10, 000 Australian couples are treated with IVF each year. The expensive and rather risky program (costing around $4000 excluding overheads) allows infertile couples to achieve pregnancy when conventional therapy has failed or is unacceptable. The procedure involves placing eggs that have been fertilised in a cultured dish directly into the uterus. A successful procedure will go as follows:
- Couples are counselled about their situation and informed on the procedure, their obligations and rights.
- Medical history, physical examination and other related tests are taken to determine candidacy.
- The woman receives hormone injections (Human Menopausal Gonadotropin and recombinant Follicle-Stimulating Hormone) to stimulate development of the ovarian follicles which contain eggs. Frequent blood tests are taken to monitor hormone secretion from the ovary and pituitary gland.
- When eggs are ripe, they are retrieved by transvaginal needle aspiration, guided by ultrasound. At the same time, semen samples from the husband (or donor) are obtained. The most active and healthy sperm are selected by forcing them to swim through a culture medium.
- The egg and sperm are placed together in a suitable medium for fertilisation to occur in a culture dish. If fertilisation does not occur after 72 hours, the oocytes (incompletely developed eggs) and sperm are disposed of. The resulting embryos are observed for the next few days.
- A small plastic tube is inserted through cervix to place embryos into the uterus. The patient is able to go home a few hours later with minimal discomfort. During the first two weeks after embryonic transfer, hormones (such as Progesterone or HCG) may be administered.
The procedure above can bring either joy or disappointment. A successful patient from the Atlanta Reproductive Healthcare Center states: “For all of us, hearing that we are pregnant will be the most wonderful news. But remember, as easily as...
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