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    in vitro fertilisation (ivf)

    Infertility through the Ages: How IVF Changed the Way We Think

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    • 4.5   (1 Votes)

    The evolution of IVF which is an infertility treatment dates back to late 18th century where a research on first known case of embryo implantation was conducted. The beginning of IVF took place with the birth of Louise Brown. The way, couples deal with infertility has changed positively over the decades.

    Infertility has always been a constant concern for couples. The problems it raises today on social, medical, political, ethical and religious levels bear witness to this emphasis, but also to how complex infertility is to deal with and understand. Introduction of IVF in the field of infertility medicine was an exhilarating event. In Vitro Fertilization or IVF treatment has led to the birth of millions of babies across the world till date. The most interesting part of Louise Joy Brown was that she was conceived in a petri dish on November 12, 1977. The first IVF baby was born on July 25, 1978 by cesarean section at the Royal Oldham Hospital in England. The baby was named Louise. Louise Brown, like many other babies’ births, was a perfect newborn of 5 pounds, having 10 fingers, 10 toes and 12 ounces of screaming. She was the first baby who was born In Vitro. (1)

    This article answers the following questions in detail:

    1. IVF- The Beginning:

    The birth of first IVF baby, Louise Brown in Oldham, England evoked attention and curiosity across the world. As per the data collected from reports, to achieve first pregnancy in vitro, it took 102 IVF procedures. Fertilization seemed futuristic at the time; IVF has since become a common procedure and has now been used to lead to the birth of an estimated five million children. Social media is over-crowded with articles about people’s experiences of infertility. There is an ongoing debate about the possible dangers of current and future reproductive technologies such as ICSI (Intracytoplasmic Sperm Injection - direct injection of sperm into eggs obtained via IVF), artificial wombs, uterus transplants, and human cloning. However, the benefits of IVF procedure are apparent in the form of successful pregnancies in some of the age-old infertility conditions.

    Ivf Treatment

    Launch of IVF as a research project in Southern Sweden:

    The IVF-technique in Sweden was introduced in the year 1978 at Kvinnokliniken in Malmö at the initiative of Stig Kullander. He was the only person among his colleagues to be a supporter of IVF procedures. The interest in ART procedures grew in Malmö and Göteborg were two dedicated medical teams who invested both large quantities of time and personal attention into becoming the first clinic to have a baby born via IVF treatment. (2)

    Research and development:

    There have been tremendous developments since the first IVF-baby was born in Sweden in 1982. Among the most important breakthroughs are:

    • Simplified hormone stimulation
    • Ultrasound Scan
    • ICSI (Male Infertility)
    • Single-embryo transfer

    2. What is the stigma attached to infertility?

    In many countries, infertility is something which is looked at as a stamp of shame, especially in women. In many cases of infertility, an infertile woman suffers from ostracism, stigma, and discrimination. There was a time when infertility was thought of as God’s way of punishing a woman for her sins. Thankfully, the theory is no more prevalent in today’s scenario. Procreation is perceived as something unnatural in either partner’s health when it doesn’t take place after a certain amount of time. People then usually come up with certain suggestions and questions like “Don’t wait too long, your biological clock is ticking.” or “When are you going to have kids?” Each of these societal statements is gut-wrenching. (3)

    3. What are the potential causes of infertility?

    In 18 percent of instances, infertility is attributable to both the partners rather than one of the partners. In 12 percent of infertility cases, no physical or physiological reasons can be detected and it can be referred to as unexplained infertility.

    infertility Treatment

    • Factors contributing to female infertility: Factors affecting female infertility may include hormonal imbalance, physiological problems, and lifestyle or environmental factors. Medical factors associated with female infertility can be endometriosis, maternal age, obesity, fallopian tube blockage, and ovulation disorders. 
    • Factors contributing to male infertility: Factors associated with male infertility include hormonal issues, genetics, sperm DNA damage, weight issues, excessive use of alcohol and tobacco, or Sexually Transmitted Disease (STD's), among other unspecified reasons. (4)

    4. How did IVF treatment evolve?

    While previously perceived impossible, IVF treatments can now help hundreds of thousands of couples each year build the family they have been longing for. One can appreciate all the advances in fertility treatments which have taken place in the last four decades. From the first successful IVF birth in a town in Great Britain to over 8 million IVF babies born around the world, ART procedures have improved pregnancy rates for a great number of childless couples. As per the information collected from 2013 estimates, around six million couples worldwide have been born through IVF due to the technological advancements.

