Assisted reproductive technologies

What is assisted reproduction?

The phenomenon Assisted reproductionis one of the medical wonders of the modern global world. This rapidly developing medical specialty in recent decades makes it possible for married couples with different types and severity of somatic problems to acquire heirs.

How does it all start?

The first data on the conduct of artificial insemination in a person date back to 1790. John Hunter, called “the founder of medical surgery”, administered the insemination of a patient with severe hypospadias, advising him to collect the semen released in coitus in a heated syringe and apply it to the woman's vagina.

In the mid-1800s, J. Marion Sims discovered the postcoital test and conducted 55 inseminations. In 1899, the first practical methods of artificial insemination of man were developed and described in Russia by Ilya Ivanovich Ivanov, who although he studied artificial insemination in domestic animals, dogs, rabbits and birds, was the first to develop the method used today in human medicine.

For many years, partner insemination has been used solely in cases of physical and psychological sexual dysfunction, such as retrograde ejaculation, vaginismus, hypospadias and impotence. In parallel with the progressive development of methods, donor inseminations began to be introduced, which quickly became routine procedures for the treatment of infertility in men with Azoospermia and severe Oligoasthenozoospermia.

The beginning of new technologies

In 1953 was the first successful pregnancy from insemination with frozen seminal fluid. It marks the beginning of a new era in Assisted reproduction. In parallel with the development of science, the discovery of new techniques for processing sperm and improving the success rate of procedures, ways to treat infertility in women without functioning fallopian tubes are being sought. For fertilization of the egg by the sperm in vivo or by insemination, it is necessary that at least one of the fallopian tubes is passable. In the past, many women with tubal sterility have resorted to reparative surgery in order to restore tubal function. Unfortunately, often these operations are unsuccessful. This necessitates the development of a method that allows fertilization of the egg outside the woman's body.

At the end of 1970. Leslie Brown, a patient with nine years of primary sterility, turns to Patrick Steptow and Robert Edwards at Oldham General Hospital in England. At this time, the fertilization of eggs outside the human body, a process known as in vitro fertilization (IVF), is considered completely experimental, leading only to abortions and one unsuccessful ectopic pregnancy. Without the use of medication to stimulate the ovaries, Leslie Brown underwent a laparoscopic puncture, extracted one egg, which was fertilized in a laboratory, and later transferred back to the uterus.

The embryo transfer became the first live birth of a child by IVF — Louise Brown, born in July 1978. This incredible success gives hope to thousands of childless couples around the world. Each year that passes and each procedure carried out contributes to the improvement of technology and the achievement of more pregnancies. Since then, a number of advances in clinical medicine and fundamental science have enabled more and more couples with reproductive problems to have children.

Controlled ovarian hyperstimulation is introduced in order to increase the number of eggs obtained. In February 1984, the first baby was born from a donor egg, and a month later, the first baby from a frozen embryo. In 1992, the introduction of ICSIIntracytoplasmic injection of sperm directly into the egg represents a huge technological advance in ART. This makes it possible to treat couples with a severe male factor. In 1997, the first babies were born. frozen eggs.

The innovation boom

The gradual introduction of new techniques — TESA, PESE, ovarian tissue freezing, IMSI, TimeLapse, PGD inevitably increase the success of the procedures. The ongoing search for new methods of treating infertility and preserving the fertile potential of certain groups of patients make the topic of assisted reproduction one of the most interesting in the field of medicine. To date, more than 6 million babies worldwide have been conceived and born through assisted reproductive technologies.