The world’s first “test tube baby”, Louis Brown, was born on July 25, 1978 in England and shocked the world with her birth. The first IVF baby was born in Taiwan Province in 1985 and one in Hong Kong in 1986.
The first IVF baby was born in mainland China on March 10, 1988, and is now 19 years old, smart and healthy. At present, more than tens of thousands of children are born every year with the help of IVF technology. Many patients with various reasons for infertility have fulfilled their dream of having children through IVF. Now, let’s talk about the “mysterious” IVF technology.
I. What is IVF?
”IVF, commonly known as in vitro fertilization-embryo transfer (IVF-ET), is the most widely used assisted reproductive technology in the world. “IVF is not a baby that is actually grown in a test tube, but a few eggs are removed from the woman’s ovaries, combined with the man’s sperm in a laboratory to form an embryo, and then transferred to the uterus where it can implant and become pregnant in the mother’s uterus.
Normal conception requires the sperm and egg to meet in the fallopian tube, where they combine to form a fertilized egg, which then returns to the uterine cavity to continue the pregnancy. IVF is a technique that involves taking out the egg and sperm from the body, which would otherwise not meet, and fertilizing and cultivating them, so it can be simply interpreted as a laboratory test tube replacing the function of the fallopian tube, hence the name “IVF”.
Who is IVF technology suitable for?
Although in vitro fertilization-embryo transfer technique was originally used to treat infertility caused by blocked fallopian tubes, in vitro fertilization has been found to be useful for infertility caused by endometriosis, ovulation disorders, sperm abnormalities (abnormal number or morphology), and even unexplained infertility.
”IVF technology is generally a treatment method for patients with severe infertility and is now increasingly used in the treatment of various types of infertility, including unexplained infertility for which other methods of treatment have failed.
Commonly applicable groups include
1. Female gamete transport disorders due to various factors.
These include tubal obstruction, failure to conceive even after surgical evacuation of the stoma for tubal obstruction or hydrocele, severe pelvic adhesions that cannot be resolved by surgery resulting in abnormal tubal function, recurrent ectopic pregnancy, etc. Whether it is tubal obstruction or poor peristaltic ability due to inflammation, tuberculosis or endometriosis, congenital tubal agenesis or ectopic pregnancy that leads to tubal resection, the “IVF” technique has built a bridge for these patients. It can be said that bilateral tubal incompetence is an absolute indication for IVF.
2. Ovulation disorders.
These include those with polycystic ovary syndrome who have undergone repeated ovulation treatment and those with unruptured follicular luteinization syndrome who have undergone treatment.
3. Endometriosis.
The effect of endometriosis on infertility is multifaceted: the fallopian tubes can be deformed, partially blocked or blocked by adhesions to the ovarian surface due to ectopic disease; the ovaries can be displaced due to ectopic disease, causing ovulation disorders or luteal insufficiency; and some immune effects, etc.
4, male oligospermia, weak spermia.
For couples who cannot conceive through artificial insemination due to male oligospermia and weak spermatozoa, IVF can be performed, while for patients with severe oligospermia, weak and malformed spermatozoa, irreversible obstructive azoospermia, spermatogenic dysfunction due to genetic defects, in vitro fertilization failure, abnormal sperm acrosome function, etc., they can choose In vitro implementation of intracytoplasmic single sperm injection (ICSI) technique for fertilization.
5. Unexplained infertility.
6. Immunological infertility.
What groups of people are not suitable for IVF technology?
1.The female partner has important organ function abnormalities, such as heart, liver, kidney disease, etc., and cannot withstand pregnancy and delivery.
2. Either of the couple suffers from serious mental illness, acute infection of the genitourinary system, or sexually transmitted diseases.
3.The female partner has malignant tumor of ovary, uterus or breast.
4. The uterus is absent or severely damaged due to congenital or acquired factors and cannot accept embryonic implantation and growth, etc.
5.Hereditary diseases that are not suitable for childbirth as stipulated in the Maternal and Infant Health Care Law and are not currently available for pre-implantation genetic diagnosis.
