Monday, September 11, 2017

In Vitro Fertilization: The Laboratory Baby Boom


Right before midnight, on July 25, 1978, Lesley and John Brown welcomed the birth of their little girl. Her name was Louise Brown, and she was born in Oldham, England. Three years later, across the world, Judith and Roger Carr welcomed their second child, Elizabeth, in Norfolk, Virginia. Two baby girls born in two different countries. Unlike millions of other babies born during that time span, Louise and Elizabeth each graced the covers of national magazines after their birth. What made these two babies so special? They were the first babies conceived using in vitro fertilization (IVF) in England and the United States.
            Since Louise Brown’s birth, over six million IVF babies have been born throughout the globe. IVF is a method that helps couples with fertility problems to conceive a child. Simply put, instead of fertilization occurring within the body, it occurs in the lab. This might be needed if a woman has damaged fallopian tubes, those tubes that connect the ovaries to the uterus, since this prevents eggs being fertilized and embryos reaching the uterus (where a fetus develops). Other scenarios can direct couples toward IVF such as problems with ovulation (egg production), sperm production, genetic disorders, or other conditions affecting reproduction.
A sequence of general steps is followed during IVF. Since eggs are required to form an embryo, synthetic hormone treatments are given to stimulate the production of multiple eggs at one time (typically, only one egg is released per month). This process is referred to as ovarian stimulation, can take 8-12 days, and increases the chances of fertilization. Yet, there are many possible side effects of the intense hormone treatments, which all doctors should educate their patients on. Ultrasounds and estrogen tests are used to monitor the eggs throughout this process. Once the eggs look ripe for fertilization, a shot is administered to commence the eggs’ release. About 36 hours later, the eggs are sucked up using a thin needle and suction (fortunately the woman is sedated). This process can result in several eggs being collected in about 20 minutes.
Once eggs are retrieved, they are fertilized with the father’s sperm in a lab. As you might expect, sperm is usually collected in a simpler method that does not require hormone treatments. Once the eggs are fertilized, and now referred to as embryos, one embryo (or sometimes multiple – to increase the likelihood of success) are implanted into the uterus to continue developing. In some cases, embryos are given about six days to develop in the lab before they’re tested for genetic diseases and chromosome number. This gives doctors greater confidence that implanted embryos do not carry common diseases or chromosomal abnormalities.
While IVF is usually associated with couples, it’s important to note that eggs or sperm can come from donors. Additionally, embryos can be implanted into a gestational carrier: a woman that carries the baby to term.
The goal of IVF is to conceive a healthy baby. Since its initial success with Louise Brown, millions of babies have been conceived using IVF, and it’s easy to imagine the joy that IVF has provided for families throughout the world. 

List of Sources

1.     The Telegraph. “Louise Brown, the first IVF baby, reveals family was bombarded with hate mail.” Victoria Ward. July 24, 2015. www.telegraph.co.uk/news/health/11760004/Louise-Brown-the-first-IVF-baby-reveals-family-was-bombarded-with-hate-mail.html

2.     WWW.mayoclinic.org (search for “in vitro fertilization” at top of screen. Then, click on top search result “In vitro fertilization (IVF) – Overview – Mayo Clinic.” See information in “Overview” and “Procedure Details” tabs.)

3.     WWW.columbiafertility.com (search for “typical IVF timeline” at top of screen. Then, click top search result “The Typical IVF Timeline: 6 Steps You Need to Know.”)

4.     WWW.urmc.rochester.edu (search for “IVF step by step” at top of screen. Then, click top search result “IVF Step-by-Step.”)