    The first IVF birth in 1978 was a momentous scientific advancement for two men who pioneered the procedure - Nobel Prize-winner physiologist Robert Edwards and the recognized gynecologist Patrick Steptoe. It is being told that both the experts underwent hundreds of challenging embryo transfers prior to Louise Brown’s conception. The chances of a successful conception via IVF decline with age, but the process is now more successful per cycle than natural reproduction. (5)
    One of the greatest recent advancements has been in the field of genetic tests. Couples can now find peace of mind with Preimplantation-genetic screening or disease tests. PGD screening process can identify embryos that may carry a genetic condition, or aneuploidy, and indicate the best quality embryos to be transferred to the patient. PGD test has improved the implantation rate and decreased the abortion rate per embryo transferred. It works efficiently as an alternative to prenatal diagnostic testing. PGD test can also work as a substitute to terminate the pregnancy. This technique offers couples an opportunity to have a child free of any genetic condition. (6)

    Reproduction through Technology:

    Assisted reproduction is fairly common for couples having trouble conceiving. Almost, 1 in 8 couples will need some sort of medical assistance in order to conceive successfully. Even with such staggering statistics, the stigma attached to infertility still prevails. It is assumed by some people that babies born via IVF procedures are actually miracles for couples proceeding with the procedure. Before moving forward, let us discuss some detailed information about the prevalence of fertility market.

    5. What is the prevailing fertility market?

    Infertility affects up to 15 percent of reproductive-aged couples globally. The demographic statistics of WHO from 2004 have revealed that in sub-Saharan Africa, around 30 percent of women aging between 25–49 suffer from secondary infertility. (7) The global fertility services market is expected to witness a rise from its initial estimated value of USD 20,398.07 million in 2018 to an estimated value of USD 41,396.21 million by the year 2026 registering a CAGR of 9.25 percent in the forecast period of 2019-2026. This rise in the market can be attributed to the increasing infertility rates and changing the lifestyle of couples across different parts of the world. (8)

    The global fertility services market is all set for rapid growth. The global fertility rates are projected by fertility experts to reach a value of over USD 34,240 million by the year 2024. The data is based on highly-effective, all-inclusive, and thoroughly analyzed information in a well-organized way based on actual facts and reliable figures about the fertility services market. The whole information from the scratch to the management and financial level of the entrenched industries associated with the global fertility services market is initially obtained by the dedicated team. The data collected by experts involves accurate information about the industry’s establishment, form, and the type of services provided, revenue generation, and annual success rates, the demand of infertility treatments in the market, treatment trends followed by the fertility centers, and a lot more important effective information. (9)

    6. What are the changing trends of globalization of IVF treatments?

    Over the past two to three decades, there has been a significant increase in the number of IVF centres across the world. This has led to a significant increase in the number of ART cycles performed worldwide. The International Federation of Fertility Societies (IFFS) surveillance project is conducted every three years to check for the significant changes in success rates of IVF treatment. The project results showed invaluable data on the steady global growth of the IVF sector in certain specific cities in different parts of the world. The report also showed the explosion of IVF treatments in the developing world, with the setup of over 500 IVF centres in India. The globalization of IVF procedures has also seen a doubling in the number of nations involved in the project. By the mid-2000s, both the Latin America and the Middle East had shown noteworthy development of their respective IVF sectors, with the widespread existence of many IVF centres in certain countries (e.g. Argentina, Egypt, Brazil, and Turkey) and regional coverage. (10)

    7. In Vitro Fertilization (IVF):

    In Vitro Fertilization (IVF) is a procedure where eggs and sperms are combined outside the body in a special fertility laboratory for the creation of embryo(s). It is an Assisted Reproductive Technology (ART) process in which a woman’s ovulatory system is monitored and stimulated, an ovum or ova is removed from a woman’s ovaries and is fertilized with sperms in a liquid in a specialized medical laboratory. This procedure has been hugely successful in assisting families who otherwise wouldn’t be able to conceive in a natural manner. When the overall statistics, this popular treatment has a good safety record for the patients. A research report of the year 2017 said that a study was conducted on Israeli teenagers born through IVF procedures. The study revealed that teenagers born via IVF treatment were reported to be healthy in terms of their physical and mental health. (11)

    In Vitro Fertilization (IVF) is an important Assisted Reproductive Technology (ART) which helps in dealing with the fertility-related issues. It is a treatment where both the egg and sperm are fertilized in a lab. IVF is the most common kind of ART procedure where an egg and sperm are combined in the medical lab to create an embryo which is then implanted into the woman’s uterus. ART allows fertility experts to manipulate the fertilization process in order to bypass some pathological challenges like non-functioning ovaries and blocked fallopian tubes in females, and low sperm count and blocked vas deferens in males. The purpose was to offer a historical outline and identify the studies that most contributed to ART. (12)

