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Page 1: 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

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Page 2: Infertility Treatment

Infertility Facts can be due to:

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

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

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Page 3: Infertility Treatment

Failure to ovulate

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

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Page 4: Infertility Treatment

Tubal blockage Due to:

– Endometriosis, scar tissue from STD, previous surgery

Treatment: surgery If surgery unsuccessful, IVF, GIFT and

ZIFT are best options

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Page 5: Infertility Treatment

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

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Page 6: Infertility Treatment

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

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Page 7: Infertility Treatment

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

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Page 8: Infertility Treatment

In vitro fertilization

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

Brown) often performed on infertile women with

tubal blockage

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Page 9: Infertility Treatment

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

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Page 10: Infertility Treatment

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)

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Page 11: Infertility Treatment

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

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Page 12: Infertility Treatment

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

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Page 13: Infertility Treatment

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?

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Page 14: Infertility Treatment

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

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Page 15: Infertility Treatment

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)

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Page 16: Infertility Treatment

Others

Ovarian stimulation protocol Surrogate pregnancy Adoption

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