In 1981 Howard and Georgianna Seegar Jones announced the delivery of the first IVF pregnancy in the United States. Instantly the Jones Institute at Eastern Virginia Medical School in Norfolk, Virginia, became an international center for IVF. With the help of pioneers in Europe, Australia, and the United States, the number of centers grew and flourished.

Initially the timing for the oocyte aspiration was based on multiple measurements of urinary LH resulting in a laparoscopic surgery, frequently performed in the middle of the night, resulting in the retrieval of one egg. This required a truly dedicated lab and operating room. With time various centers experimented with ovulation stimulating agents such as clomiphene and human menopausal gonadotropin (hMG, Pergonal). This allowed the retrieval of more oocytes, and therefore increased the chance for fertilization, development, and transfer. As these services expanded, so did the indications for IVF. In addition to tubal factors, IVF was now performed on couples having infertility from ovulatory problems, male factors, endometriosis, age related issues, and unknown reasons. In 1985 Serono developed a purified urinary FSH (follicle stimulating hormone). Uses of this product, either alone or in combination with other ovulation stimulating agents, seemed to improve both the number and quality of the oocytes. One problem still plaguing the process was that of spontaneous ovulation. Up to one third of cycles were canceled due to the development of a premature LH surge or release of the oocytes. The development and distribution of a GnRH agonist (Lupron) in 1986 (originally used for the treatment of prostate cancer) was the key to controlling that problem. This allowed the suppression of the normal LH surge in order to time retrievals. Once again, the number of follicles stimulated increased, thereby enabling the capture of more oocytes.

The next big development was changing the method by which oocytes are retrieved. Initially this was performed as a surgical laparoscopic procedure, thereby limiting to whom, when and where services could be provided. Starting in the mid-1980s, ultrasound guided ovarian cyst aspiration was developed. This method transformed oocyte collection from a surgical procedure to one performed in an office setting. At the same time GIFT (gamete intrafallopian tube transfer) was developing a following as a way of assisting pregnancy in women with normal fallopian tubes. Oocytes were aspirated, mixed with sperm and placed back into the fallopian tubes where they would fertilize normally, divide, and travel to the uterus for implantation.

Over the last two decades the success rates for IVF have risen dramatically. Although it was first thought that we would not exceed natural success rates of 15-20 percent, with lab improvements and culture media changes, the rates have increased to over 50% in women under 37. These rates are closely linked to the quality and expertise of the IVF lab.

In 1998 the Virginia IVF and Andrology Center, under the direction of Dr. Dennis Matt, opened in Richmond, Virginia. All of the most advanced technologies for IVF and sperm processing are available at the Center, insuring that the highest quality results for inseminations and semen analyses are available to the Reproductive Endocrinologists in the area. The combined efforts have enabled the Center to utilize new techniques such as Assisted Hatching and ICSI, increasing IVF success rates. Success rates can be viewed through the Center’s web page at www.vaivf.com or through the Center for Disease Control at www.cdc.gov.