What is the Latest in Infertility?
Article contributed by:
Elena Trukhacheva MD, MSCI
Reproductive Medicine Institute, a participating WINFertility Provider Network
With the development of purified injectable gonadotropins, better ultrasound techniques, and optimization of the IVF laboratories, pregnancy rates after IVF treatment improved significantly – as high as 60-70% per transfer for the patients with the best prognosis.
Advances in the Infertility Laboratory
Development of ICSI (intro cytoplasmic sperm injection) allows us to treat the most severe forms of male infertility. It opens up the door to being a biological farther for many men with an abnormal quality of sperm that cannot be treated with different methods. Some of these men are young cancer survivors.
Advances in the embryology laboratory have contributed to pregnancies from less than perfect eggs, sperm or embryos, and new technologies are continually evolving that allow for better maturation and observation of developing embryos without compromising quality. Through better selection processes, we can also cut down on the number of multiple
gestational pregnancies that occur due to transferring 2 or more embryos, previously done to better assure success. Single Embryo Transfers (SET) are now a far more common procedure, met with uncommon success.
Advances; Fresh and Frozen!
Many women find themselves in the unfortunate situation of ‘too little, too late’. Women diagnosed with Diminished Ovarian Reserve (DOR) or Premature Ovarian Failure (POF), due to advanced age, genetics or treatment to eradicate diseases such as Breast Cancer, can now turn to Donor Eggs to conceive and carry a child. Gestational surrogacy is also a viable option for some women who cannot carry the pregnancy to term.
The improvement in freezing methods and development of verification allows to successfully freeze sperm, eggs and embryos. Egg Freezing is a more recent development that has been honed over the past decade to provide women with an ‘insurance policy’ towards their future fertility, should they be in a situation where they are unable to start their family due to health, personal or financial reasons.
Same sex couples can benefit from donor eggs, donor sperm or gestational surrogacy to create or complete their families, sometimes preserving a genetic link to one parent or the other.
Advances in Preimplantation Genetic Diagnosis (PGD)
Perhaps one of the most quickly evolving areas has been Preimplantation Genetic Diagnosis (PGD), done in conjunction with Invitro Fertilization (IVF). Through this powerful combination, patients can screen for inherited genetic disease such as Cystic Fibrosis, Huntington’s Disease and Sickle Cell Anemia and gene markers associated with Chronic Illnesses including BRCA 1/2 and early onset Alzheimer’s.
Future siblings can also be conceived through IVF combined with genetic testing and HLA matching to provide lifesaving bone marrow transplants to brothers or sisters suffering from terminal illnesses including Fanconi’s Anemia.
Screening embryos for all the chromosomes also allows to select the best embryos for transfer, minimize multiple births, and avoid miscarriages in the first trimester.
With such amazing progress over the past years, we look with anticipation to what the next 25 years may hold! For today, we will relish how far we’ve come and recognize the power of Infertility Awareness Week to help us move into the exciting future ahead!