Fertility crisis: why IVF isn't working

Summary

The video script explores the challenges of age-related infertility and the rising demand for fertility treatments like IVF and egg freezing. It highlights how women’s fertility declines with age, especially after the mid-30s, making conception more difficult. While egg freezing offers a potential solution, it comes with high costs and emotional challenges. The script also delves into groundbreaking innovations in reproductive science, including in vitro gametogenesis (IVG) and efforts to stop ovarian aging. Though these advances are still in early stages, they hold promise for revolutionizing fertility options in the future.

Takeaways

• 😀 Women's fertility decreases with age, with egg count dropping significantly from over a million before birth to just a few hundred by the late 40s, leading to increased difficulty in getting pregnant after the mid-30s.
• 😀 IVF (In vitro fertilization) technology has improved over the years but remains imperfect, especially for older women, with a success rate of less than 20% for 38-year-old women after one embryo transfer.
• 😀 Egg freezing is becoming a popular option for women to preserve fertility by freezing eggs at a younger age, but the process can be expensive and emotionally challenging.
• 😀 Egg freezing costs in the U.S. range from $30,000 to $40,000 for two cycles, while in the UK the costs are lower but still substantial, requiring years of saving for many women.
• 😀 The success of egg freezing is not guaranteed, but studies show that women who freeze eggs before 38 have a 70% chance of having a baby later if at least 20 eggs are frozen.
• 😀 Despite the growing demand for egg freezing, concerns exist over clinics overselling success rates, with a significant risk of failure due to lack of transparency about lab conditions and procedures.
• 😀 IVF was originally developed for women with mechanical infertility issues, not for improving egg quality, and has not evolved enough to address the challenge of age-related infertility.
• 😀 A breakthrough in fertility research is in vitro gametogenesis (IVG), a technique where egg cells are created from skin cells using stem cell technology, potentially eliminating the need for ovaries altogether.
• 😀 Dr. Hayashi’s lab-grown eggs from mice using stem cells have sparked interest in Silicon Valley, with entrepreneurs seeing potential for IVG to provide fertility options for people with limited reproductive choices.
• 😀 One of the potential benefits of IVG is creating eggs for people who have lost fertility due to conditions like cancer, or for same-sex couples who want to have biological children together.
• 😀 While IVG offers a promising future for fertility treatments, there are significant safety concerns due to the prolonged manipulation of embryos outside the body, and it is still in the experimental stage with low success rates.

Q & A

Why does fertility decline as women age?

Fertility declines due to a decrease in both the quantity and quality of eggs. Women are born with over a million follicles, but by their late 40s, only a few hundred remain. This decline in egg number and quality makes it harder to get pregnant after a woman's mid-30s.

What is the significance of egg freezing in relation to fertility?

Egg freezing allows women to preserve their eggs at a younger age, potentially delaying pregnancy until later in life. This method aims to stop the biological clock on a woman’s fertility, but it comes with high costs and varying success rates.

What challenges are associated with IVF as a solution for age-related infertility?

IVF is an imperfect solution, especially for older women. Success rates for IVF have improved, but for women aged 38 and older, there is still less than a 20% chance of success per embryo transfer. IVF does not address the core issue of declining egg quality as women age.

How does egg freezing work, and what are the financial costs involved?

Egg freezing involves stimulating the ovaries to produce mature eggs, which are then frozen for future use. In the U.S., the cost of egg freezing, including two cycles and storage, ranges from $30,000 to $40,000. Costs are lower in the UK but still require significant savings.

What are the success rates for women who freeze their eggs?

The success rates for egg freezing are better when women freeze eggs under the age of 38. In a large U.S. study, 70% of women who froze at least 20 eggs in their late 20s or early 30s went on to have a baby, but success is never guaranteed.

What concerns are raised about the growing popularity of egg freezing?

Concerns include the possibility that some clinics may oversell the success rates of egg freezing. The quality of the clinic plays a crucial role in the outcome, and some women have experienced disappointing results despite expectations.

What is in vitro gametogenesis (IVG), and how could it change fertility treatment?

IVG is a technique that allows for the creation of egg cells outside of the body using stem cells. This process could enable fertility options for women without ovaries or with damaged eggs, as well as same-sex couples who want biological children.

How did Dr. Hayashi's team advance IVG research with mice?

Dr. Hayashi's team used stem cells from a mouse's tail to create viable egg cells, bypassing the need for ovaries. Their research progressed to the point where they were able to create baby mice from eggs grown using male mice's stem cells, demonstrating the potential for creating eggs from non-female sources.

What are the ethical concerns regarding IVG and its future applications in humans?

Ethical concerns include safety risks associated with the manipulation of embryos and the possibility of creating genetically modified organisms. Furthermore, there are potential issues surrounding the idea of using IVG to create eggs from male or non-female sources, raising questions about reproductive rights and the implications for human biology.

What potential does IVG hold for people with fertility challenges beyond women in their 40s?

IVG holds the potential to help a wide range of people, including cancer patients who have lost their eggs due to chemotherapy, same-sex couples who want biological children, and women with damaged ovaries. It could open up new avenues for fertility, offering solutions for those with limited or no options today.