Defnition:

Is your behavior more infuenced by genetics or environmental infuences? Is your personality the
result of traits you inherited or has it been shaped by your life experiences? The nature versus nurture
debate is one of the oldest issues in psychology. The debate centers on the relative contributions
of genetic inheritanceand environmental factors to human development.
Some philosophers such as Plato and Descartes suggested that certain things are inborn, or that they
simply occur naturally regardless of environmental infuences. People ho ta!e the position that all or
most behaviors and characteristics are the result of inheritance are !non as nativists. "ther ell#
!non thin!ers such as $ohn %oc!e believed in hat is !non as tabula rasa, hich suggests that the
mind begins as a blan! slate. &ccording to this notion, everything that e are and all of our !noledge
is determined by our experience. People ho ta!e the position that all or most behaviors and
characteristics are the result of learning are !non as empiricists.
Examples of Nature Versus Nurture
'or example, hen a person achieves tremendous academic success, did they do so because they are
genetically predisposed to be successful or is it a result of an enriched environment? If a man abuses
his ife and !ids, is it because he as born ith violent tendencies or is it something he learned by
observing his on parents behavior?
& fe examples of biologically determined characteristics (nature) include certain genetic diseases,
eye color, hair color, and s!in color. "ther things li!e life expectancy and height have a strong
biological component, but they are also infuenced by environmental factors and lifestyle.
&n example of a nativist theory ithin psychology is *homs!y+s concept of a language ac,uisition
device (or %&D). &ccording to this theory, all children are born ith an instinctive mental capacity that
allos them to both learn and produce language.
& number of characteristics are tied to environmental infuences. -o a person behaves can be tied to
infuence such as parenting styles and learned experiences. 'or example, a child might learn through
observation and reinforcement to say +please+ and +than! you.+ &nother child might learn to behave
aggressively by observing older children engage in violent behavior on the playground.
"ne example of an empiricist theory ithin psychology is &lbert .andura+s social learning theory.
&ccording to theory, people learn by observing the behavior of others.
Contemporary Views of Nature Versus Nurture
Today, the ma/ority of experts believe that behavior and development are infuenced by both nature
and nurture. -oever, the issue still rages on in many areas such as in the debate on the origins of
homosexuality and infuences on intelligence. 0hile fe people ta!e the extreme nativist or extreme
empiricist approach, researchers and experts still debate the degree to hich biology and environment
infuence behavior.
Experts from a variety of disciplines continue to argue over the roles that biology and
the environment ultimately play in development. This centuries1old natureversus
nurture debate concerns the relative degree to which heredity and learning affect
functioning. Both genetic traits and environmental circumstances are likely to be
involved in an individual's development, although the amount each express depends on
the individual and his or her circumstances. For example, some identical twins who are
separated at birth develop similar personality, cognitive, and social characteristics, while
other twins who are separated at birth do not. ikewise, many non1twin siblings raised
in the same household develop similar characteristics, although this similar
development of characteristics is not always the case with non1twin siblings. This
interactional nature1versus1nurture or biology1versus1environment approach to the
study of human psychological development exemplifies the multifaceted makeup of the
biopsychosocial perspective.
Infertility and In Vitro Fertilization
WebMD Medical Reference
Reviewed by Nivin Todd, MD, FACOG
Today, in vitro fertilization (IF! i" #ractically a $o%"e$old word& '%t not "o lon( a(o, it wa" a )y"terio%"
#roced%re for infertility t$at #rod%ced w$at were t$en *nown a" +te"t,t%be babie"&+ -o%i"e 'rown, born in
.n(land in /012, wa" t$e fir"t "%c$ baby to be conceived o%t"ide $er )ot$er3" wo)b&
4nli*e t$e "i)#ler #roce"" of artificial in"e)ination ,, in w$ic$ "#er) i" #laced in t$e %ter%" and
conce#tion #recede" ot$erwi"e nor)ally ,, IF involve" co)binin( e((" and "#er) o%t"ide t$e body in a
laboratory& Once an e)bryo or e)bryo" for), t$ey are t$en #laced in t$e %ter%"& IF i" a co)#le5 and
e5#en"ive #roced%re6 only abo%t 78 of co%#le" wit$ infertility "ee* it o%t& 9owever, "ince it" introd%ction
in t$e 4&:& in /02/, IF and ot$er "i)ilar tec$ni;%e" $ave re"%lted in )ore t$an <==,=== babie"&
Recommended Related to Infertility & Reproduction
Your Pre-Pregnancy Checkup
We all *now abo%t t$e i)#ortance of #renatal )edical care in a""%rin( t$e $ealt$ of a #re(nant wo)an and $er baby& '%t
)any e5#ert" now reco))end t$at wo)en "tart "eein( an ob"tetrician before t$ey beco)e #re(nant for "o)et$in(
called #re,#re(nancy or #reconce#tion care& It )ay "ee) e5ce""ive ,, after all, w$y "tart worryin( before yo%3re
#re(nant> '%t a doctor can $el# even at an early "ta(e& 9e or "$e can r%n te"t" to )a*e "%re t$at yo% and yo%r #artner
don3t $ave any $idden illne""e" t$at co%ld&&&
Read the Your Pre-Pregnancy Checkup article > >
What Causes of Infertility Can IVF reat!
W$en it co)e" to infertility, IF )ay be an o#tion if yo% or yo%r #artner $ave been dia(no"ed wit$?
