By Marilyn Olson
Herald News

Joliet -- "For couples faced with infertility, new technology offers new hope for them to complete their families and have children," according to Dr. Marek Piekos of Reproductive Health Specialists of Joliet.

"There are several kinds of assisted reproductive technologies (ART) available, based on the specific kind of infertility which has been diagnosed," Dr. Piekos says.

With in vitro fertilization (IVF), eggs are retrieved from the woman and then fertilized with the husband's sperm.  Before retrieval, the woman has hormonal treatment where she may undergo as many as 12 days of hormonal injections to encourage her ovaries to prepare more than one egg for release.  Retrieving more than one egg increases the chance for successful fertilization.

Eggs are retrieved under intravenous sedation with a needle inserted through the vagina into the ovaries, directed by ultrasound, where fluid is collected from the follicles.  The fluid is taken immediately to the IVF lab where the fluid is scanned to find the eggs.  The eggs are placed in a plastic culture medium which mimics the fluid found in the woman's reproductive tract, and the eggs are incubated at body temperature while they mature.  The process takes several hours.

Once the eggs are mature, the husband's sperm is added and the eggs are returned to the incubator where fertilization occurs within 16 hours. 

In difficult cases the sperm is introduced into the egg through a needle, called cycloplasmic injection (ICSI).  

If fertilization is successful, the eggs begin to develop and within three to five days (usually five days) they are inserted back into the woman's uterine cavity through an outpatient procedure without anesthesia.  The woman spends two hours of bedrest at the facility and then she is sent home and encouraged to spend the next two days on bedrest.  Then she may resume normal activity.

Another method of ART is tubal embryo transfer (TET).  This procedure is done in an operating room.  A laparascope is inserted through the woman's navel and then the embryo is placed in the fallopian tubes.

With gamete intra fallopian transfer (GIFT), the eggs and sperm are placed together in the fallopian tubes where it is hoped fertilzation will occur.  GIFT is possible if at least one fallopian tube is healthy.

"Diagnosis of pregnancy is possible within 10 to 12 days after transfer of an embryo," Dr. Piekos says.  "With a young couple, the chances of fertilization per menstrual cycle are 20 - 25 percent, through our program we are seeing more than a 30 percent success rate per cycle.  The chances of pregnancy with GIFT are about 45 percent, and with culturing the embryo longer so it is more developed, we are seeing about a 50 percent success rate."

If a couple is unsuccessful, IVF may be tried again after a few months.  Dr. Piekos says chances of success increase with more IVF attempts.  About 20 percent of the pregnancies end in spontaneous abortion, but there is no higher risk to either mother or child with embryo transfer than there is with any other pregnancy.

Children conceived through embryo transfer are actually less prone to birth defects than children conceived through normal cycle.  "Children conceived through embryo transfer have about a 1.5 percent chance for a birth defect, while the general population's chance is 2 - 3 percent," Dr. Piekos said.

Cost of the procedure varies according to the kind of procedure and amount of medicine needed.  Illinois law mandates coverage of ART by insurance companies.  Insurers that don't provide coverage for IVF often cover procedures such as ultrasound, examinations, blood tests, laprascopy, and injections.