Ask virtually anyone about the indications for in vitro fertilization (IVF) and you will receive the answer hear that it is a procedure performed for the treatment of resistant infertility. While this is true for the vast majority of cases, it is not true for all. In fact, an ever growing number of women/couples are electing to undergo IVF for reasons other than infertility. Let us examine some of these reasons:

Fertility Preservation: The fast pace of the 21st century has catapulted women into the career building arena. Justifiably women of today often aspire to compete with men at the professional level. One of the disadvantages that they confront is the fact that in initiating having a family, it will often require interrupting their career path for a protracted period of time to give birth and then nurture their child(ren) through much of the formative years of childhood. Then, when they attempt to re-enter the workforce, they usually will find themselves having to play catch-up. While some can overcome this hurdle, the majority will find themselves severely disadvantaged by the interruption. Many will simply not be able to make up the lost ground. In the past, this factor has compelled many such women to delay having a family until they are older and have established themselves firmly in their career paths. However, the obvious problem in delaying having children is that advancing age inevitably decreases the ability to conceive, increases the risks of miscarriage and birth defects, and is associated with a growing risk of life-endangering pregnancy complications that can affect both mother and child.

The recent introduction of egg freezing, especially when genetic testing such as Comparative Genomic Hybridization (CGH) is used to select the best quality eggs for cryopreservation (vitrification) and storage (banking), now offers promise that women will be able to safely freeze their eggs and store them for use when they are ready to embark on having a family. By resorting to egg banking they are able to “stop the clock” and are afforded the opportunity to defer child bearing to a time of their choosing and with the man of their choice. Banking frozen eggs does however mandate that when the decision is made to have a baby, they will have to be thawed and fertilized before being transferred to the uterus…….. In other words, IVF will be needed. The emerging ability to freeze eggs has the potential of profoundly expanding the reproductive choices of women. It puts them back in the driver’s seat where they belong.

Fertility Rescue: In the past, women requiring surgery and/or chemotherapy for treatment of cancer often found themselves being propelled into a premature menopause with no hope of having a baby with their own eggs. The introduction of egg banking now affords such women the option of preserving their eggs before undergoing such treatment. In this way, once they have been cured, they have the opportunity to conceive using their own eggs. As with fertility preservation, the introduction of selectively banking CGH-tested eggs has vastly improved the efficiency of this process.

Embryo Banking: In this day and age, many couples who decide upon having a family find that they are not quite ready early on. Pressures in the workplace, financial considerations and even uncertainly regarding the stability of their relationship with their partner might justifiably drive them towards delaying building a family. Unfortunately, the biological clock cannot be reset, and for many such couples, the quality of their eggs will have declined by the time they decide to embark on family building…making it much more difficult for them to succeed. For such couples, the option of undergoing an egg retrieval, fertilizing their eggs, and then freezing (vitrifying) and banking the resulting embryos will provide a safe way to plan and time having babies. Again, the process would require IVF in spite of there being no fertility issue.

Same Sex Relationships: For same-sex male monogamous couples, IVF using donated eggs is one way to have a family. The use of a gestational surrogate and an egg donor is required in such cases. While this is of course a complex arrangement, it is far safer than the alternative, where a gestational surrogate is inseminated with a male partner’s sperm and ends up contributing her genetic package (in the egg) to the offspring. The latter situation is fraught with legal concerns regarding custody. One need only go back a few decades to recall the Baby M saga where the surrogate demanded custody of the child and a horrendous legal battle ensued.

For female same-sex couples, the options of undergoing artificial insemination using donated sperm is usually the first choice because it is less costly and is not likely to be subject to legal custody conflicts. However, for a growing number of these couples, there is a desire on the part of both that they contribute equally to the creation of the baby. In such cases, IVF is required because the process will of necessity require the harvesting of eggs from one partner and transferring the resulting embryos into the other.

Embryonic Stem Cell Technology: This is probably the most controversial of all applications of IVF. Here, in some cases of childhood disease, the use of embryonic stem cells might be the only hope of a cure. It is conceivable in such circumstances that the parents might elect to undergo IVF to gain access to embryos from which cells can be harvested for stem cell propagation and therapy to the afflicted child. It is also possible, subject to resolution of serious ethical, moral, religious and societal hurdles, that in the future, embryos might be generated specifically for the purpose of propagating stem cells for therapeutic use.

Clearly in the past, IVF was largely performed in reaction to a fertility problem but things are changing as the above article suggests. We are fast approaching a time where individuals/couples will choose proactively to undergo In Vitro Fertilization so as to secure their future child bearing potential, resolve lifestyle and career issues and/or address serious life threatening ailments.