What is IVF?

I thought it might be helpful for Christians if I wrote up a brief intro to "IVF" as well as a glossary of various methods fertility doctors use to help women get pregnant.

1. There are various specific methods doctors use to help get women pregnant. IVF is only one of these methods.

2. The umbrella term for all these methods and procedures and technologies which doctors use to help women get pregnant is known as Assisted Reproductive Technology (ART).

3. First, what does it mean to be infertile? One way we can think of infertility is the following. A couple has been trying to have a baby for 12 months or more and can't get pregnant. That's far from a perfect definition but it's a definition with which we can work.

4. Why is a woman infertile? There could be various reasons. Let's categorize them according to the specific anatomical location.



a. A part of the brain controls various hormones which in turn cause a woman pop out an egg every month (give or take) during her menstrual cycle. This is called ovulation. So the first category of problems the woman could have is problems in regulating hormones. If it's a hormonal cause, then doctors will look into giving the woman certain hormones to help her ovulate or regularly ovulate or the like.

b. Next is the woman's ovaries. A woman has two ovaries. Is there something wrong with her ovaries? Think of ovaries as a sort of factory. Ovaries are like a factory for manufacturing eggs. Eggs are released about once per month (the ideal menstrual cycle is 28 days but that's often not reality). If there's a problem with her ovaries, then the doctors will try to fix her ovaries. For example, one problem could be that her ovaries are full of cysts everywhere which interfere with the production of eggs.

c. After the ovaries, we have the uterine tubes aka the Fallopian tubes. This is like a highway which transports the egg from the ovaries to its next destination, the uterus or womb. Is there something wrong with the Fallopian tubes? Maybe the woman has had a sexually transmitted infection that has somehow damaged her Fallopian tubes. Maybe her Fallopian tubes are blocked in some way.

d. Finally, the woman might have other problems such as genetic abnormalities or immunological disorders.

5. But doctors don't look just at the woman. They also look at the man who is her sexual partner. Men's reproductive problems can be divided into a few categories as well.



a. Testes. This is where men produce sperm. This is the male analogue to a woman's ovaries. It's the factory where sperm is produced. So is there a problem with the testes? Has the man had testicular cancer, for instance? Sperm need a cooler environment in order to thrive. Sperm would start to die off if they were placed in a higher temperature such as the center of the body where it's a couple of degrees hotter. That's one reason why the testes aren't at the core or center of the body like a woman's ovaries are. It's also believed professional cyclists sometimes suffer from poor sperm because of this.

b. Sperm. This is the most common problem in men who are infertile. Something's wrong with their sperm. It could be (i) a low number of sperm. Or it could be (ii) sperm which aren't moving properly or "swimming" very well. Or it could be (iii) the sperm are abnormally shaped (e.g. they have two or three tails rather than one). In fact, even in a perfectly young and healthy male, only approximately 15% of sperm are what we'd consider perfect. Most sperm look funny, function funny, swim slowly, etc. But that's "normal." The problem is when less than 4% of the sperm look funny, function funny, swim slowly, etc.

c. Penis. There could be erectile problems. Men can't get an erection for psychological reasons. Or due to age. Or for other reasons.

d. Finally, men could have problems with their genetics or immune system too. Such as if their immune system is attacking and killing their sperm.

6. Fertility doctors look into other stuff like the past medical and surgical history of the couple trying to conceive, the woman's menstrual history, previous pregnancies (if any), their weight, height, body mass index, past contraception use, vaccinations, sexually transmitted infections, history of smoking, alcohol, drugs, etc. All these things could be important in why a couple isn't able to conceive or get pregnant.

7. Finally, here's an ART glossary:

a. OI. Ovulation Induction. This is stimulating the woman's ovaries in the hopes that the ovaries release eggs. It usually involves hormonal drugs which can be taken orally or injected.

b. IUI. Intra Uterine Insemination. Also known as artificial insemination. This is taking some sperm and using a needle and injecting sperm directly into a woman's uterus or womb so that the sperm can swim up and fertilize her egg.

c. IVF. In Vitro Fertilization. Basically, doctors and scientists collect several eggs from a woman, collect sperm from her man, put the eggs in Petri dishes, put the sperm in the dishes, and wait for sperm to fertilize the eggs. Generally speaking, fertility doctors attempt to collect about nine eggs from the woman and fertilize them to form several embryos. Then they place one of these embryos into the woman. The others are cryogenically stored.

d. ICSI. Intra Cytoplasmic Sperm Injection. This is where doctors and scientists collect an egg from a woman, some sperm from a man, select a single sperm which they think is in the best condition, and inject this sperm directly into the egg so that it fertilizes the egg.



e. SSC. Surgical Sperm Collection. This is where doctors surgically remove sperm from a man's testicles.

8. I've left out a lot of other stuff including the more technical stuff. But this should hopefully serve as a rough guide.