IVF is rarely out of the news and usually concerns some brilliant technological development such as mitochondrial transfer, where a small amount of DNA from a donor can be used to prevent the inheritance of serious genetic diseases. Advances such as these involve manipulation of gametes in a very hi-tech laboratory and as a result are expensive and not widely available.
It is therefore exciting to report that the latest breakthrough should make a massive difference to the cost of IVF. It involves simplification of the laboratory by removing the need for an expensive IVF laboratory with CO2 incubators, medical gas supply and air purification systems. Professor Van Blerkom at the University of Colorado developed this low cost culture system, which is roughly the size of a shoebox, and its use has been trialled by Professor Ombelet and his team in the ZOL hospitals of Genk, Belgium. In a randomised study reported to the ESHRE 2013 Congress in London, it was found that successful outcomes with this new method compared favourably with those from a standard laboratory system. At present, 12 healthy babies have been born following embryo culture with this revolutionary new system. I am very proud to have been part of this project as the President of ISMAAR and a Visiting Professor at Hasselt University, Belgium.
At the moment this new laboratory system has been developed for use in low resource countries by the Walking Egg Foundation an international project aiming to make high quality infertility care more accessible to couples in such countries where involuntary childlessness can create more wide-ranging societal problems compared to Western societies. At the moment five million babies are born following IVF treatment worldwide but because of the expense of treatment the vast majority of these babies are born to couples in developed countries. By using this new simplified laboratory system and mild ovarian stimulation protocols IVF can be offered to couples in low resource countries for about 200 euros thus making effective fertility treatment available to a much larger part of the world population. Mild stimulation protocols have helped to reduce cost of IVF cycles and complications of IVF treatment. This laboratory method combined with mild stimulation protocols will be a real advance in making IVF more accessible.
The question will be raised as to whether this new simplified low cost technique can eventually be offered to couples in the UK especially as at the moment treatment on the NHS is severely rationed and self-funded treatment is expensive. The new treatment is not applicable to couples where ICSI treatment is indicated for sperm problems but for the 50% of couples who require IVF it could potentially be a massive breakthrough towards making this treatment more affordable to couples. The current EU directives and the UK legislation for IVF laboratories do not permit this method to be offered as a treatment option in the UK at the moment but we trust that the HFEA, the UK regulatory authority, may permit us to develop this revolutionary new method for the benefit of British couples at some point in the future.
As a global advocate for safe and accessible IVF, I am very excited about this breakthrough.
Professor Dr. Geeta Nargund is a global pioneer of Natural and Mild IVF and Advanced Ultrasound Technology in Reproductive Medicine, Medical Director of Create Health, and President of ISMAAR.