by Leonard Konis

Created on: October 09, 2007

Many couples have infertility problems for one or more reasons: Blockage in the fallopian tube or endometriosis (problem with the lining of the uterus in women 11) or low sperm count or poor quality of sperm in men. 3 When fertility problems treated unsuccessfully by conventional surgery or treatment, alternatively many couples choose In vitro fertilization (IVF) or test - tube conception. 1 Before IVF procedure, fertility drugs may be given to the woman to induce several eggs mature in the ovaries at the same time. During In vitro fertilization a woman's eggs from the ovary are removed by one of two possible procedures and then in a laboratory procedure, eggs are fertilized with male sperm. The fertilized eggs (two to four) (embryo) are inserted, about two or five days after fertilization into the uterus of the same or another woman for normal gestation. 2 Any remaining eggs may be cryopreserved (frozen) for future attempts. However IVF will not be feasible if the woman is not capable of ovulating or man is unable to produce at least a few healthy sperm. In the United States, approximately sixty percent of IVF procedures performed on women older than thirty - five years old. However, women older than thirty-five have a more difficulty time conceiving, may choose more embryos transferred than younger women and consider choosing more viable donor eggs, increase odds of conception. For those women, risk of multiple pregnancies is increased. 4

"Because of the risks of multiple pregnancy to the babies, the American Society for Reproduction Medicine recommends that women under age 35 have no more than two embryos transferred, women age 35 to 37 have no more than three, women 38 to 40 have no more than four transferred, and women have had repeated failed cycles or are over age 40 have no more than five embryos transferred ". Women pregnant with two or more embryos growing in the uterus, may be advised or counseled regarding (controversial to some couples and heart breaking) multifetal pregnancy reduction, reduces the number of fetuses in multiple pregnancies usually to two. Preventing the risk, each additional fetus from stillbirth, miscarriage and life long health concerns or disability. Selective termination 12 determines which fetus has the most severe defect or expected to die later in the pregnancy, unfortunately threatens the life of the survival fetus or fetuses. Also, the procedure increases the outcome for a healthy pregnancy and healthy infant survival

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