History and Development of IVF and ICSI

The first successful example of a "test tube baby" was born in 1978 in greater Manchester in the UK. The procedure was developed by Robert G. Edwards who was awarded the Nobel Prize in "Physiology or medicine" in 2010 for his contribution to this field with the development of intra-cytoplasmic sperm injection (ICSI), where a single sperm can be injected into the egg using a fine needle. This means that the chance of pregnancy is increased for men with a low sperm count. ICIS took almost 2 decades to be developed and is one of the greatest recent breakthroughs in this field as it has almost eradicated male infertility.

Since then IVF has become increasingly more possible with the ability to freeze and thaw embryos (the first successful full term pregnancy from a frozen embryo took place in 1984). Freezing embryos means that eggs can be stored for future use and increased the possibilities in egg and embryo donation.

New IVF procedural developments

Further developments have been made with the ICSI (intra-cytoplasmic sperm injection) technique. Dr Monica Antinori and colleges from the international Associated Research Institute for Human Reproduction in Rome conducted randomised control trials to research the possibility of IMSI (intra-cytoplasmic morphologically-selected sperm injection).

This technique goes a step further than ICSI as it uses a powerful microscope to select the healthiest sperm in order to increase the changes of pregnancy. Further reports need to be made to show the benefits of using IMSI and evaluate the costs, it is estimated that IMSI is twice as expensive and will require further specialist training and equipment.

Embryologists are also developing a method known as metabolomics, which is conducted before the embryos are inserted back into the womb after being fertilised. This process involves testing the fluid that an embryo is developing in for certain molecules or metabolites. The purpose of this is to identify which of the embryos have the best chance of successful implantation in the uterus wall.

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