Doctors in Kenya are celebrating the birth of the nation's first test tube babies, both girls, as a testament to medical breakthroughs
Both the mothers known only as Agnes and as Jane are overjoyed and are in good health as are their babies. Each had paid around 300,000 Kenyan shillings (£2,275) for the now rather commonplace in vitro fertilization procedure.
The first test tube baby, Louise Brown was born in Oldham, U.K on July 25, 1978 amid much controversy about the morality as well as safety of such a procedure. USA's first testtube baby Elizabeth Jordan Carr was born in 1981 and since then the procedure became widely popularized with more than millions of children owing their existence to this procedure.
In vitro fertilization or IVFwas developed in the United Kingdom by doctors Patrick Steptoe and Robert Edwards. Although IVF was initially developed to overcome infertility because of problems of the fallopian tube it soon proved to be successful for most other infertility reasons as well. Development of the intracytoplasmic sperm injection for this procedure has also helped to address the problem of male infertility to some extent.
Thus the prerequisites of an IVF treatment are healthy ova, sperm that is able to fertilise, and a uterus that can maintain a pregnancy. It is only cost considerations and not effectiveness that place IVF as the last option to be considered in treatment of infertility.
IVF treatment cycles which start from the third day of menstruation, involve treatment with fertility medications gonadotropins to stimulate the development of multiple follicles of the ovaries. This is followed by treatment with hormone, human chorionic gonadotropin that can cause ovulation in 42 hours. An ultrasound-guided needle pierces the vaginal wall, reaches the ovaries and follicles aspirated. This is used by the IVF laboratory to identify ova which are then stripped of surrounding cells and prepared for fertilisation. The semen of the male partner is prepared for fertilisation by removing inactive cells and seminal fluid and incubated with the egg for about 18 hours in a culture medium. Fertillized eggs are transferred to a growth medium for at least 48 hours until they reach the 6-8 cell blastocyst stage at least. The embryo or more often several embryos are transferred to the uterus via the vagina and cervix. The woman oten undergoes at least 2 weeks of uncertainty before she returns to the lab for her pregnancy test.
The average success of an IVF cycle is often only some 20 to 30 percent. Its major complication is the development of multiple births mainly due to the practice of transfer of multiple embryos. Multiple births in turn are related to premature labour, obstetrical complications, prematurity, and neonatal morbidity. Although strict embryo transfer policies have been enforced they are not followed nor accepted universally.
The cryopreservation of mature oocytes and even embryos that have not been transferred, in liquid nitrogen, is often performed, for subsequent pregnancies. This has raised several ethical questions.
IVF labelled as a method that bypasses the natural method of conception is still surrounded by controversy. 'Creating life in the laboratory', destruction, selection and modification of embryos in research are some of the issues which continues to haunt IVF.
The use of IVF has opened up a range of options for single people, same-sex couples, women after menopause and thereby several legal and ethical concerns as well. Only time will tell whether IVF has served as a boon or a bane to mankind.