Developed in England by Doctors Patrick Steptoe and Robert Edwards, the first 'test-tube' baby was born in 1978. The first succesful IVF treatment in the US took place in 1981, and there have been 45,000 babies born with the aid of IVF treatment since then. In brief, the process involves removal of ova? (eggs) from the women's body and letting sperm fertilise them in a fluid medium. They are then transferred to the mother's uterus where normal development occurs. IVF is used commonly when the father's sperm count is low or the woman's fallopian tubes are are blocked.
The eggs can be retrieved from the mother using two techniques: sonographic or laparoscopic egg recovery. The more common sonographic technique involves an ultra-sound guided needle piercing the vagina. The follicle?s of the women are punctured and the womens follicular fluid is removed and placed in an incubator. Laparocopic egg recovery involves retrieval through an incision in the abdomen. This is used in women which also require a simultaneous assesment of their pelvic anatomy through a diagnostic laparoscopy.
Semen is also taken from the husband, which can be analysed using 'sperm penetration assays', where some sperm is checked to see whether it can puncture a zone-stripped hamster egg. The sperm can also be cultured to detect bacteria which can reduce the chances of pregnancy.
The sperm and the egg are incubated together (at a ratio of about 75,000:1) in the culture? media for about 18 hours. The eggs and sperm should fertilise in the usual way in this media (see fertilisation?), but if this is not possible assisted fertilisation techniques - such as injecting the sperm directly in to the egg using ICSI techniques (see below) - may be used. They are then passed in to a special growth medium and left for 40 hours until the eggs have become pre-embryos.
The fertilised eggs are transferred to the women's uterus through a thin, plastic catheter?, which passes through her vagina and cervical canal. Often, multiple embryos? are passed in to the uterus to improve chances of succesful pregnancy. If this procedure is unsuccesful, the mother has to give one month for recovery before the IVF egg-extraction procedure is repeated. This may be avoided by freezing embryos in liquid nitrogen when they are fertilised, and transferring them during the natural [ovulation cycle]? again.
The mother has to wait two weeks before she returns to the clinic for the pregnancy test. During this time she can boost the chances of pregnancy by continuing to take [[progesterone] - which keeps the uterus lining thickened and suitable for implantation? to occur. The chances of a succesful pregnancy is approximately 20 per cent for each IVF cycle.
Gamete Intra Fallopian Transfer (GIFT) is a similar procedure to IVF, which place harvested eggs and sperm straight in to the fallopian tubes where it is hoped they will fertilise naturally.
The use of frozen embryos that are no longer needed by the mother for research (for example in to stem cells) is a largely contested issue. A lot of the problem for some people is due to the embryos being destroyed during the course of research. Some groups protest that these embryos have the right to life, whereas other scientists reply that they would have been destroyed anyway.
Another problem brought up by the use of IVF is the possibilities it can result in on who uses the technique. There was worldwide publicity in 2001 given when a French women posed as the wife of her brother in order to give birth to a donor egg fertilised by his sperm. Some saw this as a form as incest; others thought it unhealthy for the child when he grows up to learn how he was delivered; whereas other people simply couldn't see anything wrong with the situation.
The use of IVF allows same-sex couples to be able to have children together. Although gay parents already raise children, IVF makes the option much simpler and could make the option widespread. Some people object that this could give phsychological problems to the child if they grow up without a mother/father role-model.
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