Assisted reproductive methods - current status and perspectives.

OBJECTIVE

Evaluation of the development of assisted reproduction methods and their success from the time of their origin to the present.

DESIGN

Review article.

SETTING

Department of Obstetrics and Gynaecology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague.

METHODS

Literature search using the Web of Science, Google Scholar and PubMed databases with keywords (assisted reproduction, in vitro fertilization, infertility, ICSI, ovarian hyperstimulation syndrome, OHSS, uterine transplantation) and analysis of articles published in impact and reviewed journals.

RESULTS

At present children born using assisted reproduction methods are not considered as a miracle of modern medicine, but as a  more difficult way of human reproduction. Reproductive medicine helps to fulfill the desires of infertile couples for their own child and thus improve the quality of their life. Since its introduction into clinical practice it has made extraordinary progress. Robert Edwards and Patrick Steptoe, thanks to systematic scientific research and clinical work, contributed to the birth of the first „test tube“ baby in 1978. Edwards received the 2010 Nobel Prize in Physiology and Medicine for his discoveries in the field of assisted reproduction. The first child of assisted reproduction in the Czech Republic was born in 1982 in Brno. In 1986, the worlds first cryoembryotransfer was performed. 1990 was the beginning of preimplantation genetic examination. In 1992, the first pregnancy was achieved using intracytoplasmic sperm injection. The work of specialists in reproductive medicine results in more than 8 million births worldwide.

CONCLUSION

Despite the fact that around 4000 children are born in the Czech Republic each year using assisted reproduction methods, its methods are rejected by part of the society. Assisted reproduction brings a number of controversies, but the spread of information smog around it should not suppress a  rational view of the professional and general public. Indications for assisted reproduction vary, often are on the male side, but the age of the infertile woman is the most important determinant of the success of the process. The question is whether the continuous improvement of medical technologies and scientific discoveries threatens to inadequate manipulation of human gametes or embryos. The society should monitor these controversial aspects through its legislative and control mechanisms and ensure that these methods are not misused for other than strictly medical purposes.