Visions for the future

Where can reproductive medicine and technology take us? Do we want to go there?
Although Donor Insemination (DI) has been taking place for over 100 years (see history), scientific developments over the last 40 years, now allow families to be created in other more medically complex ways.

The single most important advance was the development of in vitro fertilization (IVF) in 1968, when it became possible to fertilize a woman’s eggs outside of her body in the laboratory. Further developments allowed scientists to keep those fertilized eggs in the laboratory for their first few days of life, so that they might grow into embryos that could be replaced in the woman’s womb in the hope that a pregnancy might occur.  The first baby born from IVF was in July 1978.

The development of IVF not only allowed millions of couples to have a family where otherwise this might not have been possible, but has also facilitated the development of egg and embryo donation.

Egg donation involves one woman donating some or all of her eggs to another who is unable to produce her own. The donated eggs are fertilized with sperm from the infertile woman’s partner (or if he is also infertile the sperm from a donor).  If fertilization occurs, then one of more of the embryos can be placed into her womb and the woman can become pregnant and will carry the baby in the normal way.  The first baby from egg donation was born in 1984.

Embryo donation became possible once scientists developed the technology to freeze embryos created through IVF. This allowed couples who had completed their families to donate any ‘spare’ embryos to other couples. These embryos are needed in cases where both the man and the woman have infertility problems.  Embryo donation first took place in 1985 but occurs quite rarely in the UK with less than 100 embryos being donated each year.

In some rare cases a woman may have eggs, but is unable to carry a pregnancy to term because of a problem with her womb.  In such cases, IVF allows for a fertilized embryo to be placed into the womb of another woman who becomes pregnant with a baby that is genetically unrelated to her.  This is called IVF Surrogacy was first carried out in 1985.  Once the baby is born, legal proceedings take place to allow the genetic parents to become the legal parents of the baby.

In the last few years, scientists have been developing techniques to try and grow eggs and sperm in the laboratory for women and men who do not produce any naturally.  So far, this has only been carried out in animals and has not been entirely successful.  If lab-made sperm and eggs were to ever be used in human reproduction, then the technique would have to be shown to be safe.