Posted by on Apr 24, 2017 in Blog, Infertility | 3 comments

Learning about “the birds and the bees” may be the way your parents described getting pregnant but it’s a lot more complicated than you think.  And for many couples, trying to have a baby is a result of science and technology that has come a long way in a relatively short amount of time.

In 2015, 3,978,497 babies were born in the US and 5.1 million babies in the European Union.

Infertility

According to the CDC around 1 million married couples in the US have had difficulty getting pregnant after one year of trying.  If a couple under the age of 35 is having trouble getting pregnant after a year of frequent sex, it is recommended that they see a physician about it.  If a couple is over 35, they should see a physician after six months of trying.

Infertility issues are not just a problem for women.  In fact, in 35% of couples with infertility both the male and female contribute to the issue.  In around 8% of couples with infertility, the factor affecting the couples’ ability to get pregnant rests with the male.

Issues causing male infertility

A test of semen looks at the amount of sperm  as well as the sperms’ motility or movement and the sperms’ shape.  Age and lifestyle factors like smoking, alcohol and other drug use or obesity can impact the production of healthy sperm.  Men who frequent hot tubs and men with varicocele, enlarged veins in the scrotum, may also have problems with fertility because sperm are heat sensitive. Having had treatment for cancer is yet another factor.

Issues causing female infertility

Women can have problems with their ovaries which interfere with getting pregnant.  Polycystic ovary syndrome is the most common cause.  Diminished ovarian reserve is another common problem. Diminished ovarian reserve refers to the fact that females are born with all the eggs they will ever have– between 1 and 2 million.  By the time of menstruation, that number is about 300,000.  Eggs are released with every menstruation.  As women age, fewer and fewer eggs are available for fertilization.

Women can also suffer from endometriosis, a condition in which tissue from the inside of the uterus grows outside of the uterus.  This tissue can block fallopian tubes and can cause scarring that interferes with fertility.  Pelvic inflammatory disease, cervical stenosis (narrowing of the passage into the uterus) and fibroids or myomas in the uterus also hinder the ability to get pregnant.

In Vitro Fertilization

On a yearly basis more than 85,000 women go through IVF to have a family.   But it has taken hard work and dedication to figure the process out.  The earliest attempts to fertilize mammalian eggs in a petri dish are described in scientific literature from 1878.  Yet it took until July 25, 1978 for the first baby to be born through in vitro fertilization.

Much of the problems had to do with understanding all the components of the process in vivo (in the body) in order to replicate it in the lab.  For example, for conception to occur, an egg must be fertilized with 12 to 24 hours after the egg has left the ovary.

Here is a video which describes what happens in vivo (within the body) during fertilization.

https://youtu.be/_5OvgQW6FG4

Some of the difficulties in getting to that first child, Louise Joy Brown, included understanding capacitance in sperm. Capacitance is a maturing of the sperm, a chemical reaction that must take place so that there is increased mobility of the sperm.  Additionally, the membrane covering the head of the sperm changes to allow penetration of the outer layers of the egg.  The environment inside a woman’s body encourages capacitance.

Indeed, it took time and research  to devise the right mediums that mimic the human body for sperm, egg and fertilized egg to live and mature properly.  It took until 1969,  for scientists to be convinced that there actually was a fertilization in vitro, evidenced by seeing pronuclei (2 nuclei inside one cell).

Artificial Reproductive Technology Today

The CDC collects success rates on artificial reproductive technology (ART) for many fertility clinics in the US.  In 2014, the average age of women using artificial reproductive technology services was 36 years.

Here are some success rates statistics available from 2014.    These are ART cycles (a cycle is the process of stimulation of ovaries to produce mature eggs) using the woman’s own eggs that led to live births.  It may take several cycles to collect enough eggs before attempting fertilization and transfer to the woman’s uterus.

  • “37% in women younger than 35 years of age.

  • 30% in women aged 35 to 37 years.

  • 20% in women aged 38 to 40 years.

  • 10% in women aged 41 to 42 years.

  • 4% in women aged 43 to 44 years.

  • 1% in women older than 44 years of age. “

 

With conventional IVF, many sperm are placed with the egg for fertilization.  If that doesn’t work, intercytoplasmic sperm injection– where the egg is held in place, the egg is pierced and one sperm is injected into the egg– is available.

To optimize the chances of pregnancy, often two fertilized eggs are implanted.   In 2013, 25% of live births from in vitro fertilization were twins.

The use of donor eggs increases with the age of the woman doing ART.  Women under 35 (96%) tend to use their own eggs, while 68% of women over 45 use donor eggs.  Use of donor eggs increases the success rate in completed pregnancy and live births for women over 45.

Cost of IVF

According to Forbes, the medications to stimulate egg production run between $3000 and $5000.  A cycle of IVF costs around $12,000.  For those who need pre-implantation genetic testing, which is used in cases where genetic disorders, like Tay Sachs or cystic fibrosis, are present in the couple, costs are between $3000 to $6000.

IVFThese numbers can make IVF prohibitive for many people.  However, plans that feature single cycle versus multi-cycle options may reduce costs and there are also options which involve refunds (if a pregnancy does not occur).  It is worth your while to do some research to find out what is available in your area.

Some people have insurance that covers some of the costs.  In addition, there are non profits which provide grants and many couples are utilizing crowdsourcing websites to fund their IVF.

http://abcnews.go.com/GMA/video/couples-crowdsourcing-ivf-treatments-38691150

Your Thoughts

What are your experiences with artificial reproductive technology?  Do you have any advice for others dealing with fertility issues?  How did you handle the cost of the experience?  Please share your thoughts in the comments section below.  If you have infertility issues, sign up for Medivizor.com and get up-to-date content in your inbox on infertility.