When to consider

Louise Brown, the first IVF (in vitro fertilization) success, was born in 1978 from a mother whose fallopian tubes were irreparably closed. Thus tubal damage became the first, and for a while, the only indication or use for IVF.

Male factor infertility became the second major indication for IVF and may supersede, in total patient numbers, tubal damage as the chief reason for IVF, now that direct injection of sperm into the egg known as intracytoplasmic sperm injection (ICSI) has become available.

ICSI has proven to be successful in cases that previously would have had donor insemination as the only active therapeutic choice. Other conditions that are treated with IVF include those in the table below. The point at which an individual couple should consider ART depends on many factors and you should consult with a knowledgeable doctor before making a final decision.

Factors to be considered include:

• How long you have been trying unsuccessfully to conceive.
• Age (pregnancy rates start to decline when a woman reaches 30 years and drop significantly when she’s over 40).
• The infertility therapies, if any, you have tried.
• The prognosis for pregnancy with less expensive and less invasive treatments.