The Evolution of IVF: How Far We've Come and What's Next

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12 May 2025

8 Min Read

Dr Lee Sau Har (Academic Contributor), Dr Tor Yin Sim (Academic Contributor)

IN THIS ARTICLE
Dr Lee Sau Har

Contributed by Dr Lee Sau Har, whose research focuses on cancer stem cell biology and therapeutics, virology, and more. She can be reached at sauhar.lee@taylors.edu.my.

Dr Tor Yin Sim

Contributed by Dr Tor Yin Sim, whose research focuses on genetic epidemiology and molecular pharmacology. She can be reached at yinsim.tor@taylors.edu.my.

What began as a bold experiment—creating life outside the human body—has become a lifeline for millions. Since the birth of the first IVF baby in 1978, science has transformed hope into reality, yet the journey to parenthood remains as emotional and challenging as ever.

 

Today, IVF is not just about overcoming infertility. It's about pushing the boundaries of reproduction itself, with AI selecting embryos, stem cells creating gametes, and synthetic life inching closer to possibility.

 

How far have we come—and how far are we willing to go?

The Journey of IVF

It began in 1978, when Louise Brown became the world’s first IVF baby. Born in the UK, her birth was the result of pioneering work by physiologist Robert Edwards and gynaecologist Patrick Steptoe. Their success demonstrated that human conception could occur outside the body, forever changing the possibilities of reproduction.

Robert G. Edwards, right, and Dr. Patrick Steptoe, left.

Robert G. Edwards, right, and Dr. Patrick Steptoe, left. Robert Edwards won the Nobel Prize in Physiology or Medicine in 2010 for the development of IVF—more than 30 years after the birth of Louise Brown. His work was initially rejected by many scientific journals and faced intense backlash from religious groups, yet he persevered, forever changing reproductive medicine. Image Source: New York Times

Technological Advancements That Transformed IVF
 

Since the birth of the first IVF baby, key innovations have greatly improved success rates and expanded options for those facing complex fertility challenges.

 

  • Cryopreservation changed everything for IVF. Instead of going through stressful treatments over and over again, patients can now freeze embryos, eggs, or sperm and save them for later. It’s like hitting pause at the perfect moment—giving people more chances to try again without the extra physical and financial pressure.
frozen hydrogen

Modern vitrification methods (a rapid freezing process) have dramatically improved survival rates after thawing, with post-thaw survival now exceeding 95% for embryos.

  • Ovarian Stimulation is all about giving the body a boost. Normally, the ovaries release just one egg each month, but with controlled ovarian stimulation (COS), doctors use hormones like follicle-stimulating hormone (FSH) to help grow several eggs at once. This way, during IVF, more eggs can be collected in a single cycle—giving patients a better chance at success.

  • Intracytoplasmic Sperm Injection (ICSI) was a game-changer when it first appeared in the early 1990s. Instead of leaving fertilisation to chance, scientists now select a single sperm and inject it directly into an egg using a tiny glass needle. This technique helps overcome issues like low sperm count or poor sperm movement—giving fertilisation a better shot when nature needs a little extra help.
ICSI

ICSI is especially useful when sperm have problems with count, movement, or shape. Thanks to this technique, millions of couples who might never have been able to conceive naturally have been able to start families—turning what once felt impossible into a real chance at parenthood.

The Current State of IVF

IVF today looks vastly different from its early days. What was once experimental has become a highly refined process supported by decades of scientific research and clinical improvements.

 

 

Time-Lapse Imaging (EmbryoScope)
 

Think of it as a baby monitor for embryos—but far more advanced. Time-lapse imaging allows embryologists to watch embryos develop in real time, without ever disturbing their carefully controlled environment. Systems like EmbryoScope take thousands of high-resolution images over several days, creating a detailed timeline of development.

 

This technology helps clinicians catch critical—but subtle—clues, such as how evenly cells divide or whether development is on schedule. These details can make all the difference when selecting which embryo has the highest chance of becoming a healthy baby.

 

Why It Matters:

  • Reduces handling and maintains ideal conditions for embryo growth.
  • Tracks precise developmental milestones to better predict embryo health.
  • Increases chances of success by improving embryo selection.
Embryo

Time-lapse systems can capture up to 5,000 images per embryo, helping embryologists uncover patterns invisible to the human eye.

Preimplantation Genetic Testing (PGT)
 

Behind every embryo is a genetic blueprint. PGT lets fertility specialists take a closer look—screening for chromosomal abnormalities or inherited conditions before implantation. It’s a powerful way to match hope with health. Types of PGT include:

  • PGT-A (Aneuploidy): Screens for extra or missing chromosomes (e.g., Down syndrome).
  • PGT-M (Monogenic): Detects specific inherited diseases like cystic fibrosis or thalassaemia.
  • PGT-SR (Structural Rearrangements): Identifies chromosomal translocations and other abnormalities.

