Infertility Management – Recent Advancement
Infertility is defined as a failure to conceive within one or more years of regular unprotected coitus. Assisted Reproductive Technology (ART): ART encompasses all the procedures that assist the process of reproduction by retriving oocytes from the ovary or sperm from the testis or epididymis (or) It refers to any fertility treatments in which the gametes (sperm &
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Artificial Insemination : Intra uterine insemination (IUI) | iui Procedure : IUI may be either AIH (artificial insemination husband) or AID (artificial insemination donor). Husband semen is commonly used. Purpose:- To bypass the endocervical canal which is abnormal & to place increased concentration of motile sperm as close to the fallopian tubes. Indications:- Hostile cervical
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In Vitro Fertilization | ivf Process | And Embryo Transfer ( IVF – ET ) : This involves ovulation induction, oocyte retrieval & for 3-5 days followed by sub sequent transfer of selected fertilized oocyte trans cervically under ultra sound guidance in to the uterine cavity. 50,000 selected sperms are used for insemination. ivf PROCEDURE :- Eighteen hours after insemination,
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It was first described by Aschetal in 1984.It involves aspiration of oocytes following ovulation induction either laproscopically or under ultrasound guidance transvaginally. Laparoscopic route is preferred as it anyway requires sperm & oocyte transfer in to the fallopian tube. 2hours before aspiration, semen is prepared, washed from the seminal plasma * remained in culture medium at 37 c. The oocytes
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This involves the laparoscopic transfer of day 1fertilized eggs (ZYGOTES in to the fallopian tube. It may be done either through the abdominal ostium by laparoscope or through the uterine ostium under ultra sonographic guidance. This technique is a suitable alternative of GIFT when defect
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Intra – Cytoplasmic Sperm Injection – Insemination ( ICSI ) | icsi Procedure : Is indicated & proved successfully in case of immotile sperms & sperm count less than 5 million /ml with pregnancy rate of 30 to 40% A single sperm is injected in to the cytoplasm of the oocyte, which is than incubated overnight. Micro pipette is used
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These sophisticated expensive techniques are needed if: IVF or GIFT fails due to fertilization failure. Sperm binds to zona pellucida but fails to penetrate due to either spermal antibodies (or) antibodies to Zona pellucida. No or weak binding of sperm to zona. Oligo spermia & asthenospermia. Immunological derived infertility. →Zona drilling (ZD) to allow spermal penetration has not been successful. →Partial
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This is the latest technology employed in azoospermia caused by blocked vas . Cryo preservation of semen of the husband & embryos for future fertility is required if the man has to undergo radiation or the chemotherapy for malignancy. Alternately epididymal (or) testicular aspiration technique is employed. In the latter situation, repeat aspiration can be avoided, & sperms cryopreserved. ICSI
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Donor egg IVF is used for patients with the poor egg numbers on quality. An egg donor is subjected to the stimulation protocol for inducing super ovulation, followed by standard egg retrieval ;egg are then fertilized by the sperm of the patients male partner (husband) & the embryos transferred to the patients uterus which has been simultaneously prepared as per
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Are the extensions &ramifications arising out of ART. However ethical , legal, religious &social issues surrounding these procedures need to be classified and understood. These are grey areas to be cautious about.
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