.ndo)etrio"i"
-ow "#er) co%nt"
@roble)" wit$ t$e %ter%" or fallo#ian t%be"
@roble)" wit$ ov%lation
Antibody #roble)" t$at $ar) "#er) or e(("
T$e inability of "#er) to #enetrate or "%rvive in t$e cervical )%c%"
An %ne5#lained fertility #roble)
IF i" never t$e fir"t "te# in t$e treat)ent of infertility& In"tead, it3" re"erved for ca"e" in w$ic$ ot$er
)et$od" "%c$ a" fertility dr%(", "%r(ery, and artificial in"e)ination $aven3t wor*ed&
If yo% t$in* t$at IF )i($t )a*e "en"e for yo%, caref%lly a""e"" any treat)ent center before %nder(oin(
t$e #roced%re& 9ere are "o)e ;%e"tion" to a"* t$e "taff at t$e fertility clinic?
W$at i" yo%r #re(nancy ratio #er e)bryo tran"fer>
W$at i" yo%r #re(nancy rate for co%#le" in o%r a(e (ro%# and wit$ o%r fertility #roble)>
W$at i" t$e live birt$ rate for all co%#le" w$o %nder(o t$i" #roced%re eac$ year at yo%r facility>
9ow )any of t$o"e deliverie" are twin" or ot$er )%lti#le birt$">
9ow )%c$ will t$e #roced%re co"t, incl%din( t$e co"t of t$e $or)one treat)ent">
9ow )%c$ doe" it co"t to "tore e)bryo" and $ow lon( can we "tore t$e)>
Do yo% #artici#ate in an e(( donation #ro(ra)>
What Can I "#pect From IVF!
T$e fir"t "te# in IF involve" inAectin( $or)one" "o yo% #rod%ce )%lti#le e((" eac$ )ont$ in"tead of only
one&Bo% will t$en be te"ted to deter)ine w$et$er yo%3re ready for e(( retrieval&
@rior to t$e retrieval #roced%re, yo% will be (iven inAection" of a )edication t$at ri#en" t$e develo#in(
e((" and "tart" t$e #roce"" of ov%lation& Ti)in( i" i)#ortant6 t$e e((" )%"t be retrieved A%"t before t$ey
e)er(e fro) t$e follicle" in t$e ovarie"& If t$e e((" are ta*en o%t too early or too late, t$ey won3t develo#
nor)ally& Bo%r doctor )ay do blood te"t" or an %ltra"o%nd to be "%re t$e e((" are at t$e ri($t "ta(e of
develo#)ent before retrievin( t$e)& T$e IF facility will #rovide yo% wit$ "#ecial in"tr%ction" to follow t$e
ni($t before and t$e day of t$e #roced%re& Mo"t wo)en are (iven #ain )edication and t$e c$oice of
bein( )ildly "edated or (oin( %nder f%ll ane"t$e"ia&
What Can I "#pect From IVF! continued$$$
D%rin( t$e #roced%re, yo%r doctor will locate follicle" in t$e ovary wit$ %ltra"o%nd and re)ove t$e e(("
wit$ a $ollow needle& T$e #roced%re %"%ally ta*e" le"" t$an C= )in%te", b%t )ay ta*e %# to an $o%r&
I))ediately followin( t$e retrieval, yo%r e((" will be )i5ed in t$e laboratory wit$ yo%r #artner3" "#er),
w$ic$ $e will $ave donated on t$e "a)e day&
W$ile yo% and yo%r #artner (o $o)e, t$e fertilized e((" are *e#t in t$e clinic %nder ob"ervation to en"%re
o#ti)al (rowt$& De#endin( on t$e clinic, yo% )ay even wait %# to five day" %ntil t$e e)bryo reac$e" a
)ore advanced bla"tocy"t "ta(e&
Once t$e e)bryo" are ready, yo% will ret%rn to t$e IF facility "o doctor" can tran"fer one or )ore into
yo%r %ter%"& T$i" #roced%re i" ;%ic*er and ea"ier t$an t$e retrieval of t$e e((& T$e doctor will in"ert a
fle5ible t%be called a cat$eter t$ro%($ yo%r va(ina and cervi5 and into yo%r %ter%", w$ere t$e e)bryo" will
be de#o"ited& To increa"e t$e c$ance" of #re(nancy, )o"t IF e5#ert" reco))end tran"ferrin( t$ree or
fo%r e)bryo" at a ti)e& 9owever, t$i" )ean" yo% co%ld $ave a )%lti#le #re(nancy, w$ic$ can increa"e
t$e $ealt$ ri"*" for bot$ yo% and t$e babie"&
Followin( t$e #roced%re, yo% wo%ld ty#ically "tay in bed for "everal $o%r" and be di"c$ar(ed fo%r to "i5
$o%r" later& Bo%r doctor will #robably #erfor) a #re(nancy te"t on yo% abo%t two wee*" after t$e e)bryo
tran"fer&
In ca"e" w$ere t$e )an3" "#er) co%nt i" e5tre)ely low, doctor" )ay co)bine IF wit$ a #roced%re
called intracyto#la")ic "#er) inAection& In t$i" #roced%re, a "#er) i" ta*en fro) "e)en ,, or in "o)e
ca"e" ri($t fro) t$e te"ticle" ,, and in"erted directly into t$e e((& Once a viable e)bryo i" #rod%ced, it i"
tran"ferred to t$e %ter%" %"in( t$e %"%al IF #roced%re&
What %re the &uccess Rates for IVF!
