INVITRO FERTILIZATION

An Innovative Reproductive Technology in Treating Infertility

Introduction:
As today marks World IVF Day, it is a time to embrace the gift of technology and discovery in medicine. As I reflect on different encounters I have had with patients being worked up for IVF, I can’t but admire the courage of a woman I met. She was in her mid-50s when she gave birth to a set of male and female twins after 2 failed sessions of IVF, she had the set of twins at her third session. She was celebrated by everyone as she was tagged Mother of Hope. Indeed IVF didn’t just give hope but also gave us the possibility of being a co-creator with God. Growing up in a cultural environment where giving birth is regarded as the major responsibility of a woman and a woman who can’t birth to a child is regarded as a man, IVF has been a go-to approach for many couples and families, in cases where conception is desired and all other methods have failed.

Causes of Infertility
There are many factors responsible for infertility which can be female derived such as blocked or damaged fallopian tubes, ovulation disorders, and endometriosis or male derived such as low sperm count or motility, and unexplained infertility.
In Vitro Fertilization, commonly referred to as IVF is a medical procedure used to assist couples who have difficulty conceiving naturally. It involves combining an egg and sperm outside the body in a laboratory dish, where fertilization occurs. The fertilized egg, known as an embryo, is then transferred into the woman’s uterus to establish a pregnancy.

Process of IVF
The Process of IVF requires emotional, financial, and physical support. The first procedure involves:
Ovarian Stimulation: The woman undergoes hormonal treatment to stimulate the ovaries to produce multiple eggs.
Egg Retrieval: Matured eggs are retrieved from the ovaries using a needle guided by ultrasound.
Fertilization: The retrieved eggs are fertilized with sperm in a laboratory dish. In some cases, intracytoplasmic sperm injection (ICSI) may be used, where a single sperm is injected directly into an egg.
Embryo Culture: The fertilized eggs are monitored as they develop into embryos over a few days.
Embryo Transfer: One or more embryos are selected and transferred into the woman’s uterus through the cervix using a thin catheter.
Pregnancy Test: Approximately two weeks after embryo transfer, a pregnancy test is done to determine if the procedure was successful.

Success rate of IVF
Success rates of IVF vary depending on factors such as age, cause of infertility, and the clinician’s expertise. Generally, younger women tend to have higher success rates.
For women under 35 years old, the live birth success rate per IVF cycle is typically around 40-50%.
For women aged 35-37, the success rate drops slightly to about 35-40%.
For women aged 38-40, the success rate further decreases to approximately 25-30%.
For women over 40, success rates are generally lower, with a live birth rate of around 10-15% per cycle.
Many couples undergo multiple IVF cycles to achieve a successful pregnancy. Cumulative success rates take into account the likelihood of achieving pregnancy after several cycles. For instance: After three IVF cycles, the cumulative success rate for women under 35 years old can be as high as 70-80%. The cumulative success rate tends to decrease with increasing age and with each subsequent cycle.

Complications arising from IVF:
1. Multiple births (twins or more) are more common with IVF.
2. Ovarian hyperstimulation syndrome (OHSS) is a potential complication from the fertility medications used.
3. Emotional stress and financial burdens can be significant.

Technological Advancement in IVF
In Vitro Fertilization (IVF) has revolutionized fertility treatment since its inception, but ongoing research and technological advancements continue to enhance its efficacy and accessibility. The following are innovative approaches that shaping the future of IVF:

1. Preimplantation Genetic Testing (PGT):
   PGT enables the screening of embryos for genetic disorders before implantation, reducing the risk of passing on hereditary diseases.
   Advances: New techniques like next-generation sequencing (NGS) improve accuracy and allow for the screening of more genetic abnormalities.
2. Time-Lapse Imaging (EmbryoScope):
   Monitoring embryo development without disturbing them through continuous imaging.
   Advances: Algorithms analyze developmental milestones, aiding in selecting embryos with the highest potential for successful implantation.
3. Mitochondrial Replacement Therapy (MRT):
   Address mitochondrial DNA mutations that can cause infertility or genetic diseases.
   Advances: Experimental techniques involve replacing faulty mitochondria in eggs with healthy donor mitochondria to enhance embryo viability.
4. In Vitro Maturation (IVM):
   Harvesting immature eggs from ovaries and maturing them in the laboratory.
   Advances: Minimizes the need for ovarian stimulation drugs, reducing side effects and costs while broadening treatment options for women with certain conditions.
5. Artificial Intelligence (AI) and Machine Learning:
   Analyzing vast amounts of patient data to personalize treatment protocols and predict outcomes.
   Advances: AI algorithms optimize ovarian stimulation, embryo selection, and overall IVF success rates based on individual patient characteristics.
6. Cryopreservation Innovations:
   Improving embryo, egg, and sperm freezing techniques to enhance storage efficiency and viability.
   Advances: Vitrification, a rapid freezing method, minimizes ice crystal formation, preserving genetic material more effectively.
7. Stem Cell-Derived Gametes:
   Generating gametes (sperm or eggs) from stem cells for patients with gamete deficiencies.
   Advances: Research explores the potential of pluripotent stem cells to produce functional gametes, offering new possibilities for infertility treatment.
   Conclusion
   
   These innovative approaches in IVF underscore ongoing efforts to improve success rates, minimize risks, and expand treatment options for couples facing infertility challenges. IVF is a well-established option for couples struggling with infertility, offering hope and the possibility of starting or expanding a family. Advances in technology continue to improve success rates and reduce risks associated with the procedure, making it a viable choice for many. As technology evolves and research progresses, the future holds promise for further advancements that could revolutionize assisted reproduction, making parenthood achievable for more individuals worldwide.