indications for ivfThe following information outlines the various medical conditions that may indicate the need for the use of assisted reproductive technologies.
 Tubal Infertility
Defined as persistent bilateral tubal obstruction or significant damage. Diagnosis should be confirmed by Diagnostic Laparoscopy. Also consider in patients who have not conceived following microsurgery.
Male Infertility
ICSI (microinjection of sperm) now used to treat most cases of male infertility. Men with azoospermia (no sperm) may be able to utilise epididymal or testicular biopsy prior to ICSI.
The female partner should have pelvic ultrasound but does not require laparoscopy.
Endometriosis
Severe endometriosis is where pelvic adhesions distort pelvic anatomy and mechanically interfere with the reproductive process. Even mild endometriosis may affect fertility by ovulatory dysfunction, alterations in gamete-embryo transportation and the antifertility effect of the peritoneal fluid. Pelvic ultrasound and laparoscopy is indicated and any ovarian endometrioma should be surgically removed.
Ovulatory Disorders
Most ovulatory disorders respond to ovulation induction by either tablets or injections. IVF is only required if after adequate ovulation, pregnancy still does not occur due to other factors.
Unexplained Infertility
The duration of the infertility and the age of the patient are important. IVF frequently results in diagnosing the cause for the infertility and subsequent successful treatment. Of particular concern is women over the age of 40 where early treatment and in some circumstances, preimplantation genetic diagnosis, are indicated. IVF often solves the problem without reaching a diagnosis.
Immunological Infertility
The role of immunological infertility is poorly understood. IVF may overcome the problems.
Failed Donor Insemination
Usually follows 6 failed Donor Insemination treatment cycles. However, IVF treatment cycles are 3 times more successful than a cycle of Donor Insemination.
Egg or Embryo Donation
Indicated in the absent or stub ovaries, failed ovarian stimulation, premature ovarian failure or poor quality oocytes particularly associated with increasing age.
Embryo Biopsy
Many inherited diseases can now be diagnosed on a single cell obtained from a Day 3 embryo. This includes embryo sexing for diseases where only males or females are affected; studying the correct no. of chromosomes are present, and even studying single genes that carry abnormalities.
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