:%cce"" rate" for IF de#end on a n%)ber of factor", incl%din( t$e rea"on for infertility, w$ere yo%3re
$avin( t$e #roced%re done, and yo%r a(e& T$e CDC co)#ile" national "tati"tic" for all a""i"ted
re#rod%ctive tec$nolo(y (ART! #roced%re" #erfor)ed in t$e 4&:&, incl%din( IF, GIFT, and DIFT, alt$o%($
IF i" by far t$e )o"t co))on6 it acco%nt" for 008 of t$e #roced%re"& T$e )o"t recent re#ort fro) <==0
fo%nd?
@re(nancy wa" ac$ieved in an avera(e of <0&E8 of all cycle" ($i($er or lower de#endin( on t$e
a(e of t$e wo)an!&
T$e #ercenta(e of cycle" t$at re"%lted in live birt$" wa" <<&E8 on avera(e ($i($er or lower
de#endin( on t$e a(e of t$e wo)an!&
%re here 'ther Issues With IVF to Consider!
Any e)bryo" t$at yo% do not %"e in yo%r fir"t IF atte)#t can be frozen for later %"e& T$i" will "ave yo%
)oney if yo% %nder(o IF a "econd or t$ird ti)e& If yo% do not want yo%r leftover e)bryo", yo% )ay
donate t$e) to anot$er infertile co%#le, or yo% and yo%r #artner can a"* t$e clinic to de"troy t$e e)bryo"&
'ot$ yo% and yo%r #artner )%"t a(ree before t$e clinic will de"troy or donate yo%r e)bryo"&
A wo)an3" a(e i" a )aAor factor in t$e "%cce"" of IF for any co%#le& For in"tance, a wo)an w$o i"
%nder a(e C7 and %nder(oe" IF $a" a C0&F8 c$ance of $avin( a baby, w$ile a wo)an over a(e E= $a"
an //&78 c$ance& 9owever, t$e CDC recently fo%nd t$at t$e "%cce"" rate i" increa"in( in every a(e
(ro%# a" t$e tec$ni;%e" are refined and doctor" beco)e )ore e5#erienced&
What %re he Costs of IVF!
T$e avera(e co"t of an IF cycle in t$e 4&:& i" G/<,E==, accordin( to t$e A)erican :ociety of
Re#rod%ctive Medicine& T$i" #rice will vary de#endin( on w$ere yo% live, t$e a)o%nt of )edication"
yo%3re re;%ired to ta*e, t$e n%)ber of IF cycle" yo% %nder(o, and t$e a)o%nt yo%r in"%rance co)#any
will #ay toward t$e #roced%re& Bo% "$o%ld t$oro%($ly inve"ti(ate yo%r in"%rance co)#any3" covera(e of
IF and a"* for a written "tate)ent of yo%r benefit"& Alt$o%($ "o)e "tate" $ave enacted law" re;%irin(
in"%rance co)#anie" to cover at lea"t "o)e of t$e co"t" of infertility treat)ent, )any "tate" $aven3t&
Al"o be aware t$at "o)e carrier" will #ay for infertility dr%(" and )onitorin(, b%t not for t$e co"t of IF or
ot$er artificial re#rod%ctive tec$nolo(y& Re"olve? T$e National Infertility A""ociation #%bli"$e" a boo*let
called t$e +Infertility In"%rance Advi"or,+ w$ic$ #rovide" ti#" on reviewin( yo%r in"%rance benefit" contract&
I(I or IVF! What to Consider

Intra%terine in"e)ination (I4I! v"& in vitro fertilization (IF!
i" a ;%e"tion t$at (et" a"*ed of fertility doctor" ;%ite often& +:$o%ld we do I4I (al"o *nown a" artificial in"e)ination!
or (o "trai($t to IF>+ Or, +9ow )any cycle" of I4I "$o%ld we try before )ovin( to IF>+
he Cost of I(I
I4I i" )%c$ le"" e5#en"ive t$an IF and can be a co"t,effective "ol%tion for infertile co%#le"& Heit$ 'la%er, M&D&, a
fertility doctor wit$ Re#rod%ctive Care Center in 4ta$, "ay" $i" fertility #atient" are )o"t li*ely to re;%e"t an I4I
#roced%re fir"t& +T$i" i" often a co"t benefit i""%e,+ $e "ay"& +O%r #atient" in 4ta$ are very co"t con"cio%" and #refer
to try le"" e5#en"ive o#tion" fir"t even if t$e #re(nancy rate i" low&+
I4I can co"t anyw$ere fro) GC== to G<,=== #er cycle de#endin( on t$e fertility clinic, t$e ty#e of fertility dr%(" %"ed,
and t$e ty#e of )onitorin( and blood wor* t$at i" #erfor)ed&
Who )ay *enefit from I(I!
