IVF IS EXPENSIVE. CAN RECENT COST-CUTTING TECHNOLOGIES MAKE A DIFFERENCE?

Newer culture methods and research methodologies that cut costs and complications are welcome; however, elaborate multicentre studies and a follow-up of the pregnancies and births are required to ensure that results are on par, or better than conventional and time-tested IVF methods

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The year was 2004, the date was August 4, when our article, 'Inside the tube and closer to nature', was published as a letter to the editor, in the journal Reproductive Biomedicine, online. The founder-editor of the journal was the late Robert Edwards, Nobel prize winner in physiology and more famously known for being a pioneer in the field of IVF (in vitro fertilisation), credited for the birth of the world's first test tube baby. The article spoke of our experience with performing tubal procedures in IVF and their efficacy in successful pregnancy rates. The concept being: retrieval and transfer of the female oocytes into the ampullary portion of the fallopian tube, in its natural environment. Either these oocytes were loaded with sperms, or an intrauterine insemination was performed so that the sperms swam naturally towards their destination to fertilise with the oocyte. The concept of performing this was to reliably place gametes in their natural environment to enable fertilisation.

Mimicking nature is the intention of IVF, be it temperature control or the well-fortified culture media used and their growth periodically monitored in CO2 incubators. Now, tubal procedures have become obsolete. Advances in cell culture methods and the expense of anaesthesia and it being a laparoscopic procedure, sealed their fate.

Cutting costs in conventional IVF

But then again, we feel the urge to cut costs in conventional IVF. This compels us to research techniques that could possibly reduce the number of injections that are taken by women, known as controlled ovarian hyperstimulation, to yield more than just a few mature follicles in their ovaries. When these follicles, which are monitored by ultrasounds on alternate days, reach a mature size, we surgically aspirate them to retrieve oocytes.