In Vitro Fertilization
In vitro fertilization, IVF is a form of assisted reproductive technology used to treat and facilitate issues with fertility and surrogacy. Ivf, also known as test-tube fertilization, refers to the fertilization of the male sperm and female ova or egg, in vitro or outside the body.
The fertilized embryo is allowed to divide outside the body and is then implanted into the maternal or surrogate uterus, depending on the patient’s preference.
IVF is one of the most commonly used forms of ART despite being a tedious and expensive process.
See Also
Grants for In Vitro Fertilization
History of IVF
Many attempts were made to develop IVF as a successful treatment for infertility. Still, it wasn’t until 1978 that a cycle of IVF produced the first successful result due to the efforts of two pioneering doctors, Robert Edwards and Patrick Steptoe. No ‘Purdy’ was involved in developing this first successful IVF. Louise Brown was born in July of 1978 and was the first child born successfully after maternal treatment with IVF (1).
Sixty-seven days after Louise’s birth in Oldham, England, Kanupriya Agarwal, also known as Durga, was born in Kolkata, India. She was not conceived through IVF but through a different form of assisted conception called ‘gamete intrafallopian transfer’ (GIFT).
Since then, many women have resorted to IVF to help treat infertility. IVF has also helped many women with uterine problems to have children of their own through the surrogacy route.
IVF has allowed infertile individuals, including menopausal women, to become pregnant. The term ‘inferior partners’ is incorrect and inappropriate in this context. IVF treatment helped Adriana Iliescu, who, at the age of 66, became the oldest woman to give birth at that time in 2005.
Advancements in the technique of IVF
IVF is a long process with many steps that are responsible for the procedure’s high cost and high effort.
Researchers have been trying to make the process more affordable and readily available.
A new multidisciplinary approach to IVF, namely, microfluidics technology, has shown potential to improve the overall process while making it cost-effective and highly available.
The application of microfluidics has contributed to the development of ‘IVF on a chip’ technology, which potentially enhances sperm selection processes for use in IVF treatments, including intracytoplasmic sperm injection (ICSI), a critical step in some IVF procedures (2).
The chip contains a simulated cervical and uterine environment that the sperm would have had to go through to fertilize the egg if traditional fertilization methods were applied. The chip uses the same features as a real uterine environment to choose the best sperm to fertilize the egg.
This makes the entire process of sperm selection and ICSI easier and more affordable.
A challenge with IVF technology is managing the conditions after embryo transfer into the uterine cavity, which can impact the success rates, particularly in women above the age of 35, though modern techniques continuously improve environmental control and monitoring.
However, recent advancements in the field of IVF have allowed researchers to find a solution to this specific problem. EmbryoGen is a new medium that improves cell-to-cell communication between the mother and fetus, improving live birth rates. The EmbryoGen medium is used for the development of the embryo in vitro and it is also applied during the implantation process (3).
This allows for the uterine environment to be controlled and monitored compared to the standard medium, hence facilitating the implantation process, the failure of which is one of the most common reasons for the failure of an IVF cycle.
Current research and clinical trials
Despite recent technological advancements, IVF is still not as accessible and successful as one would hope. Researchers have continued to study the different steps of IVF in detail to improve the technology, one step at a time. Some of the current studies aiming to improve and enhance the success rates of IVF include:
- Role of Lactobacillus in luteal phase support and, eventually, live birth rates
A study is being performed to identify the role of Lactobacillus in luteal phase support and the result of its presence in vaginal and cervical flora on live birth rates following IVF.
Generally, the absence of Lactobacillus, a common microbe in the natural flora of the female reproductive tract, is related to Bacterial Vaginosis, an infection commonly associated with miscarriages, premature birth, and low birth weight infants.
For this study, researchers will divide participants into two groups, all of whom have undergone the implantation procedure post-IVF cycle. One group receives lactobacillus pills, whereas the other group or the control group doesn’t.
The effects of this will be then studied to see if there is a difference in live birth rates between the control and interventional groups.
- GnRH supplementation as a means of luteal support post-implantation during an IVF cycle
Implantation after a successful IVF cycle is often followed by progesterone injections to improve the endometrial lining and facilitate the implantation and maturation of the embryo. A recent study has found that injecting GnRH at the time of embryo transfer for implantation can further reduce the process and significantly improve live birth rates.
A clinical trial is being conducted to test the hypothesis where participants, all of whom have undergone IVF cycles, are divided into the control and interventional groups.
The interventional group will receive the GnRH injection, while the control group will receive a placebo. The results will be analyzed according to the difference, if any, between the live birth rates between the two groups.
IVF Grants in the U.S.
See Also
- Johnson M. H. (2019). A short history of in vitro fertilization (IVF). The International Journal of developmental biology, 63(3-4-5), 83–92. https://doi.org/10.1387/ijdb.180364mj
- Nosrati, R., Graham, P. J., Zhang, B., Riordon, J., Lagunov, A., Hannam, T. G., Escobedo, C., Jarvi, K., & Sinton, D. (2017). Microfluidics for sperm analysis and selection. Nature reviews. Urology, 14(12), 707–730. https://www.nature.com/articles/nrurol.2017.175
- Rose, R. D., Berry, M. F., Dunstan, E. V., Yuen, S. M., Cameron, L. P., Knight, E. J., Norman, R. J., & Hull, M. L. (2020). The BlastGen study: a randomized controlled trial of blastocyst media supplemented with granulocyte-macrophage colony-stimulating factor. Reproductive biomedicine online, 40(5), 645–652. https://doi.org/10.1016/j.rbmo.2020.01.011
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