Breakthrough time-lapse image technology is offering fresh hope to couples struggling to have children.
Fertility Associates has completed a two-year trial of new video-linked incubators, giving doctors the ability to watch fertilised human eggs develop over five days before the best embryos are selected for transfer or freezing.
It is hoped the new technology will improve the odds of a successful pregnancy for women who have suffered miscarriages after failed IVF treatment.
There is a 40 per cent success rate of women aged 37 years and under having a baby after the first IVF cycle. Fertility Associates believes the success rate will rise to 50 per cent using the time-lapse technology.
The latest innovation comes as Fertility Associates celebrates its 15,000th birth using reproductive technology — from IVF's humble beginnings in New Zealand more than 30 years ago.
Clinic scientific director Dr Tex VerMilyea says the new technology means specialists can better determine successful embryo selection than using the traditional "snapshot" observation under a microscope.
Until now, developing embryos have been taken from their tiny incubator every 24 hours and put under a microscope to gauge progress.
VerMilyea says a key to the new technology is the ability to leave the petri dishes undisturbed.
"We know that minimal disturbance improves embryo development and time-lapse imaging allows us to assess daily embryo progress without daily opening of incubators, which we now know is adverse to optimal development."
The time-lapse videos, compiled from still shots of the multiplying cells taken every five minutes, mean doctors can identify minute changes in development. "Time lapse fills in the gaps," he says.
Initially, women who have found it difficult to become or stay pregnant after transfer treatment will be offered the technology. It is hoped time-lapse imaging will become standard care at the Ellerslie clinic.
Patients will be charged just under $1,000 per cycle for time-lapse imaging on top of the $10,000 cost of IVF treatment.
Mum-of-two Rochelle Payne, who gave birth to Nicolas three weeks ago on her fifth cycle of IVF treatment, says any technological advance that increases the chance of getting pregnant is great news for women having trouble conceiving.
"We'd be saying yes to using the time-lapse technology and jumping in with both feet if we didn't have our babies. I would have done anything to make sure the embryo implanted."
The world's first test-tube baby, Louise Brown, was born in 1978. New Zealand's first IVF baby, Amelia Bell, arrived in 1984.
One in 10 women experience infertility and this number is on the rise as women delay having children.
IVF treatment was introduced to New Zealand in 1983 by Richard Fisher and Freddie Graham at National Women's Hospital in Greenlane.
The pair, frustrated by long waiting lists and the reluctance of the old hospital board to develop the "orphan" unit, parted company four years later and set up their own private practice in a converted villa on Remuera Rd. "The driver was the seven-year waiting list and talk of closing the unit," says Fisher.
Both men saw an opportunity to meet the needs of men and women finding it difficult to conceive and so set up Fertility Associates. They were not without their detractors.
Rochelle Payne, who was successful on her 5th IVF cycle, says any advances that raise the chance of getting pregnant is great news. Photo / Doug Sherring
Fisher says their homes and offices were regularly targeted by protesters accusing them of exploiting women and interfering with nature. "A lot of it was about fear. They used to describe it as a failed technology."
Fertility Associates is one of three IVF providers.
At Fertility Plus, the largest publicly funded fertility clinic, scientific director Dr Margaret Merrilees says there have been up to 10,000 births as a result of IVF treatment.
The third fertility clinic, the privately run Repromed, started its Auckland laboratory in 2007 and has clocked up more than 1,000 births.
Repromed medical director Guy Gudex says his clinic was the first to introduce shorter cycles to New Zealand, which last just 14 days rather than the traditional six weeks.
Regarded as pioneers in reproductive technology and responsible for running the country's largest IVF operation, Fisher and Graham introduced procedures including embryo freezing, IVF with donor eggs and developing the intra-cytoplasmic sperm injection. The injection is the first procedure in which male factors can be treated to help conception.
"We used to leave sperm next to eggs and hoped they would become fertilised," says Fisher.
"Along came this technology where we could pick up an individual sperm and inject it into an egg."
Fertility Associates was also a driving force behind identifiable sperm donors, so that by the mid-1990s New Zealand led the world in voluntary identifiable egg and sperm donors.
Fisher, now aged 67 and still practising at his Ascot clinic, says there is more work to be done to improve the pregnancy rates, which have risen from 15 to 50 per cent per IVF cycle over the past 30 years, in assisted reproduction.
'Super-lucky' after long wait for much-wanted second child
Debbie Knight often wonders if her years of struggle to have a family could have been bypassed if she had started trying a decade earlier.
"If I knew back in my early 30s what I know now, I probably wouldn't have waited so long to have children," says Knight.
"Hindsight's a great thing."
The 40-year-old mum to 5-year-old Keisha and 7-month-old Jackson says hopes of having a second child seemed to fade after an embryologist suggested her eggs were marginal.
She was living in Singapore at the time and repeated IVF treatment was proving unsuccessful and ending in heartache.
"I was told over there my eggs might have been too old and advised to start to think about donor eggs."
But that was a path Knight was not ready to pursue.
"For me to have a biological child was something I felt strongly about."
Knight, a stay-home Auckland mother who also runs a mobile hair-salon business, says there were still reproductive technologies to pursue and she wanted to exhaust those possibilities before committing to an alternative plan.
"We would have adopted if things hadn't worked out but I hadn't given up on trying for a baby of our own."
She said it was particularly difficult for parents when the much hoped-for child proved elusive.
"There's grief, frustration, anger. It goes quite up and down. You go through quite a range of emotions depending on, say, how many times you've had treatment and if other people are having children at the same time."
Knight ended up moving back to New Zealand with her husband and daughter and started exploring new avenues of IVF treatment at Fertility Associates.
Last year, her hopes of adding to her family were realised with a long-awaited pregnancy and birth of little Jackson in January.
"After a six- or seven-year struggle, to get kids is super-lucky."
Given the gift of new life
The baby pictures hanging on the walls at Michelle and Siato Tamua's Auckland home start at an earlier point of life than most.
The first image of identical twins Feleti and Mataio was taken after conception and shows a 5-day-old single embryo grown in a petri dish ready for transfer into Michelle's womb.
The second picture is the 12-week ultra-sound scan showing the same embryo split into two developing foetuses.
Then comes the four dimensional scan at 26 weeks.
Finally, the newborn identical twin boys, the product of IVF, born at 36 weeks.
Each framed photo hangs above the other, revealing the growing life within the first-time mum over nine months. "It's a constant reminder of our journey," says Michelle.
The 18-month-old tots are bundles of energy and full of smiles. They love music and playing with toys.
Four years ago it was a picture that seemed beyond reach. Michelle and Siato, both in their late 30s, had been trying to start a family without success.
"There was no way we were going to be able to get pregnant naturally," said Michelle. "We had been trying for two years but we were too old."
They looked to IVF for answers and Michelle, then aged 39, was successful on the first treatment cycle. "This was our first embryo from our first cycle. Number one of number one."
She said she would be forever grateful to the specialists at Fertility Associates for the opportunity to start a family and couldn't praise the staff enough.
"We're so lucky," said Michelle who hopes to add to her young family in the future.
"I can never be grateful enough for what this place has given us.
"It's meant we had the chance to have children."