Three decades ago, the first in vitro baby was born. Since that time, IVF has come a long way, and it’s now a highly sophisticated (and expensive!) technique used by couples all over the world. But not all couples have thousands of dollars to spend on the expensive incubators, screening and fertility drugs. That’s exactly why some scientists are going back, back to the beginning, and developing a less complex, more economical technique that can be done for around $265.
“IVF is made to sound complicated, but the fact is that the early embryo is not very demanding,” Jonathon Van Blerkom, a fertility expert at the University of Colorado told Associated Press.
In fact, Van Blerkom says that a developing human embryo doesn’t need much outside of some basic solutions, a consistent temperature and steady pH levels.
He also believes that fertility injections are not needed because they can produce more than 20 eggs, but you only need to develop one or two, and this can be accomplished through cheaper fertility tablets, which do stimulate the ovaries to release more than one egg per month.
Van Blerkom says he decided to develop the technique after being approached by a couple of colleagues; they wanted to know how IVF could be done in developing countries.
“My first reaction was, ‘You’ve got to be kidding,’” he said.
But then he decided he was willing to give it a shot. In the end he was able to use just two test tubes and some special solutions to “generate the exact same conditions, or comparable, to what people are generating in a $60,000 incubator.”
One of the two tubes is used to prepare a solution containing carbon dioxide; this tube creates the ideal conditions for fertilization. The solution is then piped into the second tube, where one egg and a few thousand sperm are added. The tube, the egg and the sperm are then placed in a heating block, which helps maintain the proper temperature. Two to three days later, if an embryo has developed, it is examined under a microscope before being implanted into a mother.
To find out how effective the method was Van Blerkom and his colleagues worked with women under the age of 36 who were seeking IVF for the first time. They were given a mild dose of injectable fertility drugs. For mothers that produced at least eight eggs, half of their embryos underwent traditional IVF and the other half underwent the simpler version of it. A specialist who had no idea which technique was used to develop the embryo selected the best-looking embryo to be implanted into the mother.
Of the 100 women treated so far, the pregnancy rate was about 34 percent for both groups. And, interestingly enough, 14 babies have been born with the less complex method and 13 have been born with the traditional IVF method.
Of course, it still has yet to be tested out in the field. And that is a trial that’s going to have to happen before the technique can be offered to the general public.
According to The World Health Organization’s (WHO) reproductive health expert, Sheryl Vanderpoel, the sooner that happens, the better.
“Nobody thinks that infertility in developing countries is a problem,” she told AP.
But it is more of a problem than anyone realizes. Between 120 and 160 million worldwide struggle with infertility, WHO says. And women in developing countries have their own set of issues – infertility because of untreated infections and sexually transmitted diseases.
“Making IVF affordable is a public health priority,” she said.
In Egypt, the problem is somewhat different, Dr. Hassan Sallam, director of the Alexandria Fertility and IVF Center in Egypt says. According to Dr. Sallam, there is a great deal of social pressure on young, newly married couples to have children. This is even more difficult in rural areas because couples often live with the man’s family.
“All eyes are on the newlywed couple to see if pregnancy has happened after the first month,” he said in an email to AFP. When they’re unable to achieve pregnancy after two to three months, Dr. Sallam says couples sometimes come in to see him “just to please the in-laws.”
Of course, developing countries aren’t the only ones hoping to have gain access to a less complex method. In countries like the U.S., IVF often costs thousands of out of pocket dollars. In many European countries, the first few cycles, but after that, couples must pay the $10,000 private fee. Since it frequently takes more than three cycles to create a baby, many couples are having to either find a way to fork out that money or to become parents a different way.
“You should not have to be rich just to have IVF,” Dr. Geeta Nargund, medical director for Create Health Clinics, a private fertility center in London told AP. “There are so many people who cannot afford the treatment (in the West) that there would be a huge demand if there were something cheaper.”
Even patient groups are asking that this new method be made available to the general public, if and when it is approved.
“IVF is not a one-size-fits-all process,” Susan Seenan, deputy chief executive of Infertility Network UK. “Patients are being told that they need all kinds of expensive procedures and this may be a good time to step back and see if that is really the case.”
Of course, not everyone is convinced that the new method can produce results similar to the more scientific method. After all, the drugs are less potent, and extensive screening for embryos and special injection procedures aren’t used here.
“You aren’t producing as many eggs with this (cheap) method so the numbers will not be as high,” Ian Cooke, an emeritus professor of reproductive medicine at Sheffield University told AP, adding that it may be difficult to get enough people trained to meet the demands in developing countries. Still, he does believe that the method shows some promise, and since doctors aren’t using the same high-powered fertility drugs, he says it may be fine to cut back on the regular screening often carried in traditional IVF.
“From a technical point of view, they have proven it works,” he said.
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