Who Needs IVF and Why?

Tubal Factor: IVF was developed specifically for women whose fallopian tubes had been injured by prior surgery or infection. Surgical repair of damaged tubes is rarely successful except in certain cases of tubal sterilization. For women with significant damage to the ends (fimbria) of their tubes, one IVF attempt offers a better chance of a viable pregnancy than surgery ever will and at a lower overall cost.

Male Factor: IVF is clearly the best treatment modality ever developed for low sperm count problems. ICSI, where a single sperm is placed inside each mature egg, has improved dramatically since 1990 and now offers hope even when extremely few sperm are obtained, either from semen or from needle aspiration of the testicular sperm ducts (PESA - Percutaneous epididymal sperm aspiration).

Endometriosis: While not usually the first line of treatment for this problem, IVF works well for endometriosis. It is the therapy of choice for severe cases or when lesser treatments have failed or for women at or approaching age 40.

Unexplained Infertility: The results of IVF indicate that the unexplained infertility diagnosis is actually made up of four subgroups of problems. The smallest group (about 1%) has an implantation problem where a fertilized egg is just unable to imbed in the uterine lining. Another small subgroup (5-10%) has a fertilization problem such that even though sperm and eggs look normal, the sperm are unable to penetrate the eggs. This leaves the vast majority (90%) of unexplained couples where the problem is either poor egg quality or the failure of the egg to escape from the follicle at midcycle.