Louise Brown, the world’s first baby born via in-vitro fertilisation (IVF), celebrates her 40th birthday today.

Four decades after her birth it is estimated that more than seven million babies have been born as a result of IVF and other assisted reproduction treatments. Around 2.4million assisted reproductive technologies (ART) cycles are estimated to take place each year world-wide, with about 500,000 babies born as a result. If rates stay at current levels, then an estimated 157million people alive at the end of the century will owe their lives to assisted reproductive technologies (1.4 per cent of the global population).

Forty years ago, it was generally assumed that IVF would remain rare. However there has since been an explosion of assisted fertility services: intracytoplasmic sperm injection (ICSI), gamete and embryo freezing, gamete and embryo donation, embryo genetic diagnosis and surrogacy, to name some. The most common fertility treatment now is ICSI, accounting for around two-thirds of all treatments worldwide, with conventional IVF around one-third (proportions vary across countries).

IVF can provide couples with a child they desperately want. And it has brought many new lives into being, and real happiness to millions of parents.

Therefore, many now think IVF is the answer to infertility.

But it is not. While the IVF industry and media focus on and market the success stories, the average delivery rate from ART treatments is around just 19 per cent per cycle – a global IVF cycle failure rate of around 80 per cent. In the UK, the Human Fertilisation and Embryology Authority reports a ‘success’ rate of 26.5 per cent. This ‘success’ rate actually means that 73.5 per cent of cycles do not lead to a birth.

Success rates for IVF diminish rapidly after 35 years of age for women, largely because of loss of ovarian follicle reserve and oocyte quality with age. Even a woman under 35 has less than a one in three chance of having a baby per embryo transferred, using her own eggs and partner’s sperm. A woman in her early 40s has only about a one in ten chance of having a baby per embryo transferred. And the success rate drops to a mere two per cent for women over 44. This is highly relevant in a time when more and more women are delaying childbirth to concentrate on jobs and careers. When celebrities in their 50s become pregnant, what the media do not tell you is that it is almost always with a donor egg (indeed, 59 per cent of women over 44 used donor eggs in their treatment).

IVF heartbreak is real. IVF is no guarantee of success, despite all too often being touted as such. Added to this is the significant financial, emotional and physical toll that IVF can have on women.

Yet still, with one in six couples experiencing problems conceiving, the fertility industry is thriving. It is estimated to be worth over £600million in the UK alone, with one cycle of IVF costing up to £5,000 or more.

There are some very troubling aspects of the fertility industry.

For instance, the number of babies born with health challenges (see here and here too), the use of medically unproven techniques and ‘add-ons’, poor regulation, the shocking commercialisation and exploitation of women’s wombs and eggs (see this on the false hopes of egg freezing) and the change to ‘traditional’ notions of family structure and biological parenthood, through gamete donation (which can bring much heartache to the offspring) and the industry that is surrogacy. A dead or dying person can have their reproductive tissue removed to enable someone else to have a child – even a grandmother.

IVF has also opened what many regard as a Pandora’s Box of genetic engineering, cloning, pre-implantation genetic diagnosis (screening out of embryos), embryonic stem cell harvesting, research on three-parent babies and animal-human hybrids. Many IVF programmes involve the production of spare embryos, which are then used for research, disposed of, or frozen for future use. Between 1990 and 2013 over two million were allowed to perish, according to a Parliamentary answer. Now, over 170,000 IVF embryos perish every year. Embryos are experimented on, donated to other couples, frozen indefinitely . . . or even turned into jewellery.

It is worth remembering when reading the media hype on this anniversary that while the last 40 years of IVF and ART have given many couples happiness it has left even more couples with dashed hopes – and probably some pretty big bills too.

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