Developments and Advancements in Fertility Treatments

Featuring Dr. Anthony Cheung, MBBS, MPH, FRCSC     

Duration: 3 minutes, 16 seconds    

Over the years IVF and ICSI, intracytoplasmic sperm injection, have become more common and in fact, it’s been estimated in 2012 nearly five million babies have been born through IVF or its related treatment ICSI.

Concurrent with this trend are major concerns for couples. Number one, IVF treatment is expensive and is emotionally charged. Unfortunately, while it has a good success rate it is still not 100 percent. So a couple has to be prepared for the possibility of having to repeat the procedure a few times. The problem is that there’s a lot of stress and energy involved as well as cost.

When trying to conceive ‘normally’ one won’t just give up after having sex once, but keep on trying each menstrual cycle. So for IVF or IVF with ICSI couples should consider the same thing. But what’s stopping many couples is the emotional and the financial stress related to those complicated and expensive procedures.  

Another concern with respect to IVF treatment is multiple pregnancies. So one of the major breakthroughs in the last ten years is to be able to culture the embryos from, instead of three days after fertilization, to five days after fertilization, what we call the blastocyst stage.  

And as a result the implantation rate is better. A reason that you may prevent culture of the embryos to the blastocyte stage is related to the quality of the eggs and the embryos. Both are related to a woman’s age although the man’s sperm certainly can account for some of these factors as well.

A common question is whether IVF and related treatment increase the chance of birth defects. It’s still controversial. But the question arises, is it really related to IVF treatment itself or the characteristics of the couple that requires IVF treatment.

A major breakthrough in recent years is the ability to freeze eggs so that when they thaw, they survive, fertilize and form a good embryo and pregnancy and this procedure is what we call vitrification.

Key issues surrounding these procedures and associated circumstances are currently generating a lot of social and ethical debate. All these advancements would not be possible without improvement in the lab environment, particularly involving, for example, security and 24/7 continuous monitoring of the lab environment and the electronic tagging and tracking of all dishes and stages for embryos and gametes to be correct to improve patient identification for safety reasons.

Because there are so many factors involved, particularly as a woman gets older, you should be seeing their family doctor earlier so that they can be referred to a fertility center for assessment and treatment as indicated.

Presenter: Dr. Anthony Cheung