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In vitro fertilization. The Scripps Clinic experience.

The in vitro fertilization (IVF) program at Scripps Clinic and Research Foundation, La Jolla, California, was started in 1983. In vitro fertilization is now an accepted type of infertility treatment for many couples with a disorder of tubal origin, endometriosis, male-factor infertility, or idiopathic infertility. Successful outcome has depended on the woman's age, the cause of infertility, and the number of embryos transferred. The highest pregnancy rate has been achieved in women under age 35 with tubal-factor infertility and transfer of three or more embryos. During the first year, the program's overall pregnancy rate was 13% (5 pregnancies/38 embryo transfers) and the pregnancy rate for women under age 35 with tubal-factor infertility was 28%. The functioning of an IVF program depends on the availability of a clinical laboratory for daily hormone measurements, ultrasonography for monitoring follicle growth, an operating room that is available any time day or night, and a laboratory equipped for fertilization of retrieved ova and monitoring of embryo development. Clearly, a carefully integrated team of medical care providers is necessary for a program that draws on so many different clinical resources.