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Infertility Facts. can be due to:failure to conceive, loss of conceptusorigin of problem:35% female35% male20% both partners10% unexplained. Failure to ovulate. often caused by low body fat or stressGnRH surge may be inadequate. Tubal blockage. Due to:Endometriosis, scar tissue from STD, pr
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1. 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
2. Infertility Facts can be due to:
failure to conceive, loss of conceptus
origin of problem:
35% female
35% male
20% both partners
10% unexplained
3. Failure to ovulate often caused by low body fat or stress
GnRH surge may be inadequate
4. Tubal blockage Due to:
Endometriosis, scar tissue from STD, previous surgery
Treatment: surgery
If surgery unsuccessful, IVF, GIFT and ZIFT are best options
5. 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
6. 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-sperm-online.html
7. 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
8. In vitro fertilization “test - tube babies”
1st performed in 1978 (Louise Joy Brown)
often performed on infertile women with tubal blockage
9. 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
10. 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)
11. 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
12. 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
13. 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?
14. 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
15. 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)
16. Others Ovarian stimulation protocol
Surrogate pregnancy
Adoption