In the past three decades, in vitro fertilisation (IVF) success rates have steadily increased, with advancements in technology pushing the birth rate up from just 8% in 1991 to 22% in 2021. As more individuals, including older demographics, turn to IVF to grow their families, researchers are under pressure to find ways to further increase success rates. However, outdated legislation in countries like the United Kingdom and the United States is hindering research progress. The British Fertility Society (BFS) is campaigning to update legislation that restricts the use of embryos in research, which could potentially lead to a better understanding of how embryos develop and improve IVF success rates.
The legal restrictions on embryo research in the United States, where it is only legal in five states and “vaguely” legal in 13 others, also pose a challenge to advancing IVF technology. A 1996 amendment further complicates the situation by banning federal funding for such research. Despite the potential benefits, only a small percentage of the hundreds of thousands of frozen embryos available for research are being used. Experts argue that utilizing these embryos could lead to higher success rates and healthier babies, but persuading lawmakers to update legislation remains a significant hurdle.
In the absence of sufficient embryos for research, scientists often explore other avenues to improve IVF success rates. From nutritional supplements to sound waves, various methods are being tested, although the evidence supporting their effectiveness is limited. One promising area is the use of artificial intelligence (AI) models to select embryos, potentially reducing subjectivity and increasing success rates. However, ethical concerns and the need for further research remain challenges in implementing this technology.
Another innovative area of research, in vitro gametogenesis (IVG), aims to create reproductive cells from somatic cells to facilitate embryo development. While this technology holds promise for same-sex couples and individuals unable to produce viable eggs or sperm, ethical and regulatory concerns pose challenges. Researchers are working with animal models to study IVG, and while advancements have been made in mice, applying this technology to humans raises numerous questions and ethical considerations.
In addition to scientific breakthroughs, lifestyle factors and awareness play a crucial role in improving IVF success rates. General healthy practices such as maintaining a moderate body mass index, eating a balanced diet, exercising regularly, managing stress, and avoiding tobacco and alcohol can contribute to better outcomes. Racial disparities in IVF outcomes have also been noted, with Black and Asian parents experiencing lower birth rates following treatment. Age is a significant predictor of IVF success, with younger individuals having higher live birth rates. Being aware of fertility status and options, even if planning to not get pregnant immediately, can empower individuals to make informed decisions about future family planning. Overall, a combination of legislative changes, technological advancements, lifestyle modifications, and increased awareness can help individuals enhance their chances of successful IVF outcomes.