It’s been 40 years since South Australia’s first IVF baby - a little boy called Mathew - was born at Flinders Medical Centre. So much has changed in fertility medicine since 1982. In the 1980s “test-tube babies” (as they were called then!) were rare compared to today when around 1 in 20 babies are conceived through IVF and about 1 in 15 (equating to about two children in every classroom) will be born because of some form of reproductive assistance.
Intrauterine Insemination (IUI) was the first ground-breaking fertility treatment, where sperm were washed and concentrated and placed directly in the uterus to fertilise an egg. However, this required the fallopian tubes to be clear, so many women with scarring or blocked tubes were still unable to benefit. IVF (In vitro fertilisation) changed all of this by fertilising the egg outside of the body and then implanting the embryo into the uterus soon afterwards.
In the early days, the process was carried out in a single natural cycle. A breakthrough came in the late 1970s when hormone stimulating drugs were given via injections to encourage the ovaries to produce multiple eggs rather than just one. This increased the number of embryos available and improved the chances of pregnancy. The introduction of ICSI in 1992 also helped overcome male factor fertility issues by injecting a single sperm into an egg and has continued to allow many couples to have the chance to create a family when they otherwise might not have been able to.
Initially, transferring multiple embryos compensated for the low ongoing pregnancy rate following IVF treatment. However, increased knowledge of an embryo’s metabolic requirements allowed for the introduction of more advanced culture media in the late 90s, and embryos were able to be grown beyond early cleavage stages and prove their developmental potential. This helped embryologists more reliably select an embryo with the highest implantation potential, and along with more robust freezing techniques during this time when vitrification was introduced, the number of embryos required for transfer to achieve a successful pregnancy decreased. This was great news for both mother and baby, as the risk of complications due to multiple births was still relatively high up until this point.
Since these breakthroughs, there have been many other developments along the way – the improvement of genetic testing techniques, time-lapse technology, use of artificial intelligence, and three-parent IVF to name a few – all with the aim of improving success rates and the health of the future child.
These advances collectively mean women now can access IVF with less stress on their bodies and be exposed to fewer hormones. In some cases, a family can be completed from only one IVF cycle and subsequent frozen embryo transfers.
It may seem shocking today but only five years ago same-sex couples (and single women) in SA couldn’t access fertility treatment unless they were “medically infertile”. In March 2017 SA finally followed most other states in changing the law to allow all South Australians access to assisted reproductive technology. Since then, we are delighted to say we’ve helped create hundreds of rainbow and single-parent families.
There’s still some way to go, however. A medical diagnosis of infertility is still required to access Medicare rebates, meaning most of them still must pay full fees for their treatment. We believe that families come in different forms and that all patients should have equitable access to funding, as well as treatment.
We’ve also come a long way since those days 40 years ago at Flinders Medical Centre. We are now in a purpose-built new facility at Glenelg and are rapidly expanding our services. Our ethos remains the same though. Our history of growing out of a research hospital and part ownership by Flinders University means that we are not driven by profit but can focus on delivering the best treatment for each patient and provide our services at a more affordable cost.
Our Scientific Director, Dr. Ashleigh Storr, says
"As a young Scientific Director, it’s amazing to think that the technologies we use every day in the laboratory only came about 40 years ago! They have been hugely successful in helping families who otherwise wouldn't be able to have children, and I am looking forwards to seeing what the next 40 years will bring."