Advances and Controversies in Assisted Reproductive Technology

Abstract

As the incidence and awareness of infertility have increased in the last decades, reproductive endocrinologists and scientists have striven to improve the therapeutic options being offered to patients. One of the most advanced and efficient technologies currently being offered is assisted reproductive technology. Among the various techniques that are comprised by assisted reproductive technology, in vitro fertilization is the most widely studied and used, being responsible for approximately 1% of all live births in the United States. As this technology has evolved, many controversies have arisen, and it is the purpose of this article to review what in the authors' opinion are the most current and controversial aspects of the whole process of in vitro fertilization and its related techniques. Mt Sinai J Med 76:506‐520, 2009. © 2009 Mount Sinai School of Medicine

Glucose Parameters Are Altered in Mouse Offspring Produced by Assisted Reproductive Technologies and Somatic Cell Nuclear Transfer1

“…These changes became evident between 8 and 10 wk of age. Our current research adds to these findings by investigating the effects of in vitro manipulations that occur in IVF and ICSI, which are responsible for an estimated 1-3% of human births in developed nations [1]. Similar to recent reports by Ceelen et al [4], we also found a link between ART and alterations in glucose homeostasis.…”

“…Assisted reproductive technologies (ARTs) are frequently used in a clinical setting to help individuals who are experiencing difficulty conceiving through natural methods, and it is estimated that more than 1% of U.S. births, and up to 3% of European births, are a result of ARTs [1]. The majority of these children appear to be healthy, but reports that ARTs are associated with an increased incidence of imprinting disorders, congenital defects, and altered metabolism have appeared [2,3].…”

Sperm DNA damage has a negative association with live-birth rates after IVF

“…Infertility affects ~15% of couples of reproductive age (Cates et al, 1985;Hull et al, 1985;Kols and Nguyen, 1997;Rutstein and Shah, 2004) with male infertility contributing to nearly 50% of all cases (Irvine, 1998;Niederberger et al, 2007;Vela et al, 2009;World Health Organization, 2010). As a result of population ageing and adverse changes in lifestyle, infertility continues to increase but with only marginal improvement in pregnancy and birth rates after assisted reproduction treatment in the developed world (de Mouzon et al, 2010;Dupas and ChristineMaitre, 2008;HFEA, 2008;Povey AC and Stocks, 2010).…”

Laser Pulse Application in IVF

“…Blastomere biopsy becomes relevant at a later stage in development, after fertilization. Couples opt for this technique typically when one or both parents carry a hereditary genetic defect they want to avoid passing to children (Vela et al, 2009) or in cases of advanced maternal age to screen against aneuploid embryos. Until the introduction of laser assisted opening of the zona, blastomere biopsy was performed by zona drilling with an acid tyrodes solution (Talansky & Gordon, 1986, as cited in Malter & Cohen, 1989).…”

“…Currently the ability to accurately deliver the laser pulse to a very fine area and minimize heat transfer to adjacent cells has been a concern, limiting this use of lasers to research. Lasers may also be further developed to aid in elucidating a proteomic profile for embryos to help predict their success (Vela et al, 2009).…”