    IVF

    For nearly three decades, Assisted Reproductive Technologies (ARTs) have been used to treat infertility. ARTs include those infertility treatments in which both eggs and sperm are handled in a fertility lab for the purpose of establishing a pregnancy. Since the birth of the first U.S. baby conceived with ART in 1981, use of such treatments has increased significantly. Each year, both the number of fertility centers offering ART services and the total number of treatment performed have increased dramatically. (13)

    IVF may be required under the following circumstances:

    • If fallopian tubes are damaged and cannot be fixed by surgery.
    • If a woman is suffering from endometriosis when the uterine tissue implants and grows outside of the uterus often affecting the function of the ovaries, uterus and fallopian tubes.
    • If a woman has premature ovarian failure. A condition where ovulation is infrequent or absent, fewer eggs are available for fertilization.
    • If one or both partners suffer from fertility problems.
    • If a woman or her partner is at risk of passing on a genetic disorder to their child, then they may be candidates for Preimplantation Genetic Diagnosis which is often included in IVF procedure.

    8. What is the process of IVF treatment?

    The process begins by encouraging egg production with fertility medications followed by surgical egg retrieval, egg fertilization with sperms, embryo development, embryo transfer, and pregnancy evaluation. In the year 2012, there were over 176,000 ART cycles performed in the U.S., out of which major engagement was recorded for IVF treatment. These procedures are conducted at the best infertility centers and are performed by world-class, board certified infertility specialists and Reproductive Endocrinologists (REs). On average, the chance of having one or more children via IVF is around 30 percent. However, there is growing evidence that the success rates of pregnancy increases with each cycle performed. It is estimated that the number of IVF babies across the world, including Intracytoplasmic Sperm Injection (ICSI), has now surpassed five million and still counting. (14)

    IVF process

    9. How does IVF work for couples suffering from infertility?

    It seems to be a massively happy moment for everyone when family or friends happily announce that they are planning to grow their family. The bitter truth is that achieving pregnancy is not as convenient as planning to do so for every couple. Today, due to the highly advanced infertility treatments, the dream of parenthood is not as bleak as it used to be till last few years. Now, couples experiencing difficulty starting a family, either biologically or medically, have tremendous fertility options available for them. 

    In Vitro Fertilization (IVF) is often viewed as one of the prominent solutions while seeking help for conceiving babies. Most of the people do not realize that IVF procedure can be the first and most successful option for many couples who battle infertility. In vitro Fertilization (IVF) involves several steps such as ovulation induction, egg retrieval, sperm retrieval, fertilization, and embryo transfer. One cycle of IVF can take about two to three weeks, and more than one cycle may be required. IVF procedure may be recommended when alternative infertility treatments, such as Intrauterine Insemination (IUI), are not successful. In Vitro Fertilization treatment is also beneficial when one or both parents carry potential genetic defects because it allows for Preimplantation Genetic Diagnosis (PGD) or Preimplantation Genetic Screening (PGS) on embryos prior to uterus implantation. Both can help increase the chances of successful pregnancy followed by live birth because these forms of genetic testing can identify embryos with chromosomal and genetic defects. Such defects are a major cause of both the failure of an embryo to implant and miscarriage. Embryos identified through PGD or PGS as carrying these conditions are not chosen for implantation. Though IVF has advanced technologically, the chances of delivering a healthy baby with IVF depend on various factors, some of which include maternal age, embryo status, reproductive history, and certain lifestyle factors as well. Below are explained some of the pros and cons of undergoing IVF treatments. 

    10. What are the Benefits and Drawbacks of IVF?

    The fertility treatments do not offer a 100 percent guarantee of success as there are several factors contributing to the IVF success rates. The IVF success rate depends on age in a major number of cases. Younger women have more chances of a successful pregnancy via IVF procedure. However, the success rates of IVF begin to decrease with the increase of the age of a woman. It can be noted that IVF can still be effective for older women. Among several other potential benefits of IVF, the major benefit of IVF is that it allows donor screening for genetic disorders for a successful and healthy pregnancy delivery.

    11. What if IVF doesn’t work?

    For couples experiencing infertility and for couples who have experienced failed rounds of In Vitro Fertilization (IVF) or Intrauterine Insemination (IUI) may recommend seeking a second opinion. Although it is being told by the best fertility doctors that a number of IVF cycles increase the success rates of IVF, couples who have had multiple failed IVF cycles, are recommended to go for other fertility options such as Donor Gametes or Gestational Surrogacy. 
    Donor Gametes: IVF can be performed by using donor gametes (egg or sperm). It is considered to be a great option for couples where one partner is struggling with infertility. Donor gametes are also an effective option for single parents and LGBTQ couples. Egg and sperm donation is legal and regulated in most of the countries. Another fertility option for couples having multiple failed IVF attempts is Gestational Surrogacy. Gestational surrogacy is recommended in cases where IVF treatments failed to work, patients undergoing cancer treatment, women who were born without the uterus and single parents or LGBTQ couples. 

