Assisted Reproductive Technology in Infertility Treatment
Who requires ART or assisted reproductive technology?
(i). Female partner with poor quality eggs
(ii). Male partner with poor quality /less quantity sperms
(iii). Female partner with blocked fallopian tubes
(iv). Multiple pregnancy failure or miscarriages
(v). Female partners with non-functional uterus
(vi). Couples having genetic disorders in family
(vii). Cases of unexplained infertility /PCOS
Different forms of ART:There are various forms of Infertility treatment available for couples struggling with infertility problem.lets know them better ! IUI intrauterine insemination:In this procedure, washed and concentrated sperms are injected into the intrauterine cavity with the help of a thin catheter at the time the ovary releases the egg. It bypasses the vagina and cervix and places directly into the uterus. It is most commonly used as a treatment when husband has mild problem in his semen analysis and wife’s tubes are open and egg reserves are normal and also in diseases like endometriosis related infertility, pcos in women.
IVF or in vitro fertilization:There are following steps in IVF:
Ovulation induction:Hormonal injections are given to women for egg maturation. The injections are started on 2 to 3rd of cycle and given until 10 to 12 days of cycle. Naturally only one egg is released every month but in IVF multiple eggs are matured which increase chances of pregnancy.
Egg retrieval:Follicular fluid containing egg from each ovary is sucked with the help of ultrasound and a thin needle. Eggs are isolated from the follicular fluid immediately into the Petri dish.
Embryo formation:In the same Petri dish sperms are allowed to meet eggs and are incubated to form embryos.
Embryo transfer:Genetic testing of embryos is performed to select healthy embryos without any chromosome abnormalities. Then a healthy embryo is transferred into the uterus with the help of a small tube placed through the cervix to uterine cavity. There are two types of embryo transfers:
(a). fresh embryo transfer and
(b). frozen embryo transfer.
Laser assisted hatching:The outer layer of the embryo is hard and poses difficulty in implantation, in laser assisted hatching the outer layer or zona pellucida is weakened to facilitate easy attachment to the uterus wall and yield successful pregnancy.
ICSI or intracytoplasmic sperm injection:
In this procedure instead of forming an embryo in a Petri dish, healthy sperm is injected into the cytoplasm of egg with the help of a fine glass needle and allowed to fertilise.
Sperm has to pass the outer thick layer of an egg, which is difficult sometimes and leads to failure of fertilization. ICSI does not rely on sperm motility and sperm’s ability to penetrate eggs. After injection the egg may or may not get fertilised, depending on the reactivity of natural cell processes in the egg.
Donor sperm:If sperm of male partner is ineffective, then donor sperm are used for successful fertilization.
Gestational carrier:Women with high-risk pregnancy or non-functional uterus have choice of using IVF with gestational carrier. In this procedure the embryo or blastocyst is formed in the laboratory and implanted into the uterus of a gestational carrier or surrogate. In surrogacy, the carrier consents to carry and deliver a baby for another couple or individual. Consult the best infertility doctor in Lucknow.
Embryo freezing:Pregnancy through frozen and thawed embryos is another advantage of assisted reproductive technology or ART. Patients with self-egg IVF benefit more from frozen embryo transfer than fresh embryo transfer. Frozen embryos can be used during the next cycle (if required) without ovarian stimulation. These embryos can be stored for future baby planning if you get pregnant through the first IVF cycle.
Egg freezing:Many women want to delay their pregnancy till late 40s due to other priorities, but at this stage it is disappointing to know about depleted ovarian reserve. Cryo-vitrification gives hope and opportunity to such women to preserve their eggs at the right reproductive age. It will not put their fertility at stake and decrease chances of miscarriage and birth defects.
Sperm freezing:Semen freezing can be beneficial for future family planning in males with military services, occupational risks, cancer therapy. Babies born with frozen sperms do not show significant birth anomalies as long term freezing does not affect quality of sperms. State-of-the-art laboratories facilitate cryopreservation of sperms.
Genetic testing:Genetic tests are performed on embryos before implantation. Preimplantation Genetic diagnosis (PGD) is performed if parents are carriers of genetic disorders and if those abnormalities are present in the embryo.
In Preimplantation Genetic Screening (PGS) embryo is screened for abnormal number of chromosomes. It is useful in early detection of Down’s syndrome, Edward’s syndrome.
The goal of these tests is to reduce chances of miscarriage and select healthy embryos which will result in healthy pregnancy and minimise birth defects. These tests mostly benefit couples with advanced maternal age ,severe Male factor Infertility or patients facing repeated ivf failures or pregnancy losses .
Advanced maternal age affects the success of IVF so if dealing with infertility issues, reach out early to infertility doctors.