Once rare, in vitro babies have lots of company

More than 45,000 children in the United States have in vitrofertilization to thank for their very existence. That number willsoar as advances in high-tech conception continue.

When Elizabeth Casey, Colorado's first "test-tube baby," was born16 years ago, she was a pioneer. These days, "people are sort ofmatter-of-fact about IVF (in vitro fertilization)," says Dr. WilliamSchoolcraft, medical director of the Colorado Center for ReproductiveMedicine in Englewood. "Most people have a friend or relative who hasdone IVF, or they know of a baby who was conceived through IVF, sothey see it more as a standard or a normal thing."

People also are more knowledgable about the procedure, says Dr.Paul Magarelli, director of the Reproductive Medicine and FertilityCenter of Southern Colorado in Colorado Springs.

"The Internet has made them extraordinarily aware of what's outthere. They have the language, they read all the books, they know allthe statistics."

And that's a good thing, he adds: "An educated consumer is aconsumer who helps me make them pregnant."

Also helping are advances in technologies. Magarelli andSchoolcraft are among a relatively few doctors performing blastocysttransfer, a refinement of in vitro fertilization. Blastocyst transferinvolves a longer period of development outside the womb for theembryo - and results in a higher rate of success.

Both doctors also point to another breakthrough in recent years:intracytoplasmic sperm injection, or ICSI. With ICSI, doctors caninject a single sperm into the egg and fertilize it in cases where aman's sperm count is extraordinarily low or the sperm is abnormal.Before ISCI, doctors would have had to use donor sperm.

In the next few years, Schoolcraft expects testing of embryos forgenetic abnormalities before they're transferred into the uterus tobecome routine.

Implantation is an area ripe for research, Magarelli says. Abetter understanding of the interaction between embryo and uterus isneeded: "If I put four beautiful embryos in there, why on average doI only get one baby?"

He also looks forward to improvements in egg freezing and eggmaturation that will "knock off the whole issue of time." He expectsthe time will come when an 18-year-old woman could have hundreds ofeggs removed and have them put back decades later when she's ready tohave a child. A 48-year-old woman, for example, could use the eggsshe had when she was 18, thus reducing the chance of genetic problemsor miscarriage.

With all these advancements looming, Magarelli sees a time whenhigh-tech conception could promise a 90 percent chance of gettingpregnant. "That's four times greater than the way the human being wasdesigned in the first place."

- Bill Radford covers health and fitness and can be reached at636-0272 or comics@gazette.com.Edited by Colleen Keeffe. Headline byAlicia Hocrath