Giving birth to a new life is a wonderful feeling. The mere thought of welcoming a new member in the family is simply beyond the explanation of words. Becoming parents, whether for the first time or second or third, is always a blissful experience, however, not all couples are lucky enough to enjoy this blessing.
From polycystic ovary syndrome and cervical problems in women to poor sperm quality and pituitary gland disorders in men, infertility is a common problem that affects a large number of couples every year. Although it is difficult to face it; it is even more difficult to accept reality. Infertility can exhaust you both mentally and physically. For couples who have been trying to conceive for a long time, this problem can be quite a challenge.
But the good news is, even if you are dealing with infertility problems, it is not completely impossible to conceive a baby and enjoy the extraordinary feeling of parenthood. With the advancement in science and technology, it is now possible to treat infertility. One of the best methods of dealing with infertility is IVF treatment.
In vitro fertilization (IVF) is a type of assisted reproductive technology (ART). This involves taking eggs from a woman’s ovaries and fertilizing them with sperm. This fertilized egg is called an embryo. The embryo can then be frozen or transferred to a woman’s uterus.
Depending on your situation, IVF can use:
- Your eggs and your partner’s sperm
- Your donor’s sperm and your eggs
- Your partner’s sperm and donor’s eggs
- Both eggs and sperms from a donor
- Donated embryos
Your doctor may also implant embryos into a surrogate mother or gestational surrogate mother. She’s a woman who carries your baby for you.
Since its inception in 1978, the rapidly growing field of IVF has achieved many milestones. Technologies like ICSI, Blastocyst Transfer, laser-assisted hatching, pyrotechnics which allow freezing of gametes, reproductive tissues, and embryos exponentially developed to acquire an important part in the routine IVF cycle protocols around the world.
The birth of Louise Brown over four decades ago has been a living testimony to the success of the in vitro fertilization process. Today, innovations in IVF treatments to increase the pregnancy rate are enabling millions of people to live the dream of parenthood.
In today’s era of precision medicine, advances in the IVF process now encompass the advent of new fertility drugs to limit potentially serious side effects, machine learning to improve embryo selection and even an approach pioneer of self-governance by IVF physicians.
Innovations In IVF Treatments
Infertility is a common condition, with an increasing incidence rate in society. According to the Indian Society for Assisted Reproduction, between 10% and 14% of the Indian population suffers from the disease, which means that almost 1 in 6 Indian couples has had some form of infertility to treat.
Over the past decade, the advances that have been made in the field of assisted reproduction are enormous and, therefore, there is hope for those who dream of being parents but who may suffer from some form of infertility.
Advances that have been made include those to improve egg quality in older women, as well as new stimulation protocols in younger women. There is now a better understanding and protocols available regarding the number of mature oocytes to be recovered and the embryo transfer time during an IVF cycle. All of these factors have helped improve pregnancy rates.
Some of the developments and innovations in IVF treatment that has led to increase in pregnancy rates are as follows:
1. Protocols to increase pregnancy rates:
The advanced protocols implemented in the context of IVF are now specific to each individual to obtain an optimal number of eggs that can produce enough healthy embryos to lead to a positive pregnancy. However, what has remained constant over time is the effectiveness of IVF.
Regardless of the method used, IVF can be personalized for each individual for the best results. Personalized medication use and dosage modification have now further improved the odds of positive pregnancies and made the procedure safer.
2. Ultrasound and Artificial Intelligence
Ultrasound plays an essential role in the treatment of IVF as it helps to monitor the development of follicles in the ovaries, to measure the thickness of the endometrial lining, etc. Scans are also vital in the egg retrieval process as they help navigate between the vaginal walls and the ovaries.
The emergence of artificial intelligence is further revolutionizing the way ultrasound assessments are performed and how they aid the IVF process. Although a transvaginal ultrasound is cost-effective and very beneficial in identifying potential challenges in the IVF cycle, the procedure may provide an inconclusive result due to the high degree of variability between obstructions and intra obstructions. However, with the advent of artificial intelligence, these variations can be minimized.
3. OT developments: OPU and ET
Other advancements in IVF cycles include transvaginal oocyte retrieval (TVOR), or also known as oocyte retrieval (OPU), which is the collection of eggs from the ovaries. These methods allow the oocytes (OPU) to be removed from the donor’s ovaries, fertilized outside the body, and then transferred to the uterus. This allows much larger fertilized embryos to be available for implantation in recipient bodies throughout the IVF cycle.
