Ivan Anduaga Marcehtti: 5 Things Everyone Should Know About IVF
An Interview With Jake Frankel
Achieving pregnancy can be lengthy, sometimes seemingly endless, or even unsuccessful. Providing proper guidance to patients to minimize anxiety and manage expectations is crucial to offering accurate information and personalizing advice based on each case’s reality. When patients arrive at the clinic, they undergo a series of tests that can sometimes significantly delay the start of the treatment.
In vitro fertilization (IVF) has become a widely used assisted reproductive technology, helping many individuals and couples achieve their dreams of parenthood. However, despite its prevalence, there are still many misconceptions and questions surrounding IVF. Through this series, we aim to provide comprehensive and insightful information about IVF, covering topics such as the procedure itself, success rates, emotional and financial considerations, ethical concerns, and advances in the field. As part of this series, we had the pleasure of interviewing Iván Anguaga Marchetti .
Thank you so much for joining us in this interview series. Before we begin, our readers would love to “get to know you” a bit better. Can you tell us a little about yourself?
Iván Anguaga Marchetti (MS, COO): With over 20 years of experience revolutionizing the field of in vitro fertilization and assisted reproduction, I am a clinical embryologist certified in Argentina by SAMER, SAEC, and in LATAM by REDLARA. I have dedicated my career to leading top-tier laboratories and clinics. I am the visionary founder and first president of the Argentine Society of Clinical Embryology (SAEC). His most recent venture, Embryoxite, is at the forefront of embryo diagnostics using omics-metabolomics technologies, a pioneering approach that is reshaping the future of in vitro fertilization. An innovator, leader, and pioneer, Iván is redefining the future of in vitro fertilization.
Ok, thank you for that. Let’s now jump to the primary focus of our interview, about IVF. Let’s start with a basic definition so that all of us are on the same page. Can you please tell us what IVF is?
In vitro fertilization (IVF) was developed over 60 years ago, initially in animals and later applied to humans. This technique aims to fertilize an egg with sperm outside the woman’s body, in vitro, under controlled culture conditions. For the past 50 years, this technique has helped people with fertility issues conceive a child.
On the other hand, assisted reproductive treatment is a set of laboratory processes and techniques aimed at achieving pregnancy in individuals with fertility problems. The treatment begins with ovarian stimulation of the woman by administering hormones to produce multiple mature eggs. Once mature, the eggs are retrieved from the ovaries through a minor surgical procedure called follicular aspiration. The recovered eggs are then mixed with sperm in a specialized laboratory to allow fertilization, which can be performed using two techniques: the previously mentioned IVF, where sperm swim around the egg, and one of them penetrates, closely mimicking natural fertilization. The second technique is called ICSI (intracytoplasmic sperm injection), where a single sperm is injected directly into the egg. The fertilized eggs are cultured in a controlled environment for several days until they become embryos. Then, one or more high-quality embryos are selected and transferred to the woman’s uterus through a simple, non-invasive procedure. If one of the embryos implants in the uterine wall, pregnancy begins.
What are some common misconceptions about IVF that you have encountered, and how do you address them?
Many couples believe that undergoing assisted reproduction treatments allows them to modify certain aspects of their future embryos, such as the likelihood of the baby having a pathology due to being conceived by IVF. This is not true and has been scientifically disproven in many ways.
Another misconception is that simply undergoing assisted reproduction treatment guarantees a pregnancy. Unfortunately, global statistics do not support this, and it is essential to understand this to avoid misunderstandings and emotional strain throughout the process. Additionally, obtaining high-quality embryos for transfer to the uterus does not guarantee a future pregnancy. Therefore, conducting a comprehensive diagnosis that evaluates all aspects of the gametes, embryos, and the patient who wishes to conceive is crucial. Properly advising patients and informing them about the probabilities is essential to avoid false expectations.