 

Why It Matters:

  • Boosts the chances of a successful, healthy pregnancy.
  • Reduces risk of miscarriage by avoiding embryos with chromosomal errors.
  • Supports families with known genetic conditions in having healthy children.
Young couple

PGT can be especially helpful for women over 35, when the risk of chromosomal abnormalities naturally increases.

Assisted Hatching (AH)
 

Before an embryo can implant in the uterus, it has to ‘hatch’ from its protective outer layer—the zona pellucida. But sometimes, that outer shell is just too tough. That’s where assisted hatching comes in.

 

Using a fine laser or specialised chemical solution, clinicians create a tiny opening in the shell to help the embryo break free and attach to the uterine lining. It’s a delicate nudge that can make a world of difference, especially in older patients or those with previous IVF failures.

 

Why It Matters:

  • May improve implantation chances in selected cases.
  • Helps embryos with thick or hardened outer shells.
  • Offers renewed hope to patients with a history of failed cycles.
Assisted Hatching

Assisted hatching has evolved from manual microneedles and acid solutions to precision lasers—now the go-to method for helping embryos 'break out' and implant, much like giving nature a high-tech nudge. Image Source: inviTRA

The Future of IVF

As reproductive science enters a new era, breakthroughs are emerging that could completely redefine how we think about fertility, conception—and even pregnancy itself.

 

 

AI in Embryo Selection
 

Imagine if a computer could help predict which embryo had the best chance of becoming a healthy baby. That’s exactly what AI is now doing in leading fertility clinics.

 

AI systems like BELA (Blastocyst Evaluation Learning Algorithm) analyse thousands of time-lapse images and biological data points to assess embryo quality with remarkable accuracy—sometimes up to 80%. By identifying subtle patterns invisible to the human eye, AI helps embryologists select embryos that are more likely to implant and less likely to miscarry.

STORK

AI systems like STORK, seen in the image, can analyse thousands of embryo images to predict which ones are most likely to be chromosomally normal—or euploid—with over 70% accuracy. Image Source: ResearchGate

In Vitro Gametogenesis (IVG)
 

What if skin cells could be transformed into eggs or sperm? That’s the bold vision behind in vitro gametogenesis (IVG)—a cutting-edge technique that turns stem cells into fully functional gametes.

 

In 2023, Japanese researchers succeeded in generating sperm from mouse skin cells, a major milestone that edges us closer to human applications. The implications are staggering: IVG could offer fertility solutions for cancer survivors, women with early menopause, and same-sex couples wishing to have genetically related children.

Shinya Yamanaka and Katsuhiko Hayashi

The breakthrough that made in vitro gametogenesis (IVG) possible started with Shinya Yamanaka’s (left) discovery of induced pluripotent stem cells (iPSCs) in 2006. By reprogramming adult cells back into a stem-cell-like state, Yamanaka opened the door for researchers like Katsuhiko Hayashi (right) to turn skin cells into egg and sperm cells—reshaping the future of fertility science.

Artificial Wombs and Synthetic Embryos
 

Growing a baby outside the human body may sound like something out of The Matrix, but scientists are already working on it. In a 2022 study, researchers at Israel’s Weizmann Institute of Science created synthetic mouse embryos—complete with a beating heart and brain structures—using only stem cells and an artificial womb.

IVG

These embryos weren’t fertilised in the traditional sense; they were built from scratch, without eggs or sperm. Image Source: MIT

While human applications are still in the early research phase, the potential uses are groundbreaking—from supporting extremely premature babies to offering new reproductive pathways for those unable to carry a pregnancy.

Fertility science is evolving fast, from AI embryo selection to artificial wombs. As an embryologist, you’ll help create families and shape the future of parenthood through science, ethics, and compassion.

— Dr Lee Sau Har

Conclusion

From its humble beginnings in a Cambridge lab to AI-powered embryo analysis and the promise of lab-grown gametes, IVF has come a long way in just over four decades. What was once a medical miracle is now a mainstream option—and yet, the journey remains deeply personal, shaped by science but driven by human hope.

 

As we look into the future, IVF is poised not just to improve success rates, but to expand who gets to conceive, how life begins, and where the limits of reproduction lie. But with this progress comes responsibility: to ensure that innovation remains ethical, accessible, and grounded in compassion.

Every new life begins with a single cell, and the science of embryology holds the key to understanding how it all unfolds. The Bachelor of Applied Health Sciences (with specialisation in Embryology) takes you into the intricate world of fertility and reproductive health, where cutting-edge techniques like IVF and genetic screening are transforming possibilities.

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