6.Either of the spouses has serious bad habits such as drug addiction.
7. Either of the spouses is exposed to teratogenic radiation, toxic substances or drugs and is in the period of action.
IV. What is the treatment process of IVF?
”The doctors of the assisted reproduction center will introduce the process of IVF to the infertile couples who come to them for consultation. They discuss the treatment options available to them and provide them with a realistic picture of the success rate of infertility treatment. Today, due to the maturity of the technology, the total cost is not high. The total cost of a cycle is about $10,000 to $20,000, depending on the individual.
In vitro fertilization – embryo transfer technique process roughly includes
1. Pre-operative routine examination: to clarify the cause of infertility and to understand whether it is suitable for IVF. It is better to bring the information and proof of past examinations and treatments to avoid wasting time on repeated examinations.
2. Drug induced ovulation: Under normal conditions, the connection between the hypothalamus-pituitary gland and the ovaries is regulated by hormones, which eventually leads to the production of only one follicle per month, and in order to obtain a certain number of eggs, the natural activity of the pituitary gland can be suppressed, while drugs are used to stimulate the ovaries to produce a reasonable number of follicles in order to obtain eggs suitable for fertilization. This is called “controlled ovulation”.
3. Ultrasound monitoring of follicular development: Ultrasonography can determine the growth and number of follicles, each of which contains one egg. When the follicles are large enough, the eggs are removed vaginally under ultrasound guidance while the male partner undergoes semen collection and laboratory processing.
4. In vitro fertilization: The eggs are collected and placed in a special culture medium. Each egg needs to be examined and confirmed under a microscope before it is placed in the culture dish for union with the sperm. Also, sperm from fresh or frozen semen requires special handling. In general, insemination takes place 4-6 hours after egg retrieval and the fertilization process takes approximately 12-15 hours to complete. On the day after insemination, the presence of two protoplasts and two polar bodies under the microscope is considered successful fertilization and the formation of conidia.
The fertilization rate of mature oocytes is about 65%-80%. An effective method for severe oligospermia, hypospermia, and obstructive azoospermia is intracytoplasmic single sperm microinjection fertilization, which involves injecting a single sperm directly into the oocyte plasma, bypassing the zona pellucida and egg gap to fertilize it. Patients with azoospermia can also obtain their own children through epididymal or testicular sperm retrieval and then intracytoplasmic microinjection.
5. Embryo culture: Normal fertilized eggs are transferred into fresh culture fluid and placed in an incubator. Normally, fertilized eggs divide into 2-cells 22-24 hours after insemination, 4-cells 36-50 hours after insemination, and 8-cell embryos can be observed at 48-72 hours. Unfertilized eggs, degenerated eggs, and abnormally fertilized eggs are discarded.
6. Embryo transfer: Embryos are usually transferred in the uterine cavity on the third to fifth day after egg retrieval.
7. Continue to support the corpus luteum with medication after the transfer. Generally, the pregnancy can be detected by urine HCG or blood beta-HCG test 14 days after the transfer. Then the embryo growth and development will be monitored regularly under the doctor’s guidance.
V. Pregnancy rate and safety of IVF technology.
It can be said that the pregnancy rate and safety of IVF technology has been a hot topic of research since the emergence of this technology. The clinical pregnancy rate per cycle for IVF-embryo transfer has increased from 25%-30% in the past to 35%-40%, and some assisted reproduction centers can achieve a clinical pregnancy rate of 45%-50%, which is very encouraging news compared to the natural pregnancy rate of 15%-20% per natural cycle for normal couples.
Currently, there is no data showing an increase in the rate of congenital malformations in children born through the IVF technique, therefore, the IVF technique is safe and effective for infertile couples.
It is important to note that age is an insurmountable “gap” in IVF technology because the ovarian reserve function of women tends to decline gradually with age, and the risk of bad pregnancies and malformations of offspring increases with advanced age. Therefore, it is recommended that infertile couples should actively seek medical treatment, not to refrain from seeking medical help, and to promptly consider conceiving with the help of IVF technology when other methods of pregnancy assistance fail.