Another common misconception I often hear is the difference between IVF, ICSI, and intrauterine insemination. The first two are techniques for fertilizing an egg outside the body, whereas intrauterine insemination involves placing capacitated sperm inside the uterus, allowing them to fertilize the egg naturally. This technique generally yields lower success rates compared to ICSI or IVF.
Can you discuss some of the emotional challenges individuals and couples may face throughout the IVF process, and what strategies you recommend for coping?
For many young and healthy couples, starting a family can be achieved within a few months of trying. However, for those undergoing assisted reproduction treatments, this is not the case. As mentioned, global statistics indicate a success rate (achieving pregnancy) between 30% and 60%. This means that some patients may achieve pregnancy in the first treatment, while others may require a second, third, or even more treatments. All this involves time, money, and significant psychological and emotional challenges. What do patients really experience throughout this journey?
Patients arrive at the clinic in a state of emotional vulnerability, often with dreams and expectations that have been frustrated. The emotional burden comes from both the physical challenges and social pressures. As the number of IVF/ICSI cycles increases, women face greater psychological and physical exposure, experiencing a roller coaster of emotions from hope to disappointment.
The emotional impact of achieving a healthy pregnancy transforms into hope laden with anxiety. Every milestone is a cause for both celebration and concern, affecting overall well-being. The financial dimension of the treatment adds another layer of stress, impacting the emotional and mental stability of the couple.
Fertility clinics must offer a holistic approach, including psychological support, therapy sessions, and support groups. Recognizing and validating patients’ emotions helps create an atmosphere of empathy and understanding, facilitating a more positive and humanized experience. Infertility is not just a medical issue but a deeply human experience that requires an integral and compassionate approach.
How do you approach the topic of ethics in IVF, particularly regarding issues such as embryo selection and genetic screening?
Ethics are present at every moment, from when one becomes a professional and takes the Hippocratic oath to the daily practice of working with human embryos. First and foremost, it is an excellent start to access clinics that comply with all regulations, are certified and audited by a procedural management system, and require signing informed consent for each treatment.
There is a societal myth that working with embryos involves genetic manipulation and selection for specific purposes. In reality, nothing could be further from the truth. On the contrary, working with embryos is a great responsibility, involving a lot of effort and continuous stress to help patients achieve a successful pregnancy.
The term “embryo selection” is often misused and carries a distorted connotation, as mentioned earlier. I believe the correct term is “embryo prioritization” because what is actually done when choosing an embryo to transfer to the uterus is selecting one over the others available to the patient. Genetic screening and embryo selection based on morphology aim to shorten the time needed to achieve a healthy pregnancy and reduce the number of miscarriages caused by aneuploid embryos. The main morphological characteristics of the embryo include:
- The condition of its cells.
- The number of cells relative to its stage.
- Its degree of development.
Genetic screening determines the number of chromosomes in an embryo (23 pairs of chromosomes); if its constitution differs, the chances of miscarriage or genetic risks in the offspring increase.
Finally, relying on these two aspects for embryo prioritization is the only tool we currently have, supported by scientific knowledge, to achieve pregnancy and birth in the shortest possible time. This approach avoids unethical and scientifically unfounded “selection” based on genetic or phenotypic traits.
What recent advancements or innovations in IVF technology have you found most promising or exciting, and how do you see them impacting the field in the future?
There are several areas of interest in science. Still, currently, anything that involves understanding biological processes through OMIC technologies such as genomics, metabolomics, and others, analysis of large volumes of information, and the use of artificial intelligence are the most promising trends. Some examples include embryo genomic sequencing, embryo metabolomic analysis, or time-lapse analysis of embryo growth, all of which use AI in the background and appear to be the most promising.
Embryo-SelecT is an innovative test designed to identify embryos with the highest potential for pregnancy. We use advanced high-efficiency mass spectrometry and infrared spectroscopy technology to analyze the metabolic exchange of embryos in their culture medium. This non-invasive technique provides valuable information that cannot be obtained through other methods, allowing us to predict implantation success with 70% accuracy.
