Treatments for Infertility

Treatments for Infertility

Introduction

Infertility is a condition characterised by the inability to conceive or carry a pregnancy to term after a year of trying. It can be a challenging and emotionally distressing issue for individuals and couples. Fortunately, various treatments are available to address infertility, ranging from stimulating ovulation to assisted reproductive technologies (ART).

Stimulating Ovulation

One common approach to addressing infertility is to stimulate ovulation, the release of a mature egg (ova) from the ovaries. This can be achieved through various methods:

Preventing Negative Feedback of Oestrogen

1. Negative Feedback Effect of Oestrogen

Normally, the hormone oestrogen has a negative feedback effect on the secretion of follicle-stimulating hormone (FSH) by the pituitary gland. This feedback suppresses FSH levels.

2. Ovulation-Stimulating Drugs

To overcome this negative feedback effect, drugs can be administered to prevent oestrogen from inhibiting FSH secretion. This allows for the recruitment and development of multiple follicles in the ovaries.

3. Superovulation

In some cases, ovulatory drugs can result in superovulation, where multiple mature eggs are produced. Superovulation can increase the chances of conception but also carries a higher risk of multiple births.

4. Applications in In Vitro Fertilisation (IVF)

Superovulation is commonly used in IVF programmes to collect multiple eggs for fertilisation.

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Treatments for Infertility

Mimicking FSH and LH Actions

Ovulatory Drugs

Other ovulatory drugs mimic the actions of FSH and luteinising hormone (LH). These drugs can be used to stimulate ovulation and may also result in superovulation.

Artificial Insemination

1. Artificial Insemination

Artificial insemination involves the collection of several samples of semen from the male over a period of time.

2. Usefulness in Low Sperm Count

Artificial insemination involves the collection of several samples of semen from the male over a period of time.

3. Donor Semen

In cases where the male partner is sterile, donor semen may be used to provide the sperm for artificial insemination.

Intra-Cytoplasmic Sperm Injection (ICSI)

ICSI Technique

ICSI is a technique used when mature sperm are defective or present in very low numbers. It involves the injection of a single sperm directly into the egg to achieve fertilisation.

Applications

ICSI can be used in cases of severe male infertility, such as low sperm count, abnormal sperm morphology, or impaired sperm motility.

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Treatments for Infertility

In Vitro Fertilisation (IVF)

IVF Process

• Hormone Stimulation: IVF begins with the surgical removal of eggs from the ovaries after hormone stimulation to induce superovulation.
• Incubation and Fertilisation: The eggs are then mixed with sperm in a culture dish, allowing fertilisation to occur outside the body.
• Embryo Development: Fertilised eggs (zygotes) are incubated until they have formed at least eight cells.
• Uterine Implantation: The resulting embryos are then transferred to the uterus for implantation.

Pre-Implantation Genetic Diagnosis (PGD)

PGD in IVF

In some cases, IVF is used in conjunction with pre-implantation genetic diagnosis (PGD). PGD is a technique used to identify single gene disorders and chromosomal abnormalities in embryos before implantation.

Selection of Healthy Embryos

PGD allows for the selection of healthy embryos for implantation, reducing the risk of passing on genetic disorders to offspring.

Summary

In summary, treatments for infertility aim to address the underlying causes of fertility issues and increase the chances of successful conception. These treatments range from stimulating ovulation through hormonal interventions to assisted reproductive technologies such as artificial insemination, intra-cytoplasmic sperm injection (ICSI), and in vitro fertilisation (IVF). IVF, in particular, is a widely used method that involves fertilising eggs outside the body and transferring embryos to the uterus for implantation. In some cases, IVF can be combined with pre-implantation genetic diagnosis (PGD) to select healthy embryos. These treatments offer hope to individuals and couples facing infertility challenges, providing them with opportunities to achieve their dream of parenthood.