Medical Advancement & Evolution of IVF Technology

On July 25, 1978, a baby girl was born at a hospital in England. This baby girl, Louise Joy Brown was no ordinary child. She was conceived in a test tube. She was the first baby born as a result of in vitro fertilization, a technique that fertilize sperm and egg outside of the human body.

Indian IVF industry is rising at a Compound annual growth rate of 28 percent and is anticipated to be around INR. 495 crores by 2022 in India. By the end of this century, in vitro fertilization (IVF) might account for 4% of the overall population i.e. about 400 million babies. It has by now produced an approximate 6 million babies in the world. Today, with the advancement of science and technology, Assisted Reproductive Technology (ART) has got great advances in the forty years since the birth of the first IVF baby. Other than curing female infertility cases, advanced ART procedures such as Magnetic Activated Cell Sorting (MACS), intracytoplasmic sperm injection (ICSI), and DNA Fragmentation Index (DFI) analysis can also help with Male infertility cases.

Following are some of the best practices in the IVF industry that have helped to ensure 100% success rate:

Cryopreservation
Embryo cryopreservation is the method of freezing and storing gametes and is a part of most in vitro fertilization process. The process is chosen for various reasons such as providing a further chance for pregnancy or saving embryos in the case of certain medical treatments. There has been incredible improvement in cryopreservation protocols, that has assisted women undertaking cancer treatment or who wants to delay having a baby.

Blastocyst Culture
Blastocyst Culture is a procedure in which an embryo is grown in the laboratory for 5-6 days before being placed in womb. The embryo increases many cells as a result of being grown for so many days. This allows embryologists to select from the embryos with better possibility for implantation. The biggest benefit of Blastocyst Culture method is that it allows fewer embryos to be transferred without compromising the pregnancy rate and lowers the risk of multiple pregnancies.

Magnetic Activated Cell Sorting (MACS)
Magnetic Activated Cell Sorting is a semen preparation procedure that involves the magnetic separation of vigorous spermatozoa from the apoptotic ones, which have less fertility capability. The apoptosis (programmed cell death) is a regulation method of the cell cycle which may occur throughout spermatogenesis (the process of development of sperm cells), thereby affecting cell damages such as sperm DNA fragmentation. MACS helps segregate better sperms from the ones which are on the edge of death, and helps achieve better fertilization rate, cleavage rate, implantation rate and pregnancy rate.

ERA (Endometrial Receptivity Array)
ERA is a molecular diagnostic test to investigate the receptiveness of the endometrium. It is performed by taking a small sample of tissue from the covering of the womb. The ERA is a state-of-the-art diagnostic method that helps to assess the woman’s endometrial receptivity from a molecular view. Embryo implantation is the procedure of the embryo syncing with the endometrial wall in a woman.

Pre-implantation Genetic Testing – Aneuploidy and Monogenic Disorder
Genetic testing is divided into distinct categories:

1) Preimplantation Genetic Testing - Aneuploidy (PGT-A)

2) Preimplantation Genetic Diagnosis – Monogenic Disorder (PGT-M)

3) Pre-Implantation Genetic Testing - Structural Rearrangement (PGT – SR).
For several reason, genetic and otherwise, couples can be at risk of having abnormal embryos. The risk increases substantially as a woman gets older. An abnormal embryo practically always fails to implant, or even if it implants, the pregnancy ends in a biochemical pregnancy, miscarriage, fetal death later in pregnancy, stillbirth or an Abnormal Baby.

Pre-implantation Genetic Testing facilitates in choosing the best quality genetically normal embryo for implantation.

It is encouraging to witness the progress of Assisted Reproductive Technologies and its involvement towards the IVF industry, both in India and abroad. Advent of new technologies like AI, machine learning, data analytics, cloud technology, etc., has led to a massive increase in the potential for growth and development of various ART procedures, thus accomplishing the dreams of parenthood for many couples.

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