Modern fertility treatments (IVF, ICSI, FET) are effective

2.10.2016 Pekka Sillanaukee

Modern fertility treatments (IVF, ICSI, FET) are effective

Infertility is increasing rapidly all over the western world. In Finland, for example, 27 % of 35-year-old women and 40 % of men are childless (Statistics Finland). Many of them would like to have children, and more and more people actively seek help from fertility clinics.

In vitro fertilisation and new methods developed from it are the most effective treatment methods for infertility. In vitro fertilisation, or IVF, was originally developed to help women who suffered from infertility due to damaged fallopian tubes. Today, in vitro fertilisation is widely used in treating infertility of other kinds too, such as endometriosis or unexplained infertility. Successful treatment requires an egg that can be fertilised, the availability of sperm and a womb that is able to support pregnancy.

Louise Joy Brown was the first child in the world to be conceived via in vitro fertilisation. She was born in Great Britain on 25 July 1978 (Steptoe et al. 1978). The first pregnancies in Finland via in vitro fertilisation (IVF) were achieved in 1983, and the first baby was born in 1984 (Seppälä and Koskimies 1985). More than 40,000 babies have now been born in Finland thanks to fertility treatments, and 2,500 more are born every year (Statistics Finland). With the advances in technology and the rapidly increasing number of treatments, pregnancy results have also improved.

Today, fertility treatments can be offered to almost all childless couples. Often there is more than one reason for infertility. The rate of pregnancies per a single IVF treatment cycle is approximately 20–35 %.

The microinjection of a single sperm (intracytoplasmic sperm injection, ICSI, Palermo et al. 1992) revolutionised the treatment of male infertility (Hovatta et al. 1995). The treatment involves injecting a single sperm directly into an egg. ICSI is an appropriate treatment for couples suffering from infertility due to the reduced quality of the man’s sperm cells. Reduced quality may refer to low sperm count or poor motility. If the ejaculate contains no sperm, an egg can be fertilised also with sperm retrieved from the epididymis, testicle or deferent duct. Pregnancy success rates from ICSI per treatment cycle are similar to IVF rates.

Frozen embryo transfer (FET) allows for several embryo transfers after just one ovarian stimulation treatment cycle and egg retrieval. FET treatments implemented with modern vitrification methods produce excellent results. For example, FET treatments using the vitrification method developed at Ovumia through vigorous development work resulted in 40 % of clinical pregnancies, while the national rate of clinical pregnancies using FET was 27 % in 2014.

Advances in laboratory technology also play an important part in the improved treatment results. The fertility treatment sector is continuously progressing thanks to new technology and laboratory innovations. Ovumia’s laboratories have developed new methods for treating both male and female infertility in collaboration with TEKES, the Finnish Funding Agency for Innovation, since 2013. This has resulted, for example, in the first egg bank in Finland (The Finnish Egg Bank™).

Using donated eggs is a good treatment method for women whose ovaries have ceased to function at a young age, or whose ovaries’ ability to produce eggs that can be fertilised is reduced. Also, in some cases, where both partners have poor quality gametes, donated embryos can be used, or both donated sperm and eggs.

The health of children born through fertility treatments has also been monitored, and the treatments have not been found to increase their likelihood of illnesses or birth defects. In the future, more and more children will be conceived through in vitro fertilisation (IVF), intracytoplasmic sperm injection (ICSI) and frozen embryo transfer (FET). Embryos can now be stored in deep freeze for long times and they can be thawed when the parents want a second or third child. This means that the same family can have children who were conceived on the same day but born in different years. For more information, read Ovumia’s blog article “A new life from deep freeze to parents’ loving arms – Pregnancies via frozen embryo transfers (FET) and egg freezing”. In 70–90 % of cases, modern fertility treatments can provide help for childless couples. More than 42,000 embryos have been frozen at Ovumia clinics and so far more than 27,000 of them have been transferred. Our treatments have brought about more than 7,500 children.

 

Literature

Hovatta, O., Reima, I., Lähteenmäki, A. Siittiön mikroinjektio munasoluun (Microinjection of Sperm into the Egg). Duodecim 1995; 111: 1542-5.

Palermo, G., Devroey, P., Joris, H., van Steirteghem, A. C. Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte. Lancet 1992; 340: 17-8.

Seppälä, M., Koskimies, A. Koeputkihedelmöitys (In Vitro Fertilisation). Duodecim 1985; 101: 1464-74.

Steptoe, P.C., Edwards, R.G. (1978). ”Birth after the reimplantation of a human embryo.” Lancet 2(8085):366

Statistics Finland. Assisted Fertility Treatments 2014–2015. Official Statistics of Finland. Health 2016.

 

Keywords

IVF = In vitro fertilisation is a treatment where a woman’s egg is fertilised with a man’s sperm outside the body. The fertilised eggs are grown into embryos, after which normally one or two embryos are transferred to the womb. Successful treatment requires an egg that can be fertilised, the availability of sperm and a womb that is able to support pregnancy.

ICSI = Intracytoplasmic sperm injection is a fertility treatment that involves injecting a single sperm directly into an egg, after which the treatment progresses similarly to IVF treatments.

FET = frozen embryo transfer. Good-quality embryos achieved through in vitro fertilisation can be frozen and transferred to the womb later. This method enables several embryo transfers, thus increasing the likelihood of success.

IUI = intrauterine insemination refers to artificial insemination inside the womb and involves injecting sperm into the womb.

Clinical pregnancy = A pregnancy diagnosed by clinical signs; for example, a gestational sac observed with an ultrasound scan, or signs of pregnancy (e.g. an embryo, foetus, gestational sac or placenta) observed during a curettage.

 

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