To %nder"tand w$y I4I )ay be $el#f%l to a co%#le $avin( tro%ble conceivin(, it3" i)#ortant to %nder"tand $ow far
"#er) $a" to travel to fertilize an e(( I fro) t$e va(ina t$ro%($ t$e cervi5 (w$ic$ li)it" t$e n%)ber of "#er) t$at
*ee# travelin(!, into t$e %ter%" and %# into one of t$efallo#ian t%be"& Wit$ an I4I, t$e )ale #artner3" "e)en i"
collected, +wa"$ed+ in a laboratory to concentrate t$e "#er) and re)ove "e)inal fl%id (w$ic$ can ca%"e "evere
cra)#in(!, and t$en "lowly inAected via a cat$eter into t$e wo)an3" %ter%"& 'y #%ttin( t$e "#er) directly into t$e
%ter%", t$ey $ave )%c$ le"" di"tance to travel to t$e fallo#ian t%be"&
A co%#le )ay benefit fro) I4I if?
t$e fe)ale #artner $a" an ov%lation di"order and $a" been %nable to (et #re(nant wit$ only t$e ov%lation,
ind%cin( fertility dr%("
t$e fe)ale #artner $a" cervical factor infertility, "%c$ a" "carrin(, or #roble)" wit$ t$e cervical )%c%" (w$ic$
can be ca%"ed by fertility dr%(" "%c$ a" Clo)id!
t$e )ale #artner $a" a low "#er) co%nt, low "#er) )otility ()ove)ent! or #oor )or#$olo(y ("$a#e!
t$e )ale #artner $a" eAac%lation #roble)"
t$e )ale #artner freeze" $i" "#er) to #re"erve fertility before a "%r(ery or cancer treat)ent, "%c$ a" t$at for
te"tic%lar cancer
t$e co%#le i" %"in( donor "#er) in order to conceive
I4I )ay al"o be %"ed a" a fir"t,line treat)ent for %ne5#lained infertility, )ild endo)etrio"i" or advancin( )aternal
a(e& +For I4I, t$e wo)an )%"t $ave at lea"t one o#en fallo#ian t%be, rea"onable e(( ;%ality and t$e ability to ind%ce
ov%lation if needed, and t$e )ale #artner )%"t $ave ade;%ate "e)en #ara)eter",+ Dr& 'la%er "ay"&
IF i" indicated a" t$e co%r"e of treat)ent for #atient" wit$ bloc*ed fallo#ian t%be", advanced endo)etrio"i", failed
I4I cycle", very #oor "#er) #ara)eter"J"evere )ale factor infertility or va"ecto)y& In t$e"e ca"e", #atient" will
#robably "#end le"" #er live birt$ t$an if t$ey c$o"e I4I,ba"ed treat)ent&
I(I and '+ulation-Inducing )edications
I4I can be #erfor)ed wit$o%t fertility dr%(", b%t t$e c$ance" of "%cce"" are (reater if ov%lation,ind%cin( )edication"
are %"ed& 9owever, t$ere i" al"o t$e very real ri"* of beco)in( #re(nant wit$ )%lti#le" w$en ta*in( fertility dr%(" wit$
I4I&
Ty#ically, t$e fe)ale #artner will ta*e an oral fertility dr%( "%c$ a" Clo)id (clo)i#$ene citrate! or -etrozoleJFe)ara&
Ot$er ti)e", (onadotro#in" I inAection" containin( follicle "ti)%latin( $or)one (F:9! )ay be %"ed& In addition, $CG
)ay be ad)ini"tered in order to tri((er ov%lation and o#ti)ally ti)e t$e in"e)ination& T$e #roced%re can be ti)ed by
ov%lation #redictor *it" (O@H! w$ic$ deter)ine t$e )o"t fertile ti)e in a cycle by detectin( t$e #re"ence of l%teinizin(
$or)one (-9! in t$e %rine& Or, t$e #$y"ician can )onitor t$e (rowt$ of t$e ovarian follicle" via %ltra"o%nd and
confir)in( blood te"t"&
+O%r )o"t co))only %"ed #rotocol i" Clo)id I /== )( a day on day" C t$ro%($ 1 wit$ t$e I4I t$e day followin( a 3K3
on t$e O@H,+ Dr& 'la%er "ay"& 9owever, $e "ay" t$e )o"t "%cce""f%l #rotocol i" I4I wit$ a co)bination of Fe)ara
and inAectable F:9 #l%" %ltra"o%nd )onitorin(&
If I4I i" #erfor)ed in conA%nction wit$ inAectable fertility dr%(", t$e ri"* of )%lti#le" increa"e" "i(nificantly& T$erefore
%ltra"o%nd )onitorin( of t$e follicle" i" very i)#ortant in order to red%ce t$i" ri"*& If too )any )at%re follicle" develo#,
t$e I4I cycle can be canceled, or it can be converted to an IF cycle&
I(I &uccess Rates
Ty#ically, it i" reco))ended t$at a co%#le )ove on fro) I4I after t$ree to "i5 failed cycle"&
T$e "%cce"" of I4I de#end" on )any factor", wit$ a(e bein( one of t$e)& At t$e Re#rod%ctive Care Center, t$e
#o"itive #re(nancy te"t #er I4I cycle for <==0,<=// for all #rotocol" (Clo)id, Fe)ara and Fe)araJF:9! ran(e fro)
/C #ercent for a(e" E/,E< to /0 #ercent for wo)en %nder C7&
Accordin( to t$e A)erican :ociety for Re#rod%ctive Medicine (A:RM!, if I4I" are #erfor)ed )ont$ly wit$ fre"$ or
frozen "#er), "%cce"" rate" can be a" $i($ a" <= #ercent #er cycle& 9owever, t$i" de#end" on w$et$er fertility dr%("
are %"ed, t$e a(e of t$e fe)ale #artner, t$e infertility dia(no"i" and ot$er factor", "%c$ a" $ow e5#erienced t$e lab i"
in #re#arin( and wa"$in( t$e "#er)& In addition, t$e fertility tea) i" i)#ortant to t$e "%cce"" of an I4I cycle, too, "ay"
Dr& 'la%er&
+We $ave a (reat n%r"e #ractitioner tea) t$at foc%"e" on o#ti)izin( eac$ cycle&+
0hat Is the Di2erence beteen an &rti3cial Insemination
and In#4itro 'ertili5ation?
