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Thursday 24 July 2008

RAPID ROUNDUP: 30 years of IVF – Experts comment

Thirty years ago on Friday July 25, the world’s first test tube baby was born. The birth of Louise Brown in the UK in 1978 was closely followed by the birth of Australia’s first IVF baby, Candice Reed, in Melbourne in 1980. The latest figures from the National Perinatal Statistics Unit (NPSU) at the Australian Institute of Health and Welfare (AIHW) show around 50,000 treatment cycles occur in Australia each year.

Australian experts look at how far IVF has come and what the future may hold.

Feel free to use these quotes in your stories. If you would like to speak to an expert, please don’t hesitate to contact us on (08) 8207 7415 or by email.

Peter Illingworth President, Fertility Society of Australia

"The birth of the first IVF baby was an extraordinary breakthrough.  Who would have thought 30 years ago, that over 6000 babies would be born in Australia every year through this technology; that we would be able to obtain a single sperm cell from the testicle to allow a man to father children; that in the early 21st century, we would be exploring the use of embryonic stem cells in the hope of enabling human beings to grow whole new organs.

It is unlikely that we will see a single breakthrough of this magnitude in reproductive science again in our lifetimes.  The immediate future will involve refinement of the technology to make  IVF easier; freezing unfertilised eggs that can then be fertilised one by one, developing molecular selection techniques to pick out the best embryos and particularly sperm, for treatment. Looking further into the future one can foresee the use of stem cell technology to create artificial gametes and help men and women who have no eggs or sperm of their own have their own genetic children."

Keith Harrison is Director of Scientific & Administrative Services at the Queensland Fertility Group

“Before the advent of IVF only a very small percentage of infertile couples could be helped to have their own pregnancy. 30 years later, with IVF and the numerous variations that have developed from it, there are very few infertile couples who now can not be helped achieve their dream of their own child. It is now the mainstream infertility treatment in almost every country in the world. This achievement has come from developments in fertility drugs, new surgical procedures facilitated by new technologies, and scientific advances in handling sperm, eggs and embryos. In the future we look forward to the procedure being simplified to make it cheaper and less intrusive into the lifestyle of infertile couples.”

Professor Lois Salamonsen is Group Head of Uterine Biology at Prince Henry’s Institute in Melbourne. PHI is a World Health Organisation Collaborating Centre for Research in Human Reproduction.

“Many IVF attempts still fail because we do not fully understand the underlying biology of implantation. While much emphasis has been placed on the quality of the embryo that is replaced, less has been applied to the quality of the endometrium; the ‘fertile ground’ to which the embryo must first attach and then invade if a placenta is to be formed and the pregnancy established. Researchers at Prince Henry’s Institute have a substantial program of work directed to understanding how the endometrium is prepared for embryo implantation and how this can be facilitated to improve IVF success rates.”

Prof Michael Chapman is Director of IVF Australia, a NSW based IVF clinic.

“Nearly 10,000 babies were born in Australia last year from assisted conception and in excess of 80,000 since the birth of Australia’s first, Candice Reed in 1980. While the community’s acceptance has grown and the stigma surrounding this technology is subsiding the need for assisted conception continues to grow as Australians delay starting a family.

The Future of IVF

Success rates will continue to improve as we learn to select the best embryo for transfer; utilising techniques such as the IVF Australia discovered PolScope (polarised light to help view the genetic material inside an egg) and preimplantation genetic diagnosis (PGD) (selecting the healthiest embryo for transfer). Egg freezing will become an option for women to preserve their fertility. Understanding and selecting a male’s best sperm will also help optimise fertilisation.

Basic Facts

• IVF now accounts for one in every 33 Australian births; that’s one child in every classroom.
• Success rates have doubled across all age groups in the last 10 years – The average age of women undergoing assisted conception at IVF Australia for example is 36 and their chance of having a baby is over 40 per cent per treatment cycle.
• Pregnancy rates will improve as people optimise their lifestyle in preparation for pregnancy (no smoking, healthy BMI).
• Infertility is a medical condition, one in six Australian couples of reproductive age (about 15 per cent of Australian couples) are infertile and will need assistance to conceive.
• Infertility is caused by both male and female issues (40 per cent men and 40 per cent women - while in 20 per cent of cases, infertility is a combined problem or remains unexplained). Age affects men and women’s fertility.
• The time for people to conceive has significantly reduced due to societal changes – people meet their soul mate later in life.”

Dr Adrianne Pope is Director of Business Development at Repromed, a South Australian based IVF clinic. She is a human reproduction biologist and past president of the Fertility Society of Australia.

“IVF in Australia has never been more successful, affordable, convenient or accessible. Thanks to cutting edge science and government funding, IVF is a viable option to many Australians wishing to recognise their dream of having children. The introduction of technologies such as blastocyst culture (day 5 embryo development) have addressed the issues associated with multiple pregnancy by optimising success with the transfer of single embryos. The last 30 years has seen the refining of techniques to enable couples to access treatment that is no longer deemed experimental but routine and safe. With one child in every class in Australia a result of IVF, the technology has truly come of age.”

Associate Professor Jeremy Thompson is Deputy Director of the Research Centre for Reproductive Health at the University of Adelaide

"IVF has changed the lives of many over the past 30 years, especially those who require assistance in conceiving children and those that provide the technology to assist others. It is also a highly regulated area of medicine, where limits are imposed on how embryos are created and in some countries, how many embryos are created. No other area of medical intervention has such scrutiny. This will significantly affect the application of any advancement made in the field, so that when new and especially controversial techniques are developed, such as the transformation of adult somatic cells into gametes for the production of viable embryos, the safety and regulatory hurdles for clinical application will be enormous. Already there are questions about the long-term health of children derived from IVF technologies which are extremely difficult and costly to determine. However, on the positive side, automation of the existing laboratory techniques to improve safety and reliability of IVF technology and the delivery ofsystems which are affordable tomost couples around the world are admirable andshould be pursued."