When the first healthy baby conceived through in vitro fertilization (IVF) was born in 1978, it marked a transformative moment in family planning for couples dealing with infertility. The birth rate from IVF, which was just 8% in 1991, rose to 22% by 2021, thanks to clinical and laboratory advancements.

As more people turn to IVF, there is increasing pressure on researchers to further improve its success rate. Despite the demand for progress, advancements in fertility technology remain slow, hampered not only by the rigorous nature of scientific research but also by outdated laws. Experts argue that these restrictive regulations are stifling innovation and making it difficult to perform necessary research.

In the United Kingdom, legislation governing IVF has not been updated since 1990. In the United States, a patchwork of state-by-state regulations further complicates research efforts, with only five states permitting embryo research and another 13 states allowing it under vague terms. A 1996 amendment also banned federal funding for this type of research, limiting resources even further. Marta Jansa-Perez, PhD, Director of Embryology at Bridge Clinic London and Treasurer for the British Fertility Society (BFS), emphasizes the need for legislative reform.

"The law is very restrictive on the use of embryos in research," she said. "Updating this legislation is essential to move IVF forward." The BFS is campaigning to simplify consent forms, facilitate embryo donation for research, and streamline the licensing process for labs.

While legislative changes are awaited, researchers are exploring various innovative approaches. A notable area of interest is the use of artificial intelligence (AI) in selecting embryos. Traditionally, embryologists rely on morphology and personal experience to choose embryos, but AI could offer a more objective and efficient method, potentially increasing success rates. "AI models might reduce subjectivity, save time, and improve outcomes," said Jansa-Perez.

However, she cautioned that more trials are needed to validate these systems. Another groundbreaking area of research is in vitro gametogenesis (IVG), which involves creating gametes (reproductive cells) from somatic cells (normal body cells). This technology could revolutionize IVF by enabling same-sex couples and individuals who cannot produce viable eggs or sperm to have genetically related children. IVG is still in its early stages, primarily being tested in animal models, and raises numerous ethical and regulatory questions.

In the absence of immediate scientific breakthroughs, there are steps individuals can take to increase their chances of successful IVF. Research indicates that maintaining a healthy lifestyle can significantly impact IVF outcomes. Key factors include maintaining a moderate body mass index (BMI), eating a balanced diet, taking folic acid supplements, exercising regularly, avoiding tobacco and alcohol, managing stress levels, and avoiding exposure to harmful chemicals.

Despite overall advancements, disparities in IVF success rates persist. According to a report by the Human Fertility and Embryology Authority (HFEA), Black and Asian parents have lower birth rates following IVF. Contributing factors include age, underlying health conditions, and socio-economic barriers, as well as sociocultural issues that may affect access to and comfort with fertility services.

Awareness of one's fertility status and options is crucial, especially as more people delay starting families. Understanding potential fertility challenges and exploring options like ovarian reserve testing can empower individuals to make informed decisions. "Age is arguably the most important predictor of IVF success," said reproductive endocrinologist Kassie Bollig, MD, FACOG. "Communicating future family-building desires, even if the goal is not to get pregnant now, is key. Many patients wish they had known their options sooner."

As IVF technology continues to evolve, the interplay between scientific advancement and legislative reform remains critical. While researchers work to push the boundaries of what's possible, individuals can take proactive steps to optimize their chances of success. Embracing both innovation and informed self-care will pave the way for a healthier future in fertility treatment.