!any people wonder about the basic differences between these two common infertility treatments and
when they"re utili#ed.
Artificial Insemination
$n %ntrauterine %nsemination &%'%, also known as $rtificial insemination( is a procedure where the
semen from the e)aculate is washed to place a concentration of the best of all sperm into a
catheter. The catheter is passed through the cervix into the uterus where the sperm is deposited. %t is
up to the sperm at this point to find their way into the fallopian tube to find the egg to fertili#e so that
you can achieve a pregnancy.
%'%s can only be performed for those with open fallopian tubes and are usually combined with some
form of ovarian stimulation, such as *lomid and+or %n)ectable ,onadotropins. This treatment can be
used to treat, in some cases, unexplained infertility and moderately low sperm counts.
In Vitro Fertilization
%n -itro Fertili#ation &%-F( is a process where the ovaries are usually stimulated to produce numerous
eggs which are later extracted out of the ovaries via suction. This procedure is done by having
.general anesthesia/ so you"re fully asleep, but without having mechanical ventilation &i.e. tubes down
your throat(.
The eggs and sperm are placed in a 0etri1dish to allow for fertili#ation to occur and incubated for three
to five days. $ few of the resultant embryos are then placed into a catheter and deposited into the
uterus with any remaining embryos being fro#en.
%-F is usually performed for those with blocked fallopian tubes, advanced reproductive age, low sperm
counts, or unexplained infertility.
The embryo"s chromosomes can also be evaluated through a separate procedure called 0re1
implantation ,enetic 2iagnosis &0,2( to assess if an embryo has any genetic abnormalities such as
2own"s 3yndrome. $lthough %-F is costly, the technology provides the highest pregnancy rate.
,ifferences -et.een %rtificial Insemination
and In Vitro Fertilisation
Dec 14 2011
Artificial insemination is a simple technique carried
out on couples with specific fertility problems.
The ideal candidate would be a young woman with permeable fallopian tubes, less than
years of sterility and a male partner with normal semen. Artificial insemination is
useful for couples that meet these requirements. !o more than 4 tries are carried out,
and the o"erall pregnancy rates are 2#$ % 0 $.
&n 'itro (ertilisation is a completely different technique, in which the gametes are
fertilised in the reproduction laboratory. This technique has a much higher pregnancy
rate and pro"ides more information to the clinic and couple, since the beha"iour of
these embryos can be obser"ed o"er se"eral days in the laboratory.
)ach technique has its indications. &t is "ery important to diagnose each couple correctly
and recommend the most suitable treatment.
The main differences between these two treatments are e*plained simply below+
ARTIFICIAL INE!INATI"N IN VITR" FERTILIATI"N
6. This techni,ue introduces
previously selected semen into the
oman7s uterus that has been
prepared by stimulating ovulation.
This techni,ue consists of
retrieving a oman7s eggs to be
fertilised in the laboratory and later
introducing the obtained embryos
inside the uterus.
8. The fertilisation (uniting of the egg
and sperm) happens 9live: inside
the oman, speci3cally in the
fallopian tube.
The fertilisation happens 9live:
outside the oman, in the
laboratory.
;. It is a simpler techni,ue since it
does not re,uire retrieving eggs.
It is a more complex techni,ue
since it re,uires a surgical
procedure to obtain the eggs and
be fertilised in the laboratory.
<. The ovarian stimulation should be
minimal to avoid the ris! of
multiple pregnancies. The groth
of more than 8 or ; follicles should
ma!e us consider cancelling
treatment.
The ovarian stimulation aims to
obtain an ade,uate number of
eggs, hich ranges beteen = and
6>.
>. It is more a2ordable if you consider
the cost per treatment.
The 3nancial burden is higher,
although it is more a2ordable if
you consider the cost per live birth.
=. The chances of success are loer?
about 6>@ per attempt,
considering couples ith a good
prognosis.
It is the treatment ith the highest
success rates per attempt. In
certain cases, the chances of
achieving pregnancy are up to
=A@.
B. Provides no real chance of success
in cases of fallopian tube bloc!age
or severe male factor.
The possibilities of success, except
in extreme cases, are not
necessarily a2ected by fallopian
tube bloc!age or severe male
factor.
C. It o2ers very poor results hen the
sterility time is over ; years, it is
due to a moderate male factor or
the oman has endometriosis.
This could be the 3rst option for
couples ith a prolonged sterility
time, moderate male factors or
omen ith endometriosis.
D. It o2ers limited information during
treatment.
4aluable information is obtained
during treatment since important
factors are evaluated such as the
ovarian response to stimulation,
egg ,uality, fertilisation and
embryo development.
