Infertility Treatment

Infertility facts affects 1 in 6 married couples of

childbearing age definition: have engaged in unprotected

coitus for 1 year and haven’t become pregnant

Email: [email protected]

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Infertility Facts can be due to:

– failure to conceive, loss of conceptus origin of problem:

– 35% female– 35% male– 20% both partners– 10% unexplained



Failure to ovulate

often caused by low body fat or stress GnRH surge may be inadequate



Tubal blockage Due to:

– Endometriosis, scar tissue from STD, previous surgery

Treatment: surgery If surgery unsuccessful, IVF, GIFT and

ZIFT are best options



Causes of male infertility low sperm count (oligospermia) or

absence of sperm (azoospermia) male may produce antibodies to his own

sperm accessory glands / ducts may

malfunction



Intracervical or intrauterine insemination (ICI / IUI) Artificial insemination definition: sperm introduced into female

reproductive tract by means other than coitus (near cervix or in uterus)

sperm can come from donor / sperm bank or from husband

Example of a sperm bank:– http://www.spermbankcalifornia.com/buy-sp

erm-online.html



ICI / IUI, cont’d.

usually, several ejaculations are pooled 60,000 babies / year born in US. as

result of artificial insemination often used when male has low sperm

count or antibodies present in ejaculate



In vitro fertilization

“test - tube babies” 1st performed in 1978 (Louise Joy

Brown) often performed on infertile women with

tubal blockage



IVF Protocol GnRH agonist (e.g. Lupron) for 7 days FSH agonist (follistim, Gonal-F,

Repronex) until follicles measure 17-20 mm in diameter (8-14 days)

hCG given to induce egg maturation Egg retrieval (transvaginally) 34-35 h

later



IVF protocol sperm and ova added to dish;

fertilization occurs 12-14hrs. eggs transferred to new dish and cell

division occurs embryos squirted into uterus (optimal

stage: blastocyst) Preimplantation genetic diagnosis (PGD)



IVF Protocol, cont’d. 3 to 5 embryos are injected to increase

chances of pregnancy woman given progestagen to prevent

miscarriage Example of prices:

– http://www.advancedfertility.com/ivfprice.htm



IVF Protocol, cont’d. new variations / improvements:

– Intracytoplasmic sperm injection (ICSI)– use of frozen embryos

27,000 attempts made per year; 18.6% successful (success rates are increasing)

http://www.advancedfertility.com/sampleivfcalendar.htm



IVF, cont’d.

Ethical questions:– will it lead to selective breeding?– up to what stage can research be done?– if embryo dies in vitro, is it abortion, murder?– what should be done w/ unwanted embryos?– should government regulate research?



GIFT and ZIFT GIFT = gamete intrafallopian transfer useful for tubal blockage ova are collected and inserted into

oviducts below point of blockage husband’s sperm are placed in oviduct



GIFT and ZIFT woman is treated with hormones to prevent

miscarriage 28% successful ZIFT = zygote intrafallopian transfer ZIFT is like IVF, only zygotes (1 cell stage)

are inserted below blockage in oviduct (24% success rate)



Others

Ovarian stimulation protocol Surrogate pregnancy Adoption



Infertility Treatment

Documents

Transcript of Infertility Treatment