“We gravitate towards things that are instantly gratifying. IVF is one of them”

As the global IVF market is estimated to reach US$36.2b by 2026, embryologist Cynthia Hudson tells FemTech World why IVF has become the logical response when struggling to conceive.

It is estimated that infertility affects one in seven heterosexual couples in the UK.

Since the original NICE guideline on fertility published in 2004 there has been an increase in the prevalence of fertility problems and a greater proportion of people seeking treatment.

A study from 2021 published in Sociology of Health & Illness found that in the UK, IVF is presented as an entirely predictable, and linear course of action when dealing with infertility.

The increasing age at which women start families, declining male fertility along with greater social acceptance of fertility treatment has meant the market has been enjoying steady growth in recent years and so has IVF.

“If a couple runs into a perceived level of infertility, the quickest way to get pregnant statistically, is to do IVF,” says Cynthia Hudson, embryologist and VP of clinical strategy at TMRW Life Sciences.

“The reason why the odds are stacked so heavily in our favour is because we can effectively condense time. We can stimulate the ovaries to produce multiple eggs at once, as opposed to the typical menstrual cycle output of one egg per month.

“But there is a certain level of impatience in our world, and we tend to gravitate towards things that can get us to our stated goals faster. In the rush, we may not take the time to understand all of the reasons behind the infertility.”

There is a lack of awareness around what might require IVF and what might not, says Hudson. Age, lifestyle choices and timing are often overlooked, although they play an important role in achieving parenthood.

“IVF may be required as part of your fertility journey, but it’s also important to treat what the symptom is in the first place, if it is possible to do so,” Hudson explains.

“Age is the most significant predictor of success. So, if you are 25 and you’re not achieving quick success, it’s unlikely that the eggs are the cause of the problem. It could be a timing issue or an issue on the male side.

“If you’re in your 40s, however, it is likely that age is why you can’t become pregnant – your chance of success is reduced. I think it’s important to accelerate the decision-making process at this point.

“You don’t need a fertility specialist to tell you that you’re 42. But sometimes we just get impatient, and we don’t take the time to investigate the cause. We will go right to solution, rather than try to see if we can figure it out.”

During IVF, an egg is removed from the woman’s ovaries and fertilised with sperm in a laboratory. The fertilised egg or the embryo is then returned to the woman’s womb to grow and develop.

As embryos vary in quality, research has predominantly focused on advancing the methods of selecting embryos. However, scientists are now looking at ways to improve the gamete and embryo quality to begin with.

“We’ve spent a lot of time investigating how to screen the embryos and choose the best of the cohort, but what we haven’t really done is improve the egg and sperm cohorts to begin with,” says Hudson, adding that working on the development and growth of the gametes is an exciting area.

“At this point, all we can do is take the material that we have, and then put them together. But what we want to do is try and make that cohort develop better, so that we could improve success rates both in vitro (IVF) and in vivo (in the human body), and help couples conceive without IVF in the first place.”

Cellular reprogramming – the act of reverting mature, specialised cells into induced pluripotent stem cells – is another interesting area of research, says Hudson.

“This means you would get a cheek swab, you would submit that to a lab and the researchers would then deprogram those cells back to where they were at their earliest point. Then they would get those together with an egg or a sperm and eventually, grow an embryo out of that without having to go through the entire egg retrieval cycle.

“Although this is not something that we are likely to see in the next five years, it remains an area that will be further explored.”

Currently, many couples still face barriers to getting fertility treatment. According to the World Health Organisation (WHO), between 48 million couples and 186 million individuals struggle with infertility globally, but only three per cent have access to IVF and similar treatments.

Disparities – largely determined by complex social, cultural, racial, and economic factors – require further studies and cultural enrichment.

For embryologists like Hudson, improving access to fertility treatment remains a priority.

“The vast majority of humans do not have access to fertility treatment and that’s a tragedy. I think we owe it to ourselves and our fellow humans to change that.

“I would like to get to a place where we can say what definitively does or does not work in the lab to improve pregnancy rates. We need to stop charging people for treatments that haven’t been proven clinically beneficial”, the expert adds.

“There are a lot of manual steps in the IVF process right now and we’re at a point where we need to standardise these in order to help us figure out how to improve. I’ve focused a lot of my time recently trying to raise the bar and automate some of those processes.

“We need to make sure that we don’t leave things to chance. We don’t have the infrastructure yet, but we’re getting there.”

For more info about TMRW Life Sciences, visit tmrw.org.