Infertility and Assisted Reproductive Technologies

Introduction 

Reproductively healthy human beings are those mammals which can produce children round the year. Nowadays due to significant change in the lifestyle a majority of couples face difficulty in expanding their families. In case the problem of subfertility, infertility and  impotence can not be cured then these problems can be solved by  using assisted reproductive technologies (ART). Fertility therapies that work with both a woman’s egg and a man’s sperm are included. It operates by removing a woman’s eggs from her body. Embryos are created by mixing the eggs with sperm. After that, the embryos are implanted back into the woman’s body. The most popular and efficient ART is in vitro fertilisation (IVF).

Definition of Infertility

According to the WHO (World Health Organisation), infertility is defined as

disability and ‘a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse’.

What Is Assisted Reproductive Technology, and How Does It Work?

Before discussing infertility and assisted reproductive technology definition in detail, let’s learn about ART first! 

The ART refers to fertilisation treatments such as in vitro fertilisation, ICSI (intracytoplasmic sperm injection) and surrogacy to achieve pregnancy. The use of these medical procedures to treat infertility is known as assisted reproductive technology (ART). 

Cryopreservation of embryos or gametes, and the use of reproductive drugs and artificial insemination (AI) are some of the other ways to get rid of infertility.

When these procedures are done to address infertility, they are referred to as fertility treatment. Infertility and reproductive endocrinology are the primary concerns of ART. Surrogacy orders are also influenced by ART.

Infertility is treated by assisted reproductive technology, which uses both a man’s sperm and a woman’s egg. The technique begins with a woman’s eggs being extracted from her body and then merging them with sperm to create embryos. After that, the embryo is implanted back into the woman’s body.

 In Vitro Fertilisation or IVF, which is based on this idea, is the most often used and most effective ART method.

ART techniques are also used to use donor eggs, donor sperm, or embryos that have been frozen in the past. In some circumstances, a gestational carrier or surrogate is also used. A surrogate is a woman who conceives with the help of a female egg and sperm from a male partner. 

Note- Multiple pregnancies are one of ART’s problems and common complications, which can be mitigated and avoided by limiting the number of embryos implanted into a woman’s body.

What are the reasons for infertility?

 Infertility occurs by a variety of reasons or circumstances, including:

In males:

• Ejaculation or erectile dysfunction — Ejaculatory difficulties caused by impotence or ejaculatory failure.
• Sperm count disorder or production — Oligospermia and azoospermia are examples of sperm count disorders. Some sperm cells perish or are abnormal before reaching the egg.
• Age is one of the leading factors. Men of older age have a lower sperm count.
• Structural problems – Sperm motility or shape is disrupted, preventing sperm from attaching to the egg or even swimming towards it.

Sex hormone related disorder in males- The most common condition is hypogonadism, also known as “low testosterone” or “low T”.

In Females:

• Ovulation issues, such as PCOS are caused by the ovary’s inability to generate eggs.
• Uterine lining quality – Such as endometriosis, a condition in which the womb tissue invades and damages the neighbouring reproductive tissues.
• Fallopian tube structure — A blockage in the tube prevents sperm from reaching the egg.
• Maternal age —The quality of a woman’s egg deteriorates with age, limiting her capacity to conceive.

Sex hormone related disorders in women are-

Polycystic ovarian syndrome due to increased amount of male sex hormone in females

 Hirsutism  is hypersecretion  of  androgens, secreted by the ovaries or adrenal glands

 Hypogonadism is due to ecreased secretion of sex hormone

Types of Assisted Reproductive Technology

Here is infertility and assisted reproductive technology classification:

1. In vitro fertilisation (IVF) – IVF is one of the most popular types of ART. Fertilisation takes place outside the body in this case.
2. Gamete intra fallopian transfer (GIFT) – This procedure includes transferring sperm and eggs into a woman’s fallopian tube, where fertilisation occurs.
3. Zygote intra fallopian transfer (ZIFT) – Also known as tubal embryo transfer – is a method of fertilisation that takes place outside the body, comparable to IVF. The embryo is then implanted in the fallopian tube rather than the uterus.
4. Intracytoplasmic sperm injection (ICSI) — This procedure is typically done when the male partner is infertile. It is sometimes used for couples who have had unsuccessful IVF attempts or older couples. The premise is that a single sperm is inserted into a mature egg, as opposed to traditional fertilisation techniques in which the sperm and egg are placed in a Petri dish, and the sperm fertilises the egg on its own.
5. Artificial insemination — The intentional injection of sperm into a woman’s cervix or uterus to achieve pregnancy without sexual contact. It can be any of the following:

• Intrauterine insemination
• Intra cervical insemination
• Intra tubal insemination

Description of In Vitro Fertilisation (IVF)

One of the most prevalent methods is In Vitro fertilisation or IVF. The majority of patients prefer IVF to other forms of ART. Using this process, a woman’s egg and a man’s sperm are combined in the laboratory. After the embryo has been formed then it is injected  into the woman’s uterus.

Procedure:
The method begins with monitoring and stimulating the woman’s ovulatory process to extract an egg (ovum or ova) from her ovaries. The eggs are stored alongside sperm in a liquid for fertilisation in a laboratory in simulated conditions.  

Furthermore, the zygote is subjected to 2-6 days of embryo culture. Finally, the embryo is transferred into the same or another woman’s uterus to establish a successful pregnancy.

Note:The success rate of in vitro fertilisation (IVF) in India varies within the range of 30% and 35% every embryo transfer.

Conclusion 

We’ve learned about Infertility and Assisted Reproductive Technologies definition, classification, and related topics in this article. Read on for some commonly asked questions on infertility and assisted reproductive technologies.