Medical Views on Assisted Procreation

Abstract

In vitro fertilization and embryo transfer (IVF-ET) is a procedure initially developed to treat women with severe tubal disease or absent fallopian tubes following surgery. The fertilization of oocytes outside the womb in the laboratory and the replacement of in vitro cultured embryo(s) to the uterus give a previously sterile woman and possibility to conceive. The first pregnancy by IVF-ET was established in 1976, which was, however, ectopic [1]. Subsequently, the first successful pregnancies and births were described in 1978 (Louisa Brown) and 1980 [2, 3]. Later IVF-ET was also applied to treat male subfertility, unexplained infertility, and endometriosis where other traditional methods had failed [4–6]. In 1984 new applications were opened for women without ovaries when Lutjen et al. [7] published results of a successful replacement of donor embryos into the uterus of an agonadal recipient. In 1983 Trounson et al. [8] published details of a pregnancy after oocyte donation in a patient with repeated fertilization failures. Current indications for the clinical use of IVF are given in Table 1. So far, it has been estimated that between 40000 and 50000 children have been born around the world from assisted procreation.