In Vitro Fertilization (IVF)
In 2010 Dr. Robert Edwards was recognized with the Nobel Prize in Medicine for the development of human in vitro fertilization (IVF) therapy. Since then reproductive medicine has evolved in many ways. In this blog post we will take a look at where IVF is today and take a look at where it could be in the future.
Pioneers of in vitro fertilization experienced many challenges early on. IVF was a risky procedure and much less predictable than it is today.
Some of the significant medical issues with in vitro fertilization were:
- How to prevent and control ovarian hyperstimulation syndrome (OHSS)
- How to limit the number of embryos transferred while maintaining a reasonable pregnancy rate
- How to determine which embryos are most likely to achieve a healthy pregnancy
Thankfully, the future of IVF is today! Let’s take a look at those issues today and break them down.
How to prevent and control ovarian hyperstimulation syndrome (OHSS)
Today ovarian hyperstimulation syndrome has been reduced dramatically, with only 1% of patients undergoing ovarian stimulation with injectable gonadotropins experiencing severe ovarian hyperstimulation. Ovarian hyperstimulation syndrome occurs when a woman’s ovaries have over responded to their fertility medications. Patients may experience vomiting, dehydration, and fluid accumulation in their abdomen or chest requiring additional treatment such as removal of the fluid and/or close monitoring of electrolytes and hydration status. Fertility specialists today are able to prevent overstimulation from developing at all. It is rare for ovarian hyperstimulation syndrome to occur at all, which makes the IVF process much more safe and predictable for patients.
How to limit the number of embryos transferred while maintaining a reasonable pregnancy rate
The challenge of determining the number of embryos to transfer has also lessened significantly. Very simply put, the more embryos transferred, the higher chance of pregnancy. The downside to this is that transferring multiple embryos means a higher chance of multiple gestations which can have negative effects on the pregnancy. Fertility specialists now understand that if an embryo develops for 5 days and reaches the blastocyst stage before transferring, pregnancy rates are much higher. Previously, embryos were transferred on Day 3 of development which made it more difficult to determine which embryos had the best chance of implanting which is why multiple embryos were often transferred.
How to determine which embryos are most likely to achieve a healthy pregnancy
Today there is also an array of technologies available that are able to assess the reproductive potential of embryos. Many fertility clinics today urge that patients elect to have a single embryo transfer which has resulted in higher pregnancy rates while reducing the chance of multiples. Even with all of the advancements that in vitro fertilization has undergone the process does not always result in a pregnancy. Even if an excellent embryo is transferred on Day 5 other factors may determine the embryos viability. Technology is now available to choose the best embryos that will help lessen the time to a successful live birth. Selection of the best embryos by genetic testing should be offered to all couples doing IVF and will soon be the standard of care.