Understanding IVF

Understanding IVF

The treatment known as in vitro fertilization has helped countless families move forward when everything else seemed uncertain. Since the very first IVF birth back in 1978, the science has grown in ways that few could have imagined, giving real possibilities to people who once felt they had no options at all.

Understanding the basics truly matters, especially when you are just beginning to explore this path. It makes the whole process feel less abstract and more like something you can navigate at your own pace (and trust me, I hear these questions every single day).

Getting familiar with IVF means learning how each step works, from the early phase of ovarian stimulation to the moment of embryo transfer. It also means getting a sense of its benefits, its challenges, and the alternatives that might suit different situations (I always tell patients that having clarity makes everything lighter).

What is in vitro fertilization?

IVF is an assisted reproductive treatment used when natural conception feels out of reach, and it gives many people a realistic path forward. Understanding the basics helps you know what the journey actually looks like, step by step (I always tell patients that feeling prepared makes everything less overwhelming).

During the treatment, the eggs are collected from the ovaries and later fertilized with sperm in a specialized laboratory. Once the embryos begin to grow, they are monitored for a few days before being placed in the uterus to hopefully initiate a pregnancy (this waiting period can feel long, but it’s completely normal).

The entire process generally follows several stages that build on one another:

• Ovarian stimulation medications are used to encourage the ovaries to produce several mature eggs instead of just one (a common question I get is whether this is safe, and yes, it is closely monitored).
• Egg retrieval once the eggs are ready, they are collected through a minimally invasive procedure known as follicular aspiration (most patients are surprised by how quick it actually is).
• Laboratory fertilization the eggs are combined with sperm to create embryos, and in certain situations ICSI is used to place a single sperm directly into an egg (this is often recommended when sperm quality needs extra support).
• Embryo culture the embryos develop in the laboratory for two to five days while specialists monitor their growth (this is where embryologists work their magic).
• Embryo transfer the best-quality embryos are placed in the uterus using a soft catheter, a simple and gentle procedure (many compare it to a Pap smear in terms of sensation).
• Pregnancy test after about ten to fourteen days, a pregnancy test determines whether the transfer was successful (this is the hardest part emotionally, and you are definitely not alone).

Why is IVF performed?

IVF is used to support individuals and couples who struggle to conceive naturally, and it often becomes the bridge that finally makes pregnancy possible.

There are many medical reasons why IVF might be necessary. One of the most common is when the fallopian tubes are damaged, blocked, or completely absent. Without functioning tubes, the egg simply cannot reach the uterus on its own, which makes natural fertilization impossible (and people are often surprised by how common this actually is).

Endometriosis is another condition that can make conception difficult. When tissue similar to the uterine lining starts growing outside the uterus, it can disrupt ovulation, fertilization, or embryo implantation (I’ve seen many patients relieved when they finally understand why it was so hard).

Male infertility can also lead couples toward IVF. Issues with sperm count, movement, or structure can make it difficult for the sperm to reach or fertilize the egg. Some couples are diagnosed with unexplained infertility, where no obvious reason is found despite extensive testing (this is usually the most frustrating category for people).

Advanced maternal age plays a major role as well. Women aged 35 and above may face reduced egg quality or quantity, making conception more challenging. In addition, premature ovarian failure — when the ovaries stop functioning before age 40 — can also lead patients to consider IVF as a possible solution (hearing this diagnosis early in life can feel unreal, but there are still paths forward).

History and evolution of IVF

In vitro fertilization has come a long way since its inception to become one of the leading assisted reproductive options worldwide.

Understanding IVF and its historical development helps to appreciate not only the technical advances, but also the social changes it has fostered.

Early days

The first attempts at IVF date back to the early 1970s. A group of researchers in the United Kingdom, led by Robert Edwards and Patrick Steptoe, began experimenting with fertilizing eggs outside the human body.

After several attempts and improvements in the technique, the world witnessed a milestone in 1978: the birth of Louise Brown, the first baby conceived by IVF.

This event, in addition to being a scientific triumph, signaled a change in public perception of the possibilities of medical science.

Evolution and improvements

Since the birth of Louise Brown, IVF has undergone numerous advances that have refined the procedure and increased its success rates.

One of the most significant developments has been the introduction of intracytoplasmic sperm injection (ICSI) in 1992. This makes it possible to fertilize an egg with a single sperm, which helped overcome severe cases of male infertility.

Another important innovation has been preimplantation genetic diagnosis (PGD), which allows embryos to be genetically analyzed before implantation. This ensures that only healthy embryos are selected for transfer.

These complementary techniques have improved the chances of pregnancy, while helping to prevent the transmission of genetic diseases.

Comparison of IVF with Other Assisted Reproductive Techniques

There are other assisted reproductive techniques besides in vitro fertilization (IVF). Each has its own characteristics.

Artificial Insemination (IUI)

This technique involves directly introducing sperm into the uterus during ovulation to increase the chances of pregnancy. The procedure involves careful monitoring of the menstrual cycle and, in some cases, the use of medications to stimulate ovulation.

Compared to IVF, AI is less invasive and more economical. It also requires less medical preparation. However, its success rate decreases, especially for women over 35 years old. Additionally, it is a low-efficacy option for couples with severe fertility problems.

Frozen Embryo Transfer (FET)

This is a variant of traditional IVF that involves using embryos frozen during a previous cycle. The process includes thawing the embryos and transferring them to the uterus. It allows for multiple attempts at pregnancy with a single ovarian stimulation cycle.

FET is useful for those who need to undergo medical treatments such as chemotherapy and plan to conceive once their health improves. However, this treatment is not exclusive to these cases; it is also beneficial for those who wish to postpone motherhood, for example.

The difference with traditional IVF is that in IVF, fresh embryos are transferred to the uterus, whereas in FET, previously frozen embryos are used.

Other Techniques

Other reproductive techniques include surrogacy, where a woman (the surrogate) carries and gives birth to a baby for another person or couple. There is also egg or sperm donation, where donor eggs or sperm are used instead of the couple's to create embryos.