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Some people might ask whether all this is relevant to Indian conditions. While these technologic refinements are very exciting, IVF clinics in India should also focus on simplifying IVF technology, so that it can be made more affordable for the average Indian couple. Advances that have occurred and have helped to simplify IVF and make it more easily available include the following.
This is a technique for IVF, which provides the same rate of fertilization that conventional IVF does, at a fraction of the cost. In this method, which was first described by Dr. Ranoux of France in 1984, the eggs and sperm are placed in a sterile vial, which is then sealed and placed in the woman's vagina. Thus, the woman acts like her own incubator, since she keeps her eggs and embryos at body temperature. Since expensive laboratory equipment is not needed, this is much cheaper and as effective as conventional IVF!
Natural cycle IVF is much less expensive because it does away with the high expense of gonadotropin injections used for superovulation. In this method, the single egg which the woman grows in her unstimulated ovulatory cycle is used for IVF. While the pregnancy rate is lower, the expense (and the stress of IVF) is much less! Interestingly, "gentler" IVF is becoming increasingly popular in the West as well. Many doctors are very critical of the large amounts of hormones that are being used in traditional IVF in order to produce large quantities of eggs. Gentler ovarian stimulation (using only clomiphene or smaller doses of HMG) has also become popular once again, since it reduces the risks of complications, such as ovarian hyper stimulation and multiple pregnancies.
A new technique called "in vitro maturation" allows doctors to collect many immature eggs during a "natural cycle." These eggs are then matured in vitro, by adding special chemicals to the culture medium. ICSI (microinjection) can then be used to fertilize these eggs. This technique is very promises, because it allows the doctor to collect many eggs without having to superovulate the woman, thus helping to reduce the risks and costs of IVF. However, the pregnancy rates with IVM are still not as good as with conventional IVF.
Transport IVF is a recent innovation pioneered in the Netherlands; and also by Dr. Kingsland of the UK. In this, the egg retrieval is performed by the gynecologist in his own clinic or hospital and the eggs (in the follicular fluid) are then transported to a central IVF laboratory by the husband in a portable incubator. Insemination, fertilization and embryo transfer take place in the central laboratory. This method allows gynecologists to take an active part in their patients' treatment; ensures high quality, since all laboratory procedures are performed in a central laboratory; and also minimizes patient inconvenience (since superovulation and egg retrieval are done by the local gynecologist, the number of visits the patient has to make to the IVF center are minimized.)
© Dr. Aniruddha Malpani and Dr. Anjali Malpani www.drmalpani.com
Credits: How to Have a Baby: Overcoming Infertility
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