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Archive for the ‘In Vitro fertilization’ tag

ASRM Retrospective 30 Years Later

By David Kreiner MD

October 17th, 2013 at 1:48 pm

image courtesy of renjith krishnan/freedigital photos.net

 

Flying into Boston this week it occurred to me that this was the 30 year anniversary of the first ASRM meeting I ever attended.  In 1983, the American Fertility Society “AFS” meeting (as it was called then) was held in San Francisco and I attended as a third year ob-gyn resident. I was in awe attending this huge conference of about 3-5,000 held at the Hyatt Hotel as I recall.


Though I was required to man the Ovcon 35 birth control pill exhibit (since Ovcon’s manufacturer was paying my way), I was drawn to the microsurgery and in vitro fertilization exhibits and presentations.  

In the ballroom, the presenters presided over a few thousand of us eager to hear about the most recent successes in IVF.  Already, Norfolk had achieved dozens of births through this new scientific process which brought gynecological surgeons (laparoscopists) together with embryo biologists, endocrinologists, andrologists and numerous nurses, technicians and office staff.  For me, hearing Dr. Howard Jones, American IVF pioneer, and others speak about their experiences with this life creating technique was exhilarating.

Years later, as a Jones Institute reproductive endocrinology fellow, I would hear Dr. Howard proclaim that a chain is only as strong as its weakest link.  IVF required every link to maintain its integrity for the process to work.

In 1985, I presented my own paper at the AFS meeting in Phoenix, Arizona.  My wife and two sons joined me.  My presentation on endometrial immunofluorescence in front of hundreds of experts and specialists in the field remains one of the strongest memories in my life.

Today, the ASRM must be held in mega convention centers like the one in Boston where it could accommodate tens of thousands of attendees.  One presentation estimated the number of IVF births worldwide at over five million. Interestingly, per capita, the US performs one fifth the number of IVFs as Europe–where IVF is much more accessible and typically covered by government insurance.

Today, success in the US is better than fifty per cent for most people, thereby making single embryo transfer (“SET”) for good prognosis patients a viable option to avoid the risk of multiple pregnancy. Minimal stimulation IVF (“Micro-IVF”) is a viable alternative for many patients, offering a lower cost and lower risk option.  Egg freezing offers a means of fertility preservation, especially valuable to women anticipating cancer therapy.  Pre-embryo genetic screening (“PGS”) is an option that allows patients to screen for and eliminate genetically undesirable embryos that may otherwise lead to miscarriage or termination.

Looking back at the past thirty years, I am amazed at the progress and achievements made by my colleagues in IVF and happy that I was able to participate in this most rewarding field that has brought so much joy to millions of people.

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photo credit: renjith krishnan http://www.freedigitalphotos.net/images/agree-terms.php?id=10058384

 

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Infertility Podcast Series: Journey to the Crib: Chapter 17 In-Vitro Fertilization and Embryo Culture

By David Kreiner MD

July 13th, 2012 at 8:03 am

Welcome to the Journey to the Crib Podcast.  We will have a blog discussion each week with each chapter.  This podcast covers Chapter Seventeen: In-Vitro Fertilization and Embryo Culture. You, the listener, are invited to ask questions and make comments.  You can access the podcast here: http://podcast.eastcoastfertility.com/?p=103 

In-Vitro Fertilization and Embryo Culture 

In-Vitro Fertilization revolutionized infertility care when Nobel prize-winning scientist, Robert G. Edwards, succeeded in achieving the first successful birth utilizing an egg retrieved in a natural cycle and fertilized in the lab.  Back then, in 1978, the procedure was rarely successful until Georgiana Seegar Jones together with her husband Howard W. Jones Jr. in Norfolk, Virginia started stimulating the woman’s ovaries with gonadotropin hormone injections achieving their first pregnancy in 1980. 

Since that time pregnancy rates have improved as a result of experience and improvements in technique with ovarian stimulation and handling of the gametes, sperm and eggs, in the lab and, in particular, with dramatically improved culture media.  Egg retrievals, performed by laparoscopy during the early years, are now performed by transvaginal aspiration under ultrasound guidance.  The embryo transfer became much less traumatic with more accurate placement when also performed utilizing ultrasound visualization. 

Until IVF became efficient, multiple embryos were transferred resulting in many high risk, high order multiple pregnancies.  Today, single embryo transfer (SET) offers a better than 50% pregnancy rate to women under 35.  Double embryo transfer leads to pregnancy in many centers 70% of the time in these women. 

A recent study published in the New England Journal of Medicine documents that pregnancy rates for IVF are comparable to that of fertile couples and is as high as 80% after three donor egg cycles. 

According to the Center for Disease Control, IVF with single embryo transfer would save $1.1 billion annually, if used rather than insemination with fertility drugs.  Perhaps it is time for society to support safe IVF as the preferred therapy for infertile couples.  

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Was this helpful in answering your questions about IVF and Embryo Culture? 

Are you aware that Long Island IVF is giving away a free basic Micro-IVF cycle, valued at $3,900.00? Check out the contest here: http://bit.ly/LHbmQR 

Please share your thoughts about this podcast here. And ask any questions.

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