Sperm meets egg makes baby, should be simple right? Well if it were, infertility would not be a common struggle for millions of people around the world. But through incredible technology and research, assisted reproductive techniques have been created like in-vitro fertilization (IVF) have been created to help people get pregnant. And they work! Join us this episode as we explain the basics of the science of IVF, dive into the history (with a sprinkle of funny stories of course) and end with a discussion about modern implications. It’s and EGGcellent episode! Ok I’ll see myself out now…
Feminist Corner:
- What role does the medicalization of reproduction play in the IVF industry?
- Are women’s bodies being treated as vessels in the pursuit of reproductive success, and if so, how can this be mitigated?
Listen to the episode, discuss these questions with friends and family, let us know what you think!
Show Notes:
The Science:
ART or Assisted Reproductive Technology refers to all fertility treatments where eggs or embryos are handled, and does not include artificial or intrauterine insemination or procedures where egg production is stimulated without the intention of egg retrieval. IVF (In-Vitro Fertilization) falls under ART, where eggs are removed from a person’s ovaries and fertilized with sperm in a laboratory dish before being transferred back into the uterus.
The process involves several steps, including ovarian stimulation with Follicle Stimulating Hormone to produce multiple eggs, egg retrieval using a small needle and ultrasound, fertilization in a laboratory dish, and culturing of resulting embryos.
Success factors for IVF include the age of the woman undergoing the treatment, the quality of eggs and sperm, the number of embryos transferred, the woman’s overall health, and certain lifestyle factors like smoking and obesity. ART is not limited to women and anyone with a uterus or ovaries may be considered for the treatment, including same-sex couples.
The History:
IVF as we know it today did not exist in ancient times, but there are historical accounts of early attempts at fertility treatments that may have been precursors to modern-day ART, including IVF. Ancient Egyptian texts dating back to 1550 BCE describe a fertility potion made from crocodile dung and fermented dough, while in ancient Greece, it was believed that certain herbs and plants could enhance fertility. In the Middle Ages, various methods were attempted to address infertility, including the use of herbal remedies, bloodletting, and even sexual intercourse during certain phases of the moon, but these were not based on any scientific understanding of fertility.
It was not until the 19th century that more scientific methods for studying fertility began to emerge. In 1827, the Italian physiologist Lazzaro Spallanzani conducted experiments in which he successfully fertilized a dog’s egg using sperm that had been collected and stored for several hours. In 1884, Dr. William Pancoast in Philadelphia performed the first donor insemination using sperm from a medical student voted “best looking” in his class.
In the 1930s, Aldous Huxley realistically described the technique of IVF in his science fiction novel, Brave New World. In 1959, Min Chueh Chang was the first to achieve births in a mammal (a rabbit) by IVF, and in 1965, Robert Edwards together with Georgeanna and Howard Jones at Johns Hopkins Hospital in the USA attempted to fertilize human oocytes in vitro.
The first successful human IVF procedure was performed in 1978 by Dr. Robert Edwards and Dr. Patrick Steptoe in the UK, resulting in the birth of Louise Brown, the first baby born via IVF. After her birth, IVF gained wider acceptance and use, leading to higher success rates and the birth of thousands of babies worldwide. In 2010, Edwards was awarded the Nobel Prize in Physiology or Medicine for his contributions to the development of IVF.
Modern Considerations:
IVF now accounts for millions of births worldwide, and 1-3% of all births annually in the US and Europe. Techniques like intracytoplasmic sperm injection (ICSI) and comprehensive chromosome screening (CCS) of the whole embryo genome have emerged to help improve pregnancy rates and reduce the risk of multiple gestations and miscarriage.
However, there are significant racial and socioeconomic inequities in access to IVF and its outcomes. Black women are less likely to access IVF and other forms of assisted reproductive technology (ART) than white women due to financial barriers, lack of insurance coverage, and mistrust of the medical system. Black women are also more likely to experience failed IVF cycles and less likely to give birth to a live baby, possibly due to differences in the quality of healthcare received and underlying health conditions.
Sources:
“Boulet, S. L., Crawford, S., Zhang, Y., Sunderam, S., Cohen, B., Ko, J. Y., & D’Angelo, D. (2018). Disparities in infertility services utilization and outcomes among Medicaid beneficiaries. Fertility and Sterility, 109(3), 418-425. https://doi.org/10.1016/j.fertnstert.2017.11.022“
“Disparities in access to infertility care in the United States: an evidence review” by Greil, et al. (2011)
“Hodeib, M., Kort, J., & Soliman, A. (2021). Racial disparities in assisted reproductive technology outcomes in black women compared with white women in the United States: a systematic review and meta-analysis. Fertility and Sterility, 116(1), 87-98. https://doi.org/10.1016/j.fertnstert.2021.03.013“
“Cleveland Clinic. (2021). In Vitro Fertilization (IVF). Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/22457-ivf“
“Greene, M. (2018). We’ve Come a Long Way, Baby: The History of IVF. U.S. News & World Report. https://health.usnews.com/health-care/for-better/articles/2018-07-26/weve-come-a-long-way-baby-the-history-of-ivf“
“IVF-Worldwide. (2021). IVF History – IVF Treatment – IVF Procedure – Test Tube Baby. IVF-Worldwide. https://ivf-worldwide.com/ivf-history.html“
“Kass, R. E. (2013). In vitro fertilization. Embryo Project Encyclopedia. https://embryo.asu.edu/pages/vitro-fertilization“
“Kushnir, V. A., Barad, D. H., Albertini, D. F., Darmon, S. K., & Gleicher, N. (2018). Systematic review of worldwide trends in assisted reproductive technology 2004-2013. Reproductive Biology and Endocrinology, 16(1), 1-19. https://doi.org/10.1186/s12958-018-0343-3“
“Sunkara, S. K., Rittenberg, V., Raine-Fenning, N., Bhattacharya, S., & Zamora, J. (2019). Racial disparities in assisted reproductive technology utilization rate, and treatment outcomes in the USA: a systematic review and meta-analysis. Reproductive BioMedicine Online, 38(4), 571-580. https://doi.org/10.1016/j.rbmo.2018.12.027“
“Sundaram, A., & Zeitlian, G. (2020). Racial Disparities in In Vitro Fertilization Outcomes. AP News. https://apnews.com/article/science-health-racial-injustice-death-rates-in-vitro-fertilization-f45fdd08001b593e280f7e8a678a328c“
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