6A. This is a good option for couples
ith a good prognosis (young
couples that have not been trying
to conceive for a long time ithout
signi3cant semen alterations,
fallopian tube bloc!age or
endometriosis).
It is the treatment ith the highest
chances of success in assisted
reproduction and is the 3rst choice
in many cases.
IVF
&n,"itro fertili-ation in"ol"es putting an egg and sperm together for the purpose of
fertili-ation, but the procedure is done in the laboratory .as opposed to inside the body./
0hen successful, the result is a fertili-ed egg or embryo, which is later transferred into the
woman1s uterus.
Artifcial Insemination
This process in"ol"es in2ecting semen directly into a woman1s uterus using a
catheter. 3ome women will ha"e ta4en medication to increase the chance that one or more
eggs will be released at the right time.
Location
5oth procedures are typically done in a medical setting. &n,"itro fertili-ation requires
a laboratory setting to isolate the semen and to complete the fertili-ation process.
Artificial insemination can be done in a home, though it1s typically done by a doctor.
Efectiveness
According to the American 6regnancy Association, artificial insemination is
successful 10 to 20 percent of the time in one cycle, though the age of the woman and the
health of the sperm are 4ey. &n,"itro fertili-ation is 7 to # percent successful in terms of li"e
births.
Warning
8etting assistance with pregnancy does not mean that the pregnancy will succeed.
These procedures ha"e costs associated with them, and a li"e birth is not a guarantee. Also,
it may ta4e se"eral attempts before resulting in a pregnancy.
Considerations
5oth &'( and artificial insemination may be done with donors. &n the case of in,"itro
fertili-ation, the eggs, the sperm or both may be donated. Artificial insemination can in"ol"e
donated sperm.
Infertility and Artificial Insemination
:ave T$i" Article For -ater
:$are t$i"?
Font "ize?
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WebMD Medical Reference
Reviewed by Nivin Todd, MD, FACOG
Artificial in"e)ination i" a tec$ni;%e t$at can $el# treat certain *ind" of infertility in bot$ )en and wo)en&
In t$i" #roced%re, "#er) are in"erted directly into a wo)an3" cervi5, fallo#ian t%be", or %ter%"& T$i" )a*e"
t$e tri# "$orter for t$e "#er) and by#a""e" any #o""ible ob"tr%ction"& Ideally, it
)a*e" #re(nancy #o""ible w$ere it wa"n3t before& Intra%terine in"e)ination (I4I!, in w$ic$ t$e "#er) i"
#laced in t$e %ter%", i" t$e )o"t co))on for) of artificial in"e)ination&
T$o%($ t$e #re(nancy rate" for wo)en %nder(oin( artificial in"e)ination )ay not be a" $i($ a" t$ey are
for "o)e )ore advanced tec$ni;%e", t$i" tec$ni;%e $a" a *ey advanta(e? It3" a "i)#le #roced%re wit$
few "ide effect"& For t$o"e rea"on", yo%r doctor )ay reco))end it a" an initial for) of treat)ent for
infertility&
Recommended Related to Infertility & Reproduction
Infertility? W$y It 9a##en" and W$at Bo% Can Do
Anyone w$o $a" "tr%((led wit$ infertility will tell yo% t$i"? It can be ;%ite t$e roller,coa"ter ride& +T$e
$arde"t t$in( for %" wa" not $avin( an"wer",+ "ay" one wo)an, now C2& :$e and $er E7,year,old
$%"band were derailed for "everal year" w$ile doctor" tried to fi(%re o%t t$e ca%"e of t$eir infertility&
4nli*e t$i" co%#le, abo%t 2=8 to 278 of 4&:& co%#le" are able to (et #re(nant after a year of tryin(&
W$en yo% (et #a"t t$e year )ar*, $owever, it3" ti)e to "ee* $el#& If yo%3re over a(e C7, it3"&&&
Read t$e Infertility? W$y It 9a##en" and W$at Bo% Can Do article L L
What ype of Infertility Can %rtificial Insemination reat!
