Bioethics in Faith and Practice, Volume 4, Number 1

10 The Ethics of IVF all IVF procedures were performed using ICSI. 7 While some studies show that conventional fertilization may be preferred over ICSI in cases where male-factor fertility is not a concern, 8 others have found that ICSI has similar results in cases with unexplained infertility as in cases with male-factor infertility. 9 The fertilized embryos are then cultured in an incubator until they can be transferred into the womb. 10 Embryos are allowed to grow for a few days in culture so they can be assessed for health and stability. Usually, only the one or two healthiest embryos are transferred to the womb in order to increase the chance of pregnancy; recently, many clinics have begun to particularly favor single-embryo transfer to reduce the risk of multiple births (twins, triplets, etc.). The unused embryos are then preserved for future cycles, donated for research, or discarded. 11 To transfer the embryo(s), a special catheter is inserted up the vagina and into the uterus to inject the embryo into the endometrium, the lining of the uterus where the embryo will hopefully implant. The invasiveness of this procedure varies among individuals. 12 The fertility clinic typically follows up with the patient several times over the next few weeks until pregnancy can be determined, at which point care is transferred to the OB/GYN. The success rate of IVF varies widely from individual to individual. One 2012 UK study found that overall, the chances of achieving live birth after the first cycle of IVF were 29.5%, with just over two-thirds of women achieving live birth after six cycles (a significant finding since IVF treatment is typically halted after just three or four cycles). 13 In general, IVF outcomes worsen with age. 14 The 2016 National Summary Report of the Society for Assisted Reproductive Technology reported that women under the age of 35 had just under a 50% chance of conceiving for any given cycle; women aged 35-37 had a 34.8% chance; women aged 38-40 had a 21.8% chance, and women over 40 had a less than 10% chance. 15 7 Hui Liu et al., "Conventional in Vitro Fertilization (IVF) Or Intracytoplasmic Sperm Injection (ICSI): Which is Preferred for Advanced Age Patients with Five Or Fewer Oocytes Retrieved?" Archives of Gynecology and Obstetrics 297 (2018), 1301-1306. 8 Hui Liu et al., "Conventional in Vitro Fertilization (IVF) Or Intracytoplasmic Sperm Injection (ICSI): Which is Preferred for Advanced Age Patients with Five Or Fewer Oocytes Retrieved?" Archives of Gynecology and Obstetrics 297 (2018), 1301-1306. 9 Wardah Alasmari et al., "Comparable Reproductive Outcomes of ICSI for Couples with Unexplained Infertility and Couples with Male Factor Infertility," 23 (2018), 393-398. Middle East Fertility Society Journal. 10 Wdowiak, "Improving the Safety of the Embryo and the Patient during in Vitro Fertilization Procedures," , 137- 143 11 Niederberger, "Forty Years of IVF," , 185-324 12 Wdowiak, "Improving the Safety of the Embryo and the Patient during in Vitro Fertilization Procedures," , 137- 143 13 Andrew Smith et al., "Live-Birth Rate Associated with Repeat in Vitro Fertilisation Treatment Cycles," The Journal of the American Medical Association 314 (2015), 2654-2662. 14 Andrew Smith et al., "Live-Birth Rate Associated with Repeat in Vitro Fertilisation Treatment Cycles," The Journal of the American Medical Association 314 (2015), 2654-2662. 15 (Niederberger and others 2018, 185-324).