Learn More About IVF Research Studies
What Are IVF Research Studies?
Infertility is a common medical health concern. It is defined as women not being able to conceive (get pregnant) after having unprotected sex for a year or longer. Since fertility decreases in women steadily as they age, women above the age of 35 are evaluated after having 6 months of unprotected sex.
In the United States, among heterosexual women aged 15 to 49 years with no prior births, about 1 in 5 (19%) are unable to get pregnant after one year of trying (infertility). Also, about 1 in 4 (26%) women in this group have difficulty getting pregnant or carrying a pregnancy to term (impaired fecundity).
However, Infertility and impaired fecundity are less common among women with one or more prior births. In this group, about 6% of married women aged 15 to 49 years cannot get pregnant after one year of trying, and 14% have difficulty getting pregnant or carrying a pregnancy to term.
Thanks to medical and technological advancement, multiple assisted therapies, drugs, and interventions are available to help with infertility issues. One such intervention is IVF (in-vitro fertilization). In vitro fertilization (IVF) is the most common form of assisted reproductive technology and is used in managing patients with difficulty undergoing conception.
The term assisted reproductive technology is used for techniques that manipulate oocytes outside the body. IVF is its most common form; the term ‘in vitro’ means outside a living organism as oocytes mature in vivo in the ovary and embryos develop into pregnancy in the uterus, but the oocytes are fertilized in a petri dish in IVF.
IVF now accounts for 1.6% and 4.5% of all live births in the United States and Europe, respectively. However, the success rate of IVF depends on multiple factors, such as the cause of infertility, age, partner, and donor’s age. The younger you are, the higher the chance of success, i.e., under 35.
ART (i.e., IVF) can be expensive and time-consuming, but it has allowed many couples to have children that otherwise would not have been conceived.
Why Is IVF Being Studied Through Research Studies?
In-vitro fertilization is a popular research topic because it has a higher success rate than other infertility management solutions, such as drugs and surgical interventions. In 1985, the first IVF baby in Missouri was born to a couple who underwent IVF at Washington University. Since that time, the practice of IVF has continued to evolve at an astounding pace. Today, IVF accounts for millions of births worldwide and 1–3% of all births annually in the U.S. and Europe.
How does IVF work? The first step involves taking fertility medications for several months to ensure that your ovaries produce multiple eggs that are mature and ready for fertilization. This is known as ovulation induction. After an adequate amount of eggs are produced, the doctor removes the eggs from the body; this is known as the egg retrieval process and involves a minor surgical procedure.
After the eggs are removed, insemination begins, which involves mixing the eggs with the sperm cells from the donor or partner. The eggs and sperm cells are stored in a petri dish and allowed to fertilize. In some cases, where the donor’s sperm cells have weak mobility, the cells are directly injected into the eggs to promote fertilization.
Next, the cells in the fertilized eggs divide and become embryos. About 3-5 days after the egg retrieval, 1 or more embryos are put into your uterus; this is called an embryo transfer. Doctors use a thin tube to inject the eggs directly into the uterus. Pregnancy happens if any of the embryos attach to the lining of your uterus.
IVF does not have a 100% success rate because recognizing female pelvic anatomy is paramount in correctly understanding and completing IVF. To achieve optimal results in IVF, certain anatomy types appear to be associated with success rates of oocyte retrieval and embryo transfer.
What Are The Types Of Diseases Treated By IVF?
Approximately 10% to 15% of couples will have difficulties getting pregnant. An earlier evaluation is indicated if the female partner has oligomenorrhea or amenorrhea, endometriosis, tubal disease, or if there is a known male issue. The workup for couples experiencing infertility includes an assessment of ovulatory function, ovarian reserve, uterine cavity, tubal patency, and a semen analysis.
IVF (in-vitro fertilization) can treat all the above-listed fertility problems. For instance, endometriosis is a multifactorial disease generated by a combined action of genetic and environmental factors. Women with endometriosis possess a resilient endometrium to some progesterone actions, affecting implantation. IVF has provided results in retrospective cohort studies independently of the main infertility factor, thus indicating promising results in endometriosis management (as it is revealed that endometriosis does not affect IVF outcome). Indeed, IVF has been described as irrelevant to endometriosis or even additional infertility factors.
Moreover, poor semen quality is the sole cause of infertility in 20% of couples and contributes to fertility issues in another 20%. Decreased sperm count, motility, or morphology (shape of the sperm) can be successfully treated medically or surgically in approximately 50% of men. However, if such treatments fail, IVF with or without intracytoplasmic sperm injection (ICSI) can be utilized. Sperm extracted from the testicle or epididymis in obstructive azoospermia or testicular hypofunction can only be used in an IVF cycle with ICSI as the sperm have not undergone the final vitro maturation process, allowing it to fertilize an oocyte.
