IVF technology: blessing with a pinch
In-vitro fertilization (IVF) is the process by which an egg is extracted from a woman’s body and fertilized outside. IVF is considered the last resort for people with infertility problems, and who have exhausted other means of conceiving.
The resultant embryo is then implanted into the womb, often multiple embryos at once, to maximize the chance of conception. Robert G Edwards, who pioneered the method, was awarded the Nobel Prize for Medicine in 2010, and the fist ‘test-tube baby’ is Louise Brown, born in UK in 1978.
The technology has come as a blessing for people with fertility problems. Success rate is equated with live birth rate, i.e, number of successful births excluding stillbirths and miscarriages. Younger women have better chance at conceiving, and for those who are older than 48, no live births have been recorded.
According to the data available on the Centres for Disease Controls and Prevention(CDC-USA) on Assisted Reproductive Technology(ART), in 2010, “147,260 ART cycles were performed at 443 reporting clinics in the United States during 2010, resulting in 47,090 live births (deliveries of one or more living infants) and 61,564 infants. Although the use of ART is still relatively rare as compared to the potential demand, its use has doubled over the past decade. Today, over 1% of all infants born in the U.S. every year are conceived using ART.”
Concerns and cost
Of course, IVF is an expensive technology, and cannot be afforded by all. In some countries and states, IVF is covered by local Health Trusts and other programmes, where it is free. For example, in the UK, IVF is available free on the National Health Service (NHS), but it is available only in selected areas where local authorities have approved fertility treatments.
On an average, individual tries can be pegged at £4000 and £8000. However, IVF is rarely successful at the first go, and instances of people mortgaging their homes and overdrawing their accounts for going for the treatment are widely reported. Hence, most citizens from developed countries look at countries like India, Cyprus and Mexico for IVF technologies, mainly for cost factors.
However, fertility treatments have been subject to controversies, and IVF is no exception. The process is more intrusive for women, and is often painful. In many cases, artificial stimulation is provided to the woman to manipulate her fertility and ovulation cycle, and these have serious health implications. Hyperstimulation syndrome can be observed in 30% of patients. Harvesting of eggs, if done improperly, can lead to internal damage.
Apart from the usual risks involved with normal pregnancies, IVF pregnancies have added risks, the most significant being that of multiple births. This happens when multiple embryos are implanted together for maximizing the chances of live birth.
Astudy in 2012 showed that singleton pregnancies resulting from IVF have links with chances of birth defects. In 2008, an analysis of the data of the National Birth Defects Study in the US found that certain birth defects were significantly more common in infants conceived through IVF, notably septal heart defects, cleft lip and anorectal atresia. According to a Swiss study, children conceived through IVF display generalized vascular dysfunction.
Moral and social red flags
Japan's government prohibited the use of IVF procedures for couples in which both partners are infected with HIV, despite some hospitals claiming to have successfully removed HIV genes from the sperm. Also, it is still debatable whether women undergoing IVF treatment suffer from more stress than others.
Often, embryos are cryogenically frozen, so that women may have them implanted later. This process is a widely controversial one. There are also many illegal fertility clinics, and reports are available of women who have suffered due to botched up methods and have been mishandled. Cyprus and Crete, for example, have seen some major exposes on such centres.
IVF technology also, comes with a host of social and moral questions. In many cases, parent(s) ask for sperms/eggs from donors with specific attributes- including race, education, physical features and skills. Many concerns have also been raised by activists and health professionals about the method of extraction from donors; and in many cases, it has been reported that people have been held up against their will or kept in medically unviable conditions for extracting gametes. Immigrants, economically poor and marginalized groups are particularly vulnerable.
As medical science advances, IVF technology, too, is getting more refined. Not only will that mean increased chance at success, it will also lead to safer methods; which will not endanger the health of the donors, surrogates or the patients. Awareness is on the rise about the advantages and pitfalls associated with it, and governments and civil society groups are working at making things better.