Artificial in"e)ination can be %"ed for )any *ind" of fertility #roble)"& It3" a #o#%lar infertility treat)ent for
)en w$o $ave very low "#er) co%nt" or "#er) t$at aren3t "tron( eno%($ to "wi) t$ro%($ t$e cervi5 and
%# into t$e fallo#ian t%be"& Artificial in"e)ination i" al"o "o)eti)e" an o#tion for wo)en w$o
$ave endo)etrio"i" or abnor)alitie" of any of t$eir re#rod%ctive or(an"&
Wo)en wit$ +%nrece#tive cervical )%c%"+ are al"o (ood candidate" for artificial in"e)ination& In t$e"e
wo)en, t$e )%c%" "%rro%ndin( t$e cervi5 i" $o"tile to "#er) and #revent" "#er) fro) (ettin( into t$e
%ter%" and fallo#ian t%be"& Artificial in"e)ination allow" t$e "#er) to "*i# t$e cervical )%c%" entirely&
Doctor" al"o often "%((e"t artificial in"e)ination w$en t$ey cannot deter)ine t$e rea"on a co%#le i"
infertile&
What to "#pect ,uring %rtificial Insemination
Bo%r doctor will %"e ov%lation *it", %ltra"o%nd, or blood te"t" to )a*e "%re yo% are ov%latin( w$en yo%
%nder(o artificial in"e)ination&
W$en yo% are ov%latin(, yo%r #artner will be a"*ed to #rod%ce a "a)#le of "e)en& T$e doctor will
"%((e"t t$at yo%r #artner ab"tain fro) "e5 for two to five day" in advance to en"%re a $i($er "#er)
co%nt& If yo% live clo"e to t$e clinic, yo%r #artner )ay be able to collect t$e "e)en at $o)e by
)a"t%rbatin(& Ot$erwi"e, t$e clinic will #rovide a #rivate roo) for t$i" #%r#o"e& T$e "#er) )%"t be
+wa"$ed+ in a laboratory wit$in one $o%r of eAac%lation&
T$e #roce"" of +wa"$in(+ t$e "#er) en$ance" t$e c$ance of fertilization and re)ove" c$e)ical" in t$e
"e)en t$at )ay ca%"e di"co)fort for t$e wo)an& It con"i"t" of li;%efyin( t$e "#er) at roo) te)#erat%re
for C= )in%te"& T$en a $ar)le"" c$e)ical i" added to "e#arate o%t t$e )o"t active "#er)& T$en a
centrif%(e i" %"ed to collect t$e be"t "#er)&
T$e "#er) are t$en #laced in a t$in t%be called a cat$eter and introd%ced t$ro%($ t$e va(ina and cervi5
into t$e %ter%"& Artificial in"e)ination i" a "$ort, relatively #ainle"" #roced%re t$at )any wo)en de"cribe
a" bein( "i)ilar to a @a# ")ear& :o)e wo)en $ave cra)#in( d%rin( t$e #roced%re and li($t bleedin(
afterward& I))ediately after t$e #roced%re, yo%r doctor will #robably $ave yo% lie down for abo%t /7 to E7
)in%te" to (ive t$e "#er) a c$ance to (et to wor*& After t$at, yo% can re"%)e yo%r %"%al activitie"&
In "o)e ca"e", yo%r doctor will #lace yo% on fertility dr%(", "%c$ a" Clo)id, to ind%ce "%#erov%lation
(ov%lation of )%lti#le e(("! before yo% %nder(o artificial in"e)ination&
:%cce"" rate" for artificial in"e)ination vary& Factor" t$at le""en yo%r c$ance of "%cce"" incl%de?
Older a(e of t$e wo)an
@oor e(( ;%ality
@oor "#er) ;%ality
:evere endo)etrio"i"
:evere da)a(e to fallo#ian t%be" (%"%ally fro) c$ronic infection!
'loc*a(e of fallo#ian t%be" (I4I will %"%ally not wor* in t$i" ca"e!

In Vitro Fertilisation #IVF$ is a medical procedure that many couples

and individuals turn to hen they are facing fertility issues. In fact, 6 in =
couples ill need some form of fertility assistance in their life time. 0hilst
there are treatment options other than I4', such as ovulation induction
and intra uterine insemination, I4' is certainly the most tal!ed about of
these treatment options.
The procedure of I4' has many a%&anta'es for a couple ith infertility
problems, hoever, li!e all medical procedures, it also has
some %isa%&anta'es and ris!s. .efore embar!ing upon an I4' cycle, it
is extremely important that a couple or individual understands hat the
advantages and disadvantages are and as such, they need to see a
fertility specialist ho can outline the entire process for them, so informed
decisions can be made.
& successful pregnancy and a healthy baby born are, of course, the
biggest advantages of underta!ing an I4' procedureE -oever, this
outcome is not going to be the same for everyone ho goes through I4'.
Fnfortunately, I4' is not the anser for everyone.
&nother advantage to I4' is that it can be used to help bypass problems
ith a oman7s fallopian tubes. I4' as 3rst pioneered for this very
reason so omen ho had tubal damage or bloc!ages could still have
children of their on.
*on3rmation of fertilisation is also an advantage of having I4' treatment.
'or some people, the cause of their subfertility is labelled as Gidiopathic7
(a technical term for un!non). In instances such as this, it is possible
that there may be a problem ith the egg and sperm interacting in the
normal ay, preventing an embryo from being created. If the sperm and
egg do not interact in an I4' cycle and no embryos are created, this is
called a Gfailed fertilisation7. 0hilst this is devastating for the couple, it
can also provide some ansers as to hy they have not had success in
achieving a pregnancy naturally in the past.
Should a failed fertilisation be the result, then the next step ould be for
the couple to consider having another I4' cycle, but this time try
intracytoplasmic sperm in/ection (I*SI) as the method of fertilisation. If
this treatment fails to produce fertili5ation, then it is time for the couple to
reassess their options ith their fertility specialist. 0ith the advent of I4'
using I*SI, men ho have had a vasectomy or have a very lo sperm
count no have the potential father children that are biologically theirs.
I4' can also be used as a treatment option enabling any embryos that are
created, to be tested for some abnormalities before they are transferred
into the uterus (omb). In some instances, couples can be at ris! of
having children born ith conditions such as Don7s Syndrome or *ystic
'ibrosis, and using I4' ith pre#implantation genetic diagnosis (PHD) or
comparative genomic hybridi5ation (*H-), the incidences of these
conditions can be reduced.
& clear disadvantage ith I4' is that success is not guaranteed. In fact,
less than >A percent of all couples starting an I4' cycle ill achieve a
pregnancy. "f those ho do become pregnant, not all of the pregnancies
ill result in a baby? & little over 8> percent of I4' cycles started, result in
a live birth.
