1. Getting pregnant
  2. Trouble conceiving
  3. Fertility treatments

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Fertility Treatment: Recent Advances That Can Help You Have a Baby

Dr. Lubna Pal, professor of obstetrics, gynecology, and reproductive sciences, tells Flo about the latest advances in fertility treatment to help you build your family.

Fertility technologies are developing at a rapid pace. The most important breakthrough is probably in vitro fertilization (IVF).

Today, successful pregnancies can be achieved with the use of IVF in couples with male factor infertility, which is when there are very few sperm in the ejaculate. With IVF, successful pregnancies in cases like these have been achieved using testicular sperm.

According to Dr. Pal, thanks to IVF, a person doesn’t need normal open uterine tubes to get pregnant. “And we can also surgically correct the uterus,” she adds. 

“IVF with the use of donor eggs has allowed us to help people who are older, who don’t have ovaries, or who have undergone premature ovarian failure to have a biological child. The child has the partner’s genetics, but it is the recipient’s uterus and body that nurtures this baby until birth. The child is theirs in all biological senses. Egg donation and IVF options have allowed us this option,” shares Dr. Pal.

“In the near future, we’ll be able to routinely help people who were born without a uterus or lost their uterus to a disease to conceive after uterine transplant.”

Dr. Pal also notes that gestational surrogacy has allowed people who don’t have a uterus to be biological parents. Similarly, with the participation of an egg donor and a gestational surrogate (the same person can donate their eggs and be a gestational surrogate), two male partners can have a child.

“In the near future, we’ll be able to routinely help people who were born without a uterus or lost their uterus to a disease to conceive after uterine transplant,” says Dr. Pal. “Theoretically, I think we are there, but the safety of this technology still needs to be established in the long term.”

Dr. Pal colloquially compares fertility to the “seed” and the “soil.” The egg and the sperm are the seeds, and the lining of the uterus is the soil. “With IVF, we can achieve embryo development outside the body. And now, we are trying hard to focus on strategies that will help us to get the best of the seeds,” she says. 

A lot of progress toward providing same-sex couples with options for pregnancy has been made in recent years. 

“Let’s start with a same-sex female couple who needs a sperm donor,” suggests Dr. Pal. “That donor could be someone known to the couple (known donor) or an anonymous donor.” 

Once the sperm source is selected, one of the partners can go through a simple and cost-effective strategy of donor sperm insemination. This is the simplest and most cost-effective approach. A more complicated approach is when one person serves as an egg donor. Then their eggs are mixed with the donor sperm to create an embryo, which is then transferred to the uterus of the other partner. This allows an opportunity for both female partners to contribute to the pregnancy: one contributes genetically, the other physiologically.

Same-sex couples also have the option of adopting an embryo, which can be implanted in one of the partners or a gestational surrogate. 

Same-sex male partners who have the sperm may need an egg donor and a gestational surrogate to carry the embryo. We are not there in transplanting a uterus to a male body yet,” says Dr. Lubna.

Couples like this may choose to get an egg from one person and then have another carry that embryo, or the same donor may provide eggs and carry the baby for the couple.  

Same-sex male couples may also choose to use both partners’ sperm to inseminate the eggs. This gives each of the partners a chance to contribute to the pregnancy genetically. 

Adoption is also an option. Same-sex couples can adopt an embryo, but in this case, they won’t contribute genetically to the pregnancy. 

Dr. Pal notes that major advances have been achieved in the field of genetics: “We are now able to identify genetically normal and abnormal embryos through preimplantation genetic testing techniques. We have come to appreciate that genetically tested embryos are sometimes in a gray zone (neither completely normal nor completely abnormal), and embryos in this zone are called mosaics.”

Mosaic embryos don’t carry as high of a risk for problems as abnormal embryos, nor as low of a risk as completely normal ones. However, mosaic embryos have resulted in normal, healthy children, explains Dr. Pal. 

“However, we still have not been able to reassure the public that a mosaic embryo will grow into a child without health issues because we don’t have data on the long-term health of these babies. These are the limitations right now.” 

Dr. Pal says that despite the many advances in the field of infertility, reproductive specialists have still not been able to cure reproductive issues related to aging: “We are just beginning to learn what impact aging in men may have on the health and well-being of a child. In recent years, we have learned that certain health conditions in children, such as autism, may be linked to aging of fathers.” 

While we currently focus on egg freezing to minimize the risk of age-related infertility in women, timely sperm freezing may also be something we should be thinking about, suggests Dr. Pal. 

There have been tremendous advancements in infertility treatment over the last few decades. [You can read more about the ones we haven't mentioned here.] But we are still far away from ensuring that every person can get pregnant if they want to. 

If you want to learn more about pregnancy planning, read the first part of the interview with Dr. Pal

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