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IVF is the only choice in women with blocked, non functioning Fallopian tubes and Men with severe problems of their Sperms.

Many couples do not realize that male factor is a large contributor to infertility.Male problem contributes in 45 to 50% of cases of infertility. In cases of severe male infertility, the sperm may not be able to penetrate the egg and therefore assisted fertilization is done by ICSI. A single sperm can be injected into the egg resulting in significantly higher likelihood of fertilization. This process is used in conjunction with IVF. In other cases Fertilization by ICSI is not as efficient as conventional IVF-ET, but it is an excellent way to achieve fertilization in cases where conventional method would surely fail. IVF has also been instrumental in helping women to become pregnant in case of endometriosis, infertility of unknown causes and in nearly all the couples where efforts to restore fertility are not successful by other means

IVF brought a real breakthrough in reproduction. It is logically emphasized that IVF may be offered without extensive investigations in marriages of > 5 years with continued unprotected relationship. In marriages of > 3 years it is policy at many centers to identify those couples for whom the potential benefits of IVF treatment merit the associated risks and costs. The risk, benefit balance is in favor of benefits. As the procedure is simple and over 60 per cent success is expected in fertile couples, there are increasing demands from the couples for IVF by choice to get pregnant, as the first option for social reasons instead of remaining in a state of expectancy.

Pretreatment Prediction Based on the results of the couple's medical histories, physical examinations and the evaluations, the best possible procedure with the best prognosis is considered for individuals. It is determined whether the couple meets the criteria for IVF. IVF success rates for the couples are discussed. Female age, duration of infertility, previous pregnancy and live birth influence pregnancy rates.

Age of wife is the main determinant of success. The whole body system of woman gets sluggish in the premenopause phase, nature’s arrangements for population control. Quantity and quality of primordial follicle pool diminishes with age. Most women above 40 do not show good response to stimulation. Some women below 40 may also fail to respond as a result of accelerating ageing. Poor response is associated with chronologic age related to ovarian age. Predicted live birth rate is 17% at age 30, 7% at 40 and 2% at 45.

Duration of infertility After 3 years of failure to conceive, chances of spontaneous pregnancy fall to 40% and after 5 years to 20%.

Previous Live birth has positive association: 23.2% successful live births are achieved with IVF if there has been a live birth compared to 12.5% without previous history if live birth.

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