The transfer of the embryo to the receiving uterus is the last step in the IVF process. Fertility experts use various drugs to stimulate the ovaries, which in turn cause the release of eggs, which are then collected and fertilized in a lab. After fertilization, the embryos are transferred to the woman’s uterus for further development. Improved protocols, equipment, and understanding of procedures have now made them even safer and offer a higher level of success per cycle of IVF.
4. Procreation of three parents:
A collaboration between Greek and Spanish researchers led to the birth of a baby through an IVF technique called mitochondrial replacement therapy (MRT).
Commonly referred to as triparental IVF, MRT encompasses several methods that combine nuclear DNA from a male and female partner with mitochondrial DNA from a donor. The main goal of this therapy is to enable women with rare genetic diseases to avoid passing these conditions on to their children.
To study the MRT more broadly, a pilot project is looming which plans to recruit twenty Greek women. However, the technique is not without controversy. The United States and most European countries severely limit or categorically prohibit its use, while the UK Embryo and Human Fertilization Authority allow MRT in rare circumstances. Reports from Ukraine and Mexico suggest that this technique also resulted in births in that country.
5. Avoid OHSS
A California drugmaker is testing whether a natural hormone might reduce the risk of ovarian hyperstimulation syndrome (OHSS). Severe OHSS is rare, but mild forms can appear in up to a third of IVF cases, according to the Royal College of Obstetricians and Gynecologists.
A typical IVF cycle involves the administration of human chorionic gonadotropin (HCG) to stimulate the ovaries to produce multiple eggs and then retrieve the eggs under ultrasound guidance.
The drug in development is a kisspeptin agonist, which not only stimulates the hormonal pathway responsible for the onset of puberty but can also trigger ovulation.
The researchers hope the drug may eventually offer clinicians an alternative to HCG for ovulation induction, potentially reducing the incidence of OHSS.
6. Pioneers of self-regulation
Preimplantation genetic testing (PGT) is a procedure that allows couples undergoing IVF to screen for genetic abnormalities in embryos before selecting one or more for implantation. Originally developed in the UK in the 1980s, according to the Journal of Human Reproductive Sciences, PGT has been the subject of controversy in recent years.
Some clinics in the United States, where the technique is not regulated, offer pre-implant screening tests for controversial reasons, such as sex selection or detection of deafness or achondroplasia, according to the American Medical Association Journal of Ethics. Some physicians have advocated for the self-regulation of PGT by setting standards by professional societies to guide practice.
Japanese doctors were the pioneers of this approach. Guidelines developed by the Japanese Society of Obstetrics and Gynecology (JSOG) guide the use of PGT by restricting it to JSOG-approved clinics that practice the technique for research. Patients are rigorously monitored and their cases are submitted to an ethics committee for approval. As a result, PGT is rarely used in Japan.
The question of whether physicians in other corners of the world will adopt this form of self-government or a form more suited to achieving accepted professional or ethical goals is an evolution to be reckoned with for years to come.
7. Role of embryology and embryologists
In addition to fertility experts, successful IVF requires the help of embryologists who study prenatal gamete development, fertilization, and embryo and fetal development.
As noted above, during IVF, mature eggs are collected (retrieved) from the ovaries and fertilized by the sperm in a laboratory, which is then transferred to the uterus for further development.
A complete cycle of IVF takes about three weeks and embryologists play a vital role in it. Their mandate is to maintain the most favorable laboratory environment for the development of the embryo; for the effective recovery of eggs; monitoring of fertilization; incubation and monitoring of preimplantation genetic tests; cryopreservation and final embryo transfer.
Significant progress has been made in improving the media used both in culture and in vitrification (freezing) in IVF. This means that we now have an almost natural growth environment to develop growing gametes and embryos. Vitrification is also close to perfection with success rates close to 100%.
These innovations in IVF treatments to improve pregnancy rates are helping several couples to cure infertility and conceive a healthy baby.
If you are one of the couples who are on the verge of giving up, do not just lose hope yet, your dream of parenthood could turn into a blissful reality.
Book your appointment now with the best IVF treatment expert Dr A.K. Jain, Sexologist – the best IVF specialist in India who has successfully brought happiness to the lives of more than 10,000 couples fighting with infertility issues.