There are too many different fertility treatment options
Talking about assisted reproduction technology (ART) itself, we know too many different fertility treatment options, aimed at helping infertile couples in the birth of their long-awaited child. Such fertility treatment options as intrauterine insemination (IUI) or artificial insemination (AI) are used often. However, with the technology development more fertility specialists refer to the IVF, ISCI or third-party reproduction methods, including either sperm donation, or egg donation, or gestational surrogacy, or combination of them.
We will briefly introduce some of fertility treatment options hereafter and will talk about the key fertility treatment options in the sections that follow.
Artificial insemination (AI) vs. Intrauterine insemination (IUI)
Artificial insemination (AI) is a historic term that involves any technique related to the development of sperm in the female reproductive tract without sexual intercourse. Semen can be put into the uterus (intravaginal insemination) or into the cervix (intracervical insemination) with no special preparation of the specimen. However, if unprepared semen is placed into the uterus (intrauterine insemination (IUI)), then severe spasmodic uterine cramping can happen.
Thus, when carrying out an IUI, the sperm must be cleaned and prepared just before being placed into the uterus.
Cleaning the sperm removes prostaglandins, the body’s hormones that create the violent uterine contractions. Cleaning also eliminates substances that may lower the sperm quality, therefore resulting in enhanced sperm motility. Generally, the IUI specimen is prepared in the doctor’s office before insemination.
The IUI is a painless, simple, in-office method that is frequently carried out by a nurse. It always takes only a minute to do. Fertility specialists typically ask patients to come with a full bladder so that the angle between their uterus and cervix is modified, which enables for simple passage of the catheter into the uterine cavity.
In vitro fertilization (IVF)
In vitro fertilization (IVF) was initially realized effectively in Oldham, England, in 1978, following the birth of Louise Brown. Thereafter, more than a million of children were born using the IVF. The development of this method completely altered – and greatly enhanced – our ability to treat even the most challenging cases of infertility, many of which were formerly untreatable. Even though it is clearly not quite a “cure-all” for infertility issues. The IVF has revolutionized our approach to and knowledge about the disease known as infertility.
The IVF literally means “the fertilization of eggs with sperm within the Lab”. An IVF cycle includes several discrete phases that we describe in details in the below sections.
Intracytoplasmic sperm injection (ICSI)
An Intracytoplasmic sperm injection (ICSI) differs from the IVF. With the ICSI an egg is individually injected with a single sperm utilizing a small needle under a microscopic guidance. The resulting embryo will be cultivated in the same way as an embryo cultivated during a non-ICSI IVF.
Both ICSI and non-ICSI IVF have similar pregnancy rates and outcomes. The embryos cultivated with either of the method should not be considered superior to those created with others. ICSI is only a method to make sure that the egg is fertilized. ICSI is really a safe and proven IVF method that decreases the likelihood that a child created in this manner would have a birth defect.
Another well-known technique is the assisted hatching, during which a human embryo hatches from the eggshell (zona pellucida) in the blastocyst stage of development. Assisted hatching involves weakening the zona to facilitate the emergence of the embryo and consequently transferring it into the uterus after IVF treatments. Advocates of the assisted hatching claim that it increases implantation and pregnancy rates.
Assisted hatching is nearly always carried out chemically. In this technique, an acid solution is used to dissolve the exterior eggshell. Some treatment centers, however, perform mechanical hatching, where a slit is created in the eggshell, or perhaps laser-aided hatching, where a laser can be used to thin the zona.
PGD and PGS
Preimplantation genetic diagnosis (PGD) and preimplantation genetic screening (PGS) are techniques that offer diagnostic information concerning an embryo just before its transfer in the uterus. Most PGD and PGS methods are carried out by removing one or two cells (or blastomeres) of the 6- to 8-cell embryo on the 3d day of the embryo culture. These cells are quickly examined, and on the 5th day, the untouched embryos are selected for embryo transfer.
Donor egg-IVF involves a usage of a healthy female who are typically in their twenties as egg donors. The Donor plans in Ukraine are anonymous, although it is possible to get to know an IVF egg donor. In the latter situation, the known contributors are often family members or friends. In our experience, the majority of our patients choose to make use of an anonymous egg donor to prevent family and interpersonal conflicts.
Fertility doctors sometimes recommend using a third-party gestational carrier when the infertile couple wants their very own biological child. Usually many health conditions require a usage of a gestational carrier, including cases when the intended mother has no uterus due to a hereditary (at birth) condition or whenever a disease required its removal. A gestational carrier can also be the best choice whenever the intended mother has a systemic disease that may affect either her own or her baby’s health, for example, advanced cardiovascular disease, severe diabetes or multiple sclerosis. Likewise, a women with a poor pregnancy outcome in the past – including repetitive pregnancy deficits, preterm delivery, abnormal cervix or severe preeclampsia – can be a good candidate for the IVF utilizing a gestational carrier.