The key to Embryo-SelecT is its foundation in deep learning and a unique database. This database has been built from our scientific research in collaboration with various clinics around the globe. This combination of technology and data lets us offer a much more precise and detailed analysis.
The main benefit is the significant increase in success rates in fertility treatments. By identifying embryos with the highest implantation potential, we can improve pregnancy rates and help more people achieve their dream of becoming parents. Additionally, being a non-invasive technique, it is entirely safe for the embryos.
Ok super. Here is the main question of our interview. Based on your experience and research, can you please share “5 Things Everyone Should Know About IVF?” If you can, please share a story or an example for each one.
1 . According to the World Health Organization, 1 in 6 people faces fertility issues, and the global success rate of in vitro fertilization (IVF) is 30%. This means that, on average, 3 to 4 attempts are needed to achieve pregnancy. Individuals seeking these treatments aim to improve their chances of overcoming infertility but often expect to achieve pregnancy on the first attempt, which does not always happen.
2 . Achieving pregnancy can be lengthy, sometimes seemingly endless, or even unsuccessful. Providing proper guidance to patients to minimize anxiety and manage expectations is crucial to offering accurate information and personalizing advice based on each case’s reality. When patients arrive at the clinic, they undergo a series of tests that can sometimes significantly delay the start of the treatment.
3 . Assisted reproduction treatments involve hormonal stimulation in women to obtain the maximum number of mature and viable eggs for treatment. This stimulation is done through injections that cause more extreme changes than natural cycles, resulting in pain and discomfort for the woman. Strict schedules, multiple injections, and follicle aspiration in the operating room lead to significant physical and emotional strain. Patients must receive psychological support and feel supported by professionals, family, and friends.
4 . Both women and men must receive comprehensive early counseling on factors that may affect their reproductive future. Patients often arrive at the assisted reproduction clinic with depleted gamete reserves or require treatments that will affect their reserves wholly or partially. If they do not have sufficient time to preserve their gametes, their chances of having children with their own gametes are diminished or even eliminated.
5 . In assisted reproduction, many techniques can contribute to improving outcomes; however, not all treatments are suitable for all patients. Each couple’s reproductive factors are assessed, and a treatment that is as personalized as possible is recommended based on their diagnosis. It is essential to know that only some techniques apply to every case and that performing them only sometimes offers benefits; it may even negatively impact the outcome. Additionally, it is essential to understand that even if two patients have the same infertility conditions and receive the same treatment, they may have different clinical results, as each person is physiologically distinct from another.
In your experience, what are some of the key factors that contribute to IVF success, both medically and psychologically, and how can someone optimize these factors?
Each treatment is unique, so counseling and selected techniques must be personalized for each case. Currently, the entire procedure remains highly individualized, requiring assessing each patient’s response to stimulation and adjusting medication dosages at every stage. Additionally, decisions in the laboratory are based on embryonic development, making each case distinct and highly dependent on the professional’s experience. Using data collected from the preliminary assessment and each individual’s developmental history, tools like artificial intelligence can be applied to optimize treatment and achieve the best results. This allows, for example, the selection of the most suitable stimulation protocol for each patient and the maximization of the number of oocytes obtained per cycle.
You are a person of great influence. If you could start a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂
Given our social context, where life expectancy continues to increase, professional and material goals often take precedence. At the same time, peak fertility does not align with this extended life span; I would invest in a global campaign to educate the public on the crucial importance of preserving their gametes. This would ensure that it is not too late when setting a still timeline, a future where every individual, regardless of age, has the power to choose the perfect time to have children, free from the pressure of the biological clock. This initiative would empower people and open new possibilities in family planning and reproductive health.
Finally, I would invest in research, as it is the path to knowledge and optimal decision-making.
How can our readers further follow you online?
https://www.linkedin.com/company/embryoxite/
https://www.linkedin.com/in/ivan-anduaga-marchetti-9087159/
Thank you for the time you spent sharing these fantastic insights. We wish you only continued success in your great work!
Ivan Anduaga Marcehtti : 5 Things Everyone Should Know About IVF was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.