In vitro fertilization - In vitro fertilization(IVF a...

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In vitro fertilization (IVF): a review of 3 decades of clinical innovation and technological advancement Jeff Wang and Mark V Sauer Abstract In vitro fertilization, popularly referred to as IVF, has captured the attention of the public since its sensational introduction in 1978. Today assisted reproductive technology is available throughout most of the civilized world, and the practice is largely different from that used during the early days. Refinements in laboratory technology and clinical practice have allowed IVF to evolve into a medical procedure that is efficient, safe, readily accessible, and relatively affordable. More than 2 million IVF children have been born to date, and it is likely that continued enhancements will widen its appeal and applicability. Keywords: IVF, assisted reproduction Introduction The birth of Louise Brown in 1978 was the culmination of decades of scientific research in reproductive medicine. Since then, an abundance of breakthroughs in both clinical medicine and basic science have allowed increasing numbers of infertile couples the chance to have a baby ( Figure 1 ). To date, more than 2 million babies have been born worldwide through assisted reproductive technologies (ART). The most recent Centers for Disease Control (CDC) statistics noted that 48 000 babies were born in the US and over 100 000 ART cycles were performed in the year 2003 alone ( CDC 2005 ). Figure 1 Timeline of major milestones in assisted reproductive technologies. Go to: The early days of IVF Prior to 1978, women without functioning fallopian tubes were largely considered to be sterile by their physicians. At least one patent fallopian tube is necessary for natural fertilization of an oocyte by sperm in vivo. In the past, many women with damaged tubes resorted to reparative surgery, or tuboplasty in hopes of re-establishing a conduit for gametes to transit. Unfortunately, often these surgeries failed. In the late 1970’s Lesley Brown, a patient with nine years of primary infertility secondary to tubal occlusion, sought the assistance of Patrick Steptoe and Robert Edwards at the Oldham General Hospital in England. At
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that time, fertilization of oocytes outside the human body, a process known as in vitro fertilization (IVF), was considered entirely experimental and when attempted had only resulted in miscarriages and an unsuccessful pregnancy in the fallopian tube ( Steptoe and Edwards 1976 ). Without using medications to stimulate her ovaries, Lesley Brown underwent laparoscopic egg retrieval, with her single egg fertilized in the laboratory, and later transferred back into the uterus. The embryo transfer resulted in the first live birth from IVF, a daughter Louise Brown, who was born in July 1978 ( Steptoe and Edwards 1978 ). Following this sentinel and critically important event, Steptoe and Edwards, as well as several other contemporary scientists, not only successfully repeated this clinical achievement but went on to further improve and refine their pioneering efforts. The initial experience with unstimulated cycles by
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  • Fall '14
  • ET AL, In vitro fertilisation, in vitro fertilization

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