Final frontiers of infertility to be cracked as five millionth IVF baby in the world is born

AS the five millionth IVF baby is born, Victoria's pioneers in the procedure are poised to crack the final frontiers of infertility.

IVF

LUKE Taylor's arrival as the first - and long-awaited - child of Sarah and Michael was a monumental milestone for the Melbourne family.

But the eight-week-old's birth - which came as the five millionth "test tube" baby born in the world - is a milestone being celebrated more widely by the international IVF community as a justification of the legal and ethical battles waged, and the scientific boundaries pushed, since first proving the technology 39 years ago.

And just as Victoria's team of pioneering embryologists and gynaecologists - including Carl Wood, Alan Trounson and John Leeton - were the original "miracle makers", Victoria is again at the front of the pack as the final frontiers of infertility are poised to be cracked.

Victoria is credited with the world's first IVF pregnancy in 1973 and Australia's first IVF baby seven years later.

In the 1970s, IVF involved a lengthy hospital stay, three-hourly urine collections to gauge optimal harvest time and the surgical removal of eggs through the abdomen.

The average age of women treated was 28 years and her chance of having a baby was 2 per cent.

Today, the average age of women treated is 37 and women in their late 20s have a 50 per cent chance of falling pregnant through IVF.

IVF is used in one in every 25 Australian babies born.

Hormone stimulation has now made egg collection an exact science and insights into the intricate genetic properties of eggs and sperm mean only the best embryos are selected for transfer.

We might never have been able to have children without IVF, so we feel very, very lucky to have a baby after 12 months

Women can even preserve their fertility by freezing their eggs, embryos can be transferred into surrogate carriers and genetic diseases can be weeded out.

And as the first generation of IVF babies are using the technology to have children of their own, Victoria is again leading the way.

Monash IVF scientific director of embryology Dr Tiki Osianlis said other countries are scrambling to make single embryo transfers standard policy to reduce multiple births, and which has been routine in Victorian clinics in recent years.

"In Australia we've come a long way in decreasing our multiple pregnancy rates, as we decided many years ago we can't artificially increase twinning and triplet rates because of the burden it puts on our patients and our hospital system," Dr Osianlis said.

"Freezing is exceptional these days - about 90 per cent survive thawing - so only transferring a single embryo and having a second one frozen means you don't compromise you chance of having a baby."

IVF

It's those technological advances that have allowed Melbourne couples such as the Taylors to fast-track their desire to have children, with Luke's arrival on June 1.

"We were told we might be able to conceive naturally, but that was only a maybe and you don't know how long it might take," she said.

"I'm 35 and I didn't want to be having children too late because the chances of getting pregnant decrease with age.

"We might never have been able to have children without IVF, so we feel very, very lucky to have a baby after 12 months."

But many developments have been hard fought.

Melbourne IVF director Associate Professor John McBain said he continued to believe the "the law has done more harm than good to IVF".

"At the beginning the law in Victoria stopped us from doing the experimentation which would have allowed us to progress further earlier," Prof McBain said.

"There is now danger of retrospective legislation being introduced to name people who gave sperm as anonymous donors.

"But one of the biggest disappointments I've had is that governments consider people who need reproductive medicine of needing a police check.

"Those who are naturally fertile, and no matter what their parenting skills, can reproduce without any of these needs."

There are still many challenges ahead for IVF.

Universal access and reducing costs is the main aim of the Australian-led Low Cost IVF Foundation, which is helping women in developing countries overcome the stigma of infertility.

Prof McBain said the Federal Government needed to subsidise IVF and genetic testing for families with genetic diseases, who typically could not afford IVF to stop them passing on devastating conditions.

Another hurdle is solving the mystery of why 40 per cent of "genetically normal" embryos don't result in pregnancy once transferred to the uterus.

"We know we can grow chromosomal normal embryos, but making sure the environment in the uterus is right is the next frontier," Dr Osianlis said.

"With the technology we've got at the moment we're not making embryos better, we're just being very selective in which ones we use.

"In the future hopefully we'll have a treatment to make the environment (in the uterus) more receptive."