Infertility

Infertility:

Infertility is the inability to produce children in spite of unprotected sexual cohabitation. Reasons could be physical, congenital, diseases, drugs, immunological or even psychological. Often female is blamed for being childless but the fault could more often than not lie with the male as well. Specialized health care units like infertility clinics could help in the corrective treatment of some of these disorders. In case corrective treatments are not possible couples could be helped with Assisted Reproductive Technology (ART). Infertility is of two types: Primary and secondary. 

• Primary: If patients have never conceived. 
• Secondary: In patients who have previously conceived. 
  

Cure of Infertility:  

If by medical attention, infertility is cured then fertility may be regained. But if fertility cannot be cured, then the couple has to depend on Assisted Reproductive Technology. Art helps infertile couples in retrieving egg/sperm from gonads, bringing about artificial insemination and development of embryo, