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In Vitro Fertilization (IVF) The steadily increase in success rates with IVF treatment over the past 10-15 years has inevitably widened the scope for the use of this treatment for couples with different types of fertility problems. In the early days of IVF, it was used most often for women with severe damage to their tubes, or severe endometriosis, or pelvic adhesions. Now the scope is much wider. It has revolutionised the management of many types of male fertility problems. It is now frequently used to treat couples with “unexplained infertility”, or for more complex cases of ovulation disorder. As IVF results get better and better, there is also the increasing potential to introduce this treatment at an earlier stage in a couple's infertility. Some couples may have such severe fertility problems that they cannot become pregnant any other way than with IVF. Clearly, they should begin IVF treatment as soon as the diagnosis is made, irrespective of how long they have been trying. Many other couples, however, will have reduced or impaired fertility rather than complete infertility. These couples retain some chance (albeit reduced) of conceiving naturally. We know that a couple with unexplained infertility who have tried to achieve a pregnancy for three years have a future chance of natural conception of between 2% and 3% per cycle. IVF has the potential to give that same couple a chance of conception, per cycle, of between 25% and 30%, or more, depending on the circumstances. How long should that couple be expected to wait, before beginning treatment, in the hope that they will conceive naturally? The increased success rates with IVF treatment adds a new dilemma both for the doctor and for the community (who help to pay for this!) in determining when we should introduce treatment. Some would argue that young couples should be required to wait for longer periods of time before proceeding with IVF treatment in the hope that a pregnancy will occur naturally. I do not think so. IVF is not in itself a miracle solution, nor can it guarantee success, but it can frequently offer couples a markedly increased chance of achieving a pregnancy. It is much cheaper than many people imagine, and it is much simpler. A modern IVF cycle has been streamlined to such a degree that it is much less intrusive than it used to be. It is now a very realistic solution to a very common problem in our community. |
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