IVF can also be used for women that want to preserve their fertility; for instance, women with cancer or other illnesses or those who want to delay child-bearing can utilize IVF to preserve their eggs. These women can cryopreserve either oocytes or embryos before chemotherapy or radiation that can then be transferred at a future time.
What Are Some Recent Breakthroughs in IVF Research Studies?
There have been several landmark studies involving IVF in recent years. Some of the most notable studies are:
2015: Revised guidelines for good practice in IVF laboratories - The guideline provides recommendations on the general organization of an IVF laboratory (staffing and direction, quality management, laboratory safety) and the specific aspects of the procedures performed in IVF laboratories (Identification of patients and traceability of their reproductive cells, consumables, handling of biological material, oocyte retrieval, sperm preparation, insemination of oocytes, scoring for fertilization, embryo culture and transfer, and cryopreservation). The last section provides recommendations regarding an Emergency plan for IVF laboratories.
Some guidelines include the following:
- Quality management: ensuring full traceability of cells and tissues, materials, equipment, and personnel involved in specific laboratory activities, with records maintained accordingly.
- Laboratory safety: Materials used in laboratory construction, painting, flooring, and furniture should be appropriate for clean room standards, minimizing Volatile Organic Compounds (VOC) release and embryotoxicity.
- Laboratory air quality: Procedures involving gamete or embryo manipulation should be performed in a controlled environment. Background and processing air quality should comply with European and national guidelines and should be regularly monitored.
2019: Fresh versus elective frozen embryo transfer in IVF/ICSI cycles - this study focuses on whether eFET (elective frozen embryo transfer) should be offered to the overall IVF population or only to specific subsets of patients. Until recently, the clinical usage of eFET was supported by only a few randomized controlled trials (RCT) and meta-analyses, suggesting that the eFET reduced not only ovarian hyperstimulation syndrome (OHSS) but also improved reproductive outcomes.
Eleven studies, including 5379 patients, fulfilling the inclusion criteria were subjected to qualitative and quantitative analysis. A significant increase in LBR was noted with eFET compared with fresh embryo transfer in the overall IVF/ICSI population.
Although the use of eFET has steadily increased in recent years, a significant increase in LBR with eFET was solely noted in hyper-responders and patients undergoing PGT-A. Concerning safety, eFET significantly decreases the risk of moderate and severe OHSS, albeit at the expense of an increased risk of pre-eclampsia.
2021: Does mRNA SARS-CoV-2 vaccine influence patients' performance during the IVF-ET cycle? - This study aims to assess the influence of the mRNA SARS-CoV-2 vaccine on IVF treatments. All couples in the study underwent consecutive ovarian stimulation cycles for IVF before and after receiving the mRNA SARS-CoV-2 vaccine and reached the ovum pick-up (OPU) stage. The stimulation characteristics and embryological variables of couples undergoing IVF treatments after receiving the mRNA SARS-CoV-2 vaccine were assessed and compared to their IVF cycles prior to vaccination.
Results showed no in-between cycles differences in ovarian stimulation and embryological variables before and after receiving mRNA SARS-CoV-2 vaccination. Thus, the mRNA SARS-CoV-2 vaccine did not affect patients’ performance or ovarian reserve in their immediate subsequent IVF cycle.
Who Are Some Of The Key Opinion Leaders / Researchers / Institutions Conducting IVF Research Studies?
Reproductive Medicine Associates (RMA) Network
RMA has been a pioneer in fertility science since its inception in 1999, with an unwavering commitment to improving patient outcomes. It is recognized as a global leader in providing the highest-quality, most advanced in vitro fertilization (IVF) technology available today. They have worked with several organizations and published research on oocyte cryopreservation, ovum donation, male factors, and much more.
Grupo Eugin is an international network of medical services clinics specializing in assisted reproduction treatment (ART) of patients with reproductive issues. Their mission is to promote and develop excellent, cutting-edge, internationally competitive research, focusing on clearly defined clinical problems in both male and female ART patients, to provide translational transfer and support to all our clinics for the benefit of assisted reproduction patients worldwide. Their publications include;
- Trophoblast attachment to the endometrial epithelium elicits compartment-specific transcriptional waves in an in-vitro model
- Exploring the pros and cons of new approaches for gamete cross-border donation based on fresh and vitrified oocytes
- Oxidative Stress in Reproduction: A Mitochondrial Perspective