In infertile couples where women have blocked or absent fallopian tubes, or where men have low sperm counts, in vitro fertilization (IVF) offers a chance at parenthood to couples who until recently would have had no hope of having a "biologically related" child.

In IVF, eggs are surgically removed from the ovary and mixed with sperm outside the body in a Petri dish ("in vitro" is Latin for "in glass"). After about 40 hours, the eggs are examined to see if they have become fertilized by the sperm and are dividing into cells. These fertilized eggs (embryos) are then placed in the women's uterus, thus bypassing the fallopian tubes.

IVF has received a great deal of media attention since it was first introduced in 1978, but it actually accounts for less than five percent of all infertility treatment in the United States.

Yes. IVF was introduced in the United States in 1981. Since 1985, when we began counting, through the end of 2006, almost 500,000 babies have been born in the United States as a result of reported Assisted Reproductive Technology procedures (IVF, GIFT, ZIFT, and combination procedures). IVF currently accounts for more than 99% of ART procedures with GIFT, ZIFT and combination procedures making up the remainder. The average live delivery rate for IVF in 2005 was 31.6 percent per retrieval--a little better than the 20 per cent chance in any given month that a reproductively healthy couple has of achieving a pregnancy and carrying it to term. In 2002, approximately one in every hundred babies born in the US was conceived using ART and that trend continues today.

To ensure that a patient receives high quality care, they should seek a doctor who has attained SART membership. The purpose of SART is to set the standards for the practice of IVF by providing its members with strict guidelines that optimize reproductive care for patients.

SART is the professional society for doctors and laboratory scientists who work together as a team to provide services in assisted reproduction. It is an affiliated society to the American Society for Reproductive Medicine (ASRM). SART is the place for these professionals to share information and experience. Many SART members meet on a regular basis at the annual ASRM meeting.

SART has rigorous requirements for membership. SART members must agree to:

• Report all their pregnancy data yearly. These data are subject to validation (a modified audit) by a team comprised of the CDC and the SART validation committee. This validation includes a site visit to the SART member’s clinic and review of the medical records.
• Embryo laboratory inspection and certification every two years by an outside agency, usually the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) or the College of American Pathologists (CAP).
• Abide by all practice, laboratory, ethical, and advertising guidelines.
• All new practices must have a board-certified reproductive endocrinologist as medical director.

Patients seeking IVF services can be reassured that a SART member has satisfied these rigorous requirements.

The degree of services covered depends on where you live and the type of insurance plan you have. Fourteen states currently have laws that require insurers to either cover or offer to cover some form of infertility diagnosis and treatment. Those states are Arkansas, California, Connecticut, Hawaii, Illinois, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas and West Virginia. HOWEVER, the laws vary greatly in their scope of what is and is not required to be covered. For more information about the specific laws for each of those states, please call your state's Insurance Commissioner's office or to learn about pending insurance legislation in your state, please contact your State Representatives.

Whether or not you live in a state with an infertility insurance law, you may want to consult with your employer's director of human resources to determine the exact coverage your plan provides. Another good source of assistance is RESOLVE, an infertility patient advocacy and information organization.

The desire to have children and be parents is one of the most fundamental aspects of being human. People should not be denied insurance coverage for medically appropriate treatment to fulfill this goal.