty of stories that are reminding us to practice cautious optimism. I am sure I will cry when I see that picture. I tear up just thinking about it. There are still too many things that can go wrong—the embryos, still months from viability, may not implant, or they may implant but stop developing. Extra embryos are frozen, and we are given three options: We can store the embryos for future tries, we can donate them for research purposes, or we can transfer them during a cycle where development is nearly impossible. This is an area that we have struggled with personally, but we do have some time left to make the decision that is best for us.

 

Understanding what it takes to create a baby has given me an appreciation and is none the less a miracle.