In Vitro Fertilization (IVF)

IVF can be used in couples in following situation-

When intrauterine insemination (IUI) has failed
In women over 40 years of age or low ovarian reserve
Bilateral tubal disorders
Severe endometriosis
Severe male factor infertility

IVF involves the fertilization of the female egg outside of her body. About 100,000 sperm are added for each egg in a special medium.
A minimum of 50,000 to 500,000 motile sperm are generally required for IVF; otherwise, ICSI will be required.
Usually, about 12 eggs are retrieved per cycle. After 2-3 days, the embryos from successfully fertilized eggs are at the 4 to 8-cell stage. Two to three embryos are implanted into the female partner, and the remaining embryos are frozen.
Pregnancy rates are reported at 10% to 45%.

ICSI, is similar to the IVF described above but involves the use of a microscope and micropipette to inject a single sperm taken from the male partner directly into an egg from the female partner that has been surgically extracted. The fertilized eggs are implanted into the uterus of the female partner. The overall fertilization rate of ICSI is about 60%, with an initial pregnancy rate of about 20% to 30% per cycle. This rate increases by up to 45% for multiple cycles. Multiple fetuses occur in about 30% to 40% of all pregnancies produced by IVF with ICSI. Overall, IVF with ICSI is preferred when there are very significant male factors that cannot be overcome by other means, but at least a few viable sperm can still be retrieved. It is also reasonable when all other treatments have failed. The only male contraindication to the procedure is the absence of retrievable, viable sperm and necrospermia, which, fortunately, is quite rare.