In some cases, such as tubal factor or severe male factor infertility, IVF is the first-line treatment.
In others, IVF is only recommended if simpler therapies have failed, e.g. in the case of unexplained (idiopathic) infertility, etc.
Common indications for IVF treatment are:
Tubal factor (blocked or damaged fallopian tubes)
The only treatment options in the case of tubal factor infertility are surgical repair or bypassing the fallopian tubes with IVF.
Surgical repair is rarely attempted nowadays and involves painful surgery with questionable results and a high risk of ectopic pregnancy.
In the past 10 years, in the vast majority of women with tubal factor infertility, IVF treatment was preferred.
It is important to consider the individual characteristics of each case when contemplating treatment options.
On of the most important advances in the treatment of infertility is intracytoplasmic sperm injection (ICSI).
ICSI is often recommended if:
- there is a suggestion of a sperm and / or egg problem
- the sperm is collected surgically from the testes
- there has been a prior failure with the method of standard IVF
Endometriosis can be treated effectively with a combination of surgical and pharmaceutical treatments.
IVF is very effective second-line therapy when initial treatment has failed.
Ovarian function decreases with age.
In many cases, this reduced function may be overcome by IVF or in combination with other techniques, such as assisted hatching and ICSI.
Most women with anovulation do not need IVF and will conceive with simpler treatments. However, those requiring IVF treatment tend to be the high responders to gonadotropins and it should be noted that their prognosis is good.
Unexplained (idiopathic) infertility
A comprehensive evaluation will shed no light on 20% of couples regarding the cause of their infertility.
IVF is sometimes successful when other more conservative therapies have failed.
Pre-implantation Genetic Diagnosis (PGD)
Genetic screening of the embryos before they implant is recommended to patients at high risk of genetic disorders such as: cystic fibrosis, thalassaemia, recurrent miscarriages, repeated IVF failure, etc.