When couples find it difficult to conceive, they will often seek out fertility treatments. Problems with conception can stem from both men and women. Some of the possible reasons behind this problem include:
- Reduced fertility in men and women
- Blocked fallopian tubes
- Genetic disorders
Couples are often advised to seek fertility treatment only after they have tried to conceive naturally by engaging in regular unprotected sex for at least a year. If they fail to conceive, going to a doctor or fertility specialist is a good way to try and discover if there is a problem.
There are several ways fertility issues can be addressed. This can include taking medications to help with ovulation, undergoing surgery to correct physical anomalies in the reproductive system, and assisted conception. These treatment options do not always assure success in conceiving, but when undertaken under the care of a qualified specialist, can certainly boost chances of conception. The history of fertility medicine has been fraught with many difficulties in trying to achieve progress. Let’s look at how IVF came about and how the term test-tube babies relate.
A Brief History
In vitro fertilisation (IVF) is the most commonly chosen and effective option of assisted conception. The first baby conceived in this manner, or IVF baby, was born in 1978 and ever since this treatment has helped millions of families conceive.
Test tube baby is a term coined in the 1930s to refer to cases where women underwent artificial insemination to conceive. In this case, a semen sample taken from the man was specially washed before being directly transferred into the woman’s uterus via the cervix. Fertilization would therefore take place inside the body, or in vivo. This is different from IVF, where the egg and sperm are mixed in a glass culture dish, or in vitro.
IVF vs Artificial Insemination
As a result, the term test tube baby is misleading. The embryo is not created in a test tube or other lab apparatus. Fertilization actually takes place within the woman’s uterus. It is patently different from what happens with IVF procedures that require extraction of the egg and sperm from the body and combining them in the lab before the embryos are transferred to the woman’s uterus for implantation to occur.
For a long time, children conceived through IVF were also called test-tube babies. The first baby conceived via IVF in 1978 is Louise Joy Brown. She is still alive today and was referred to as a test-tube baby.
Many of the first children conceived through IVF were persistently referred to as test-tube babies. The idea of fertilisation outside the body drew much controversy and condemnation from within the medical community and churches. It was difficult for doctors that pursued this research to find funding. They often found their activities highly scrutinized and had to contend with multiple legal and ethical issues.
IVF Treatment Today
However, with time and more babies being successfully conceived and born from this treatment, IVF became widely accepted and is available worldwide. The procedure has also become less complicated since its inception. At first, women that were implanted had to remain hospitalised under strict medical supervision. They would undergo laparoscopy procedures for egg retrieval as part of the IVF process. Now, an ultrasound guided needle is used to facilitate extraction through the cervix, a process that is less invasive and faster to recover from.
Women also had to collect their urine for regular hormone testing while confined to the hospital. Today, IVF treatments are far less physically invasive and confining. Women need only visit their doctor regularly for blood tests that will check on hormone levels. There has also been useful research into fertility drugs that can help boost ovulation and make the egg retrieval process easier and better timed.
Within the medical fraternity, the term test tube baby has negative connotations. This is mostly due to the controversial way it has been garishly portrayed in sci-fi film imagery and other media to exaggerate and mislead as to how IVF actually works.
So while at one time IVF and test-tube babies did refer to the same thing, the history of fertility medicine confirms that they referred to different procedures that were used to help in conception. Not to mention that there are no actual test tube babies as the original procedure did not involve any fertilisation in the lab, and in the case of IVF, it is a glass culture dish that is used.
How IVF Works
The process involves 5 basic steps once appropriate screening of both the man and woman have been done.
- Ovarian stimulation – This helps to stimulate the production of multiple healthy eggs. Retrieving multiple eggs all at once is easier than waiting for the single egg that develops each month. It also reduces the need to keep subjecting the woman to an invasive procedure to obtain the eggs. Different medications can be used to stimulate the ovaries, promote oocyte maturation, and prevent the release of the developed eggs till they can be retrieved.
- Egg retrieval – This is the physical procedure performed by the doctor to retrieve the eggs before ovulation takes place. An ultrasound guided needle is inserted through the vagina to follicles where the eggs are retrieved from. Sometimes the needle may be inserted through the abdomen. The eggs are then placed in a culture medium and incubated. Once the healthy and mature eggs are identified and separated, they can then be mixed with sperm.
- Sperm retrieval – A sperm sample is taken from the man through masturbation or testicular aspiration. Where there are no viable sperm to be retrieved, donor sperm may be used. The sperm is then separated from the seminal fluid in the lab.
- Fertilisation – Conventional insemination is done by mixing the eggs and sperm and incubating them. Intracytoplasmic sperm injection (ICSI)is a more precise method used where sperm quality and number are a concern. It allows for the selection of healthy sperm and injecting them directly into a mature egg.
- Embryo transfer – This takes place a few days after egg retrieval when fertilisation has occurred. The embryos are placed inside the uterus using a catheter inserted through the cervix. Successful implantation takes place within 6 to 10 days after egg retrieval. Your doctor will undertake a pregnancy test 2 weeks later to confirm success.
If you have any questions about the IVF Process or would like to speak to a specialist, contact us today for a free, no-obligation consultation.