&nother disadvantage of I4' is because the process involves an operative
procedure, there are the associated ris!s of infection, anaesthetic ris!s
and haemorrhage. "varian -yperstimulation Syndrome ("-SS) is also a
ris! that is only associated ith treatment here the ovaries are
stimulated through the use of medications, to ma!e multiple eggs. This of
course is hat happens in I4' and as such, "-SS is a ris! for patients
undergoing this treatment.
Iany people ould not consider the prospect of multiple pregnancies a
disadvantage of I4'. -oever, many couples are unaare of the serious
nature of the ris!s of multiple pregnancy, and the fre,uency ith hich
these complications can occur. If you transfer more than one embryo,
there is a chance that all of the embryos ill implant, leading to multiple
pregnancies. In &ustralia, clinics are leading the ay in reducing the
incidence of multiple pregnancies as a result of I4' by only transferring a
single embryo on the ma/ority of cases.
I4' can also be an expensive medical procedure, and if you have access
to Iedicare entitlements, some of the costs are subsidised, but there are
still out of poc!ets expenses that come ith I4' treatment. &nd hilst
private health insurance may cover the hospital admission, the total out of
poc!et cost to a couple depends on each individual7s situation. There
are loer cost options available for I4' that you might consider exploring.
Em(ryo Transfers
&s previously mentioned, ith any medical procedure there are possible
ris!s involved, and the embryo transfer procedure is no exception.
Sometimes, despite all best e2orts, embryos can implant in the rong
place (i.e. the fallopian tubes), hich results in an ectopic pregnancy. This
can ,uic!ly become a life threatening situation re,uiring urgent surgery.
In many cases an embryo transfer ill not result in a successful
implantation, despite everything being as optimal as possible.
I4' procedures have been performed for more than ;A years no, ith
the 3rst human baby being born in 6DBC. During this time scientists,
nurses, and fertility specialists have been constantly developing ne
medications and medical procedures to increase the I4' procedure7s
success rate, hile minimi5ing the ris!s of complications associated ith
the procedure. Despite this constant revie and the advent of ne
technologies, there are still ris!s and disadvantages associated ith this
treatment option.
Advantages And Disadvantages Of In Vitro Fertilisation
Women .ho use In Vitro Fertilisation to esta-lish a li+e -irth ha+e a-out a /01 chance of
ha+ing a single -a-y2 031 chance of t.ins2 and a 41 chance of triplets or more$
'ne round of In Vitro Fertilisation costs on a+erage 5632 788$ If a .oman
concie+es using IVF2 she may not ha+e to undergo surgery on her fallopian tu-es$
It is estimated that the treatment has reduced such surgeries -y half$ In cases
.here infertility is due to genetic factors2 In Vitro Fertilisation may allo. these
factors to pass on to their children .ho may then gro. up to -e infertile
themsel+es$ (VF in+ol+es surgical procedures 9for egg collection2 or laparoscopy:
.here local or general anaesthetics are used$ here are slights risks .ith these
treatments2 such as infection and -leeding$ he .oman should consult her doctor
if she has any concerns$ he hormones used to help stimulate the o+ary to
produce ripe eggs for collection may ha+e minor side effects2 and can cause a
condition called o+arian hyperstimulation$ his condition is life-treatening in 31
of .omen and is more common in younger .omen and .omen .ith polycystic
o+arian disease$ here ha+e also -een concerns that the occurance of of -reast2
o+arian2 uterine or cer+i+al cancers may -e higher in In Vitro Fertilisation patients
due to the hormones used to stimulate egg gro.th$ ;o.e+er2 regular pap smears
and -reast e#aminations -efore and during infertility treatment are encouraged$
&ince IVF is still a relati+ely young science2 long-term health risks for the .oman
or child cannot -e definiti+ely ruled out$ For .omen2 there are also ha<ards
accociated .ith pregnancy and -irth2 such as miscarriage$
Things to Consider
Advantages
%n vitro fertil#ation is a very popular alternative to natural childbearing for several reasons.
The main advantage is that for couples with certain infertility problems, %-F has the obvious
benefit of boosting the odds of getting pregnant. %t's helpful for women with blocked
fallopian tubes or for men with a low sperm count. $nother advantage is that in vitro
fertil#ation could also be a treatment of choice any time a couple decides to use donor eggs,
when the woman is having trouble producing her own. $ third advantage is the the %-F
treatment, can greatly reduce surgery on woman's fallopian tubes. %t is estimated that %-F
has cut these surgeries by nearly fifty percent4
Disadvantages
$lthough there are many advantages of %-F, there are also several cons to consider. The
most basic disadvantage is the cost. 2epending on the circumstances, %-F has a success
rate of thirty percent. 5owever, each cycle costs an average of ten grand. That is a lot of
money, but can you really put a price on a child6 $ second disadvantage is having multiple
births. Five 0ercent of the time, women undergoing the in vitro fertili#ation process, have
more than the one desired child. 7nly expecting to have one kid, having three or more could
be 8uite a shock. 5owever, if properly regulated this is a very slim chance.The last
disadvantage involves ethical morals. !any times, not all the fertili#ed eggs are being used
and some people believe that this is a waste of life. %t can get very controversial for people
who are pro1life and could lead to outrage.