    12. How IVF Changed the Way We Think:

    In the decades since In Vitro Fertilization (IVF) has shifted from being front-page news to a standard choice available to couples struggling with infertility. Refinements in the procedure have boosted the average success rate of an IVF cycle from 10 percent to 40 percent, and research has helped doctors identify some of the most common side effects and risks during pregnancy and birth. As technologies continue to advance, experts predict fertility treatments will become cheaper, better, and more widespread in the next decade and beyond. In addition to helping infertile couples conceive, such treatments could become a common way for women to extend their chances of conception even after the reproductive age has passed, or for those couples to avoid passing on serious conditions to their children. However, such infertility treatments raise a number of ethical issues, including the idea that parents may be able to select certain desirable traits in their children in some of the countries where gender selection is legally accepted. Experts say guidelines should be created today in order to prevent ethical problems in the future. Today it is very important to lay a foundation for what our expectations and acceptable standards will be, as a medical profession and as a society. Here are seven reasons how IVF treatments have changed the way we think:

    Genetic screening has lead to better pregnancy rates: Screening of embryos created by IVF to check for genetic abnormalities is one technology that is already been used today and is likely to become more widespread in the future. Newer screening technologies today can detect more of these genetic abnormalities. Currently, about 40 to 50 percent of women under age 35 who undergo a single cycle of IVF become pregnant. 

    More women prefer to freeze their eggs: Although egg freezing has been practiced for many years, it wasn't until recently that researchers came up with a way to freeze eggs that does minimal damage to them. In the past, eggs were frozen slowly, but a new technique, perfected in the last five years or so, allows eggs to be frozen so quickly that crystals do not form. Egg freezing is no longer experimental because eggs frozen with the new technique, called vitrification, are similar to fresh eggs in terms of their ability to lead to pregnancy (if eggs are frozen at a young age). In the future, there is a real possibility that women in their early 20s commonly opt for egg freezing.

    Three-parent embryos could prevent certain diseases: This technique is intended to prevent women from passing on diseases to the growing baby in the fetus that is carried by the mitochondria, the powerhouse of the cell that contains its own DNA. Mitochondrial diseases can cause a number of serious conditions, including seizures, muscle weakness, vision impairment, and hearing loss. Mitochondrial diseases are devastating and any potential technique to avoid their transmission would be helpful. However, cautionary steps should be taken before moving forward because scientists do not have a good understanding of the long-term repercussions of manipulating embryos in this way. 

    Fertility treatments use fewer hormones: IVF treatment requires women to receive daily hormone injections for nearly two weeks to stimulate the ovaries to produce more than the usual number of eggs.

    Genetic screening could eliminate cancer and increase life span: Researchers have identified more and more genes responsible for the condition; the genetic screening of IVF embryos is going to take a whole new direction. Fertility specialists at the top fertility centers could screen for a slew of genes, including those that increase the risk of cancer. Doctors already can screen for the BRCA1 and BRCA2 genes, which significantly increase the risk of breast and ovarian cancer, and some fertility clinics have screened BRCA carriers to select embryos without the gene. There are certain genes that can code for cancer cells in order to prevent the progression of the cancerous condition in the patient. 

    Stem cells could produce sperm and egg: Experiments in mice show that skin cells of the animals can be turned into stem cells that can then be made into the precursor cells for sperm and egg. If these cells are implanted into sterile mice, the mice become fertile, producing sperm and egg that can be used to produce live baby mice. The findings raise the possibility that women who have run out of eggs and men who do not make sperm may now be able to make new eggs or sperm from stem cells.

    We hope this article was helpful enough and cleared your doubts about the effectiveness of IVF treatment and the roles it can play in the future. The fertility experts at OVO Fertility continue to study the effective fertility treatment which impacts the success rates of IVF treatments, thereby maintaining hope that further advancements in the field of fertility treatments that will continue to improve the odds of IVF process over the course of upcoming years. For more IVF related articles follow OVO Fertility blog. Today, there are many kinds of infertility treatments that can help women get pregnant and OVO Fertility endeavors to provide the best fertility centers which have high success rates. To get all your queries quickly answered, visit OVO fertility".com or talk to OVO fertility fertility experts at +918268260808.

    1 Comment

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    Ibhanan Raman

    May 23, 2019, 6:24 p.m. 4.5

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