It is written by
Dr. Eleni Kontogianni, B.Sc., Ph.D.
Senior Clinical Embryologist
Embryological Laboratory of the HYGEIA IVF Embryogenesis Unit

● Over 12 million babies to date worldwide
● About 750,000 children per year after IVF
● The World Health Organization estimates that approximately 186 million people worldwide suffer from infertility

The Future Directions of IVF: Advances in Reproductive Medicine and Beyond

Since the birth of the first “tube baby” to date, we estimate that over 12 million babies have been born. The numbers are shocking, but not satisfactory when you consider the enormity of infertility.

About 1 in 6 couples have difficulty conceiving a child. Infertility is constantly increasing, especially male infertility. The number and quality of sperm throughout the world is showing a continuous decline. In addition, technology continues to evolve, the future of IVF promises a lot and has huge potential, opening new horizons in various fields. In this article, we explore the exciting future directions of IVF, including advances in IVF, in vitro spermatogenesis and oogenesis, infertility treatment, and reproductive lifespan extension.

What have we achieved since 1978 when the birth of Louise Brown was announced until today? Scenarios that were at the level of science fiction are today our daily routine.

For example, I mention:
● Preimplantation Genetic Diagnosis, i.e. diagnosis of a genetic disease before the embryo is placed in the uterus (PGD)
● Microinsemination (ICSI) for severe male infertility (Oligoasthenoteratozoospermia)
● Possibility of biologically having a child of their own from men with Azoospermia, after a testicular biopsy and the use of testicular spermatozoa
● Egg, sperm and embryo donation
● Surrogacy
● Freezing eggs and embryos with vitrification for medical (e.g. before chemotherapy) or social reasons

Greece has many reasons to be particularly proud of its extracorporeal performance. The level of scientific and medical staff is very high, supporting Medical tourism.
We are already visited by couples from over 65 countries from all over the world to achieve the desired pregnancy.

However, the road is long. What are we waiting for:

1. In vitro fertilization (IVF). Even higher success rates

IVF has come a long way since its inception, but the journey is far from over. The future of IVF aims to achieve even higher success rates by leveraging cutting-edge technologies such as time-lapse imaging, AI-based embryo selection and improved culture media. Real-time embryo development monitoring and comprehensive genetic testing will enable healthier embryos to be selected with greater precision, with the goal of increasing the likelihood of successful implantation and reducing the risk of multiple pregnancies and miscarriages.

2. In Vitro Spermatogenesis: A Ray of Hope for Male Infertility

The male factor accounts for 35-70% of infertility cases. By testicular biopsy, spermatozoa are found in approximately 50% of azoospermic men. The rest do not currently have the possibility to use their own sperm and can have a child only with a sperm bank or adoption. Research in the field of in vitro spermatogenesis is the subject of many research protocols and, if successful, could revolutionize the landscape of reproductive medicine. In vitro spermatogenesis, a promising field, aims to generate functional sperm from progenitor cells.

3. In vitro oogenesis: Unlocking the secrets of female reproduction

The ability to produce mature eggs in vitro has long been a goal of reproductive medicine. Research on in vitro oogenesis aims to exploit the potential of precursor cells to create eggs outside the body. Success in this area could be groundbreaking, providing solutions for women experiencing premature ovarian failure or other conditions that affect egg production, such as chemotherapy at a young age

4. Targeted treatment of infertility: Personalized Medicine

The future of IVF envisions personalized treatment plans tailored to each individual’s unique needs. Advances in genetic testing and molecular diagnostics will allow better diagnosis of the underlying causes of infertility. This will allow for targeted treatments and interventions, increasing the chances of a successful pregnancy.

5. Prolongation of reproductive life: Preservation of fertility

Advances in oocyte and ovarian tissue cryopreservation are expanding options for fertility preservation. For women facing gonadotoxic treatments such as chemotherapy, freezing ovarian tissue or eggs may offer hope for future fertility.

6. Robotics

Already the first robotic micro-insemination has been carried out and the laboratory on a small chip is in an experimental stage. Automation of some processes will aim to increase the accuracy and repeatability of methods and reduce the cost of IVF, making it more accessible to many more people. Already millions of couples around the world do not do IVF solely because of their financial situation.

7. Artificial intelligence in IVF: a game changer

The incorporation of artificial intelligence (AI) into IVF procedures aims to revolutionize the field. Artificial intelligence algorithms aim to analyze vast amounts of data to predict treatment outcomes, improve treatment protocols, improving the overall effectiveness of IVF. At the moment the word artificial intelligence (AI) is in fashion and a large number of start ups, with or without a scientific background, are investing in its use for extracorporeal. It remains to be proven that data from different populations, with a multitude of heterogeneous pathologies, pre-existing diseases and different genetic backgrounds will give a clear picture and really help.

Scientists’ groundbreaking work so far in IVF has laid the foundation for a promising future for reproductive medicine. Advances in IVF, spermatogenesis, oogenesis, and personalized treatment approaches are challenging and hopeful for couples struggling with infertility. Moreover, AI-driven innovations are an area that offers hope for the next generations. As technology and research evolve hand in hand, the future of IVF looks really bright.