Third Millennium Assisted Reproductive Technologies: The Impact of Oocyte Vitrification

IVF has been widely used since 1978 (Steptoe & Edwards, 1978) to help infertile couples conceive when nature has failed. The IVF field was improved through embryo freezing/thawing, a technique developed by A. Trounson (Trounson & Mohr, 1983). The next major innovation came with ICSI in 1992, through the work of G.P. Palermo (Palermo et al., 1992). C. Chen was the first to publish work on oocyte freezing (Chen, 1986), but results remained too unreliable for this technique to be adopted in routine ART practice. Oocyte freezing became the focus of experimental efforts when in 1999 the first birth using oocyte vitrification was reported by L. Kuleshova (Kuleshova et al., 1999). M. Kuwayama in a 2005 publication confirmed that this new procedure could be useful in clinical practice (Kuwayama et al., 2005). Within a few years his method for freezing the human oocyte has become the standard for the field. Its clinical application has been widely developed and is now routine, even if other variants have since been proposed. There have been efforts to assess the safety of the procedure (Chian et al., 2008, Noyes et al., 2009). Noteworthy is R. Chian's report on the health of 200 babies born after having been conceived with vitrified oocytes. The safety of the procedure is also supported by all the data available on the health of children born from vitrified embryos (Takahashi et al., 2005, Mukaida et al., 2009). Use of the technique has reached France (Boyer et al., 2010) with passage of a new bioethics law in the summer of 2011. From Italy we have a good overview of what takes place on a nationwide basis once the technique has become standard practice, thanks to the yearly report of ART results published by the country's ministry of health (Relazione del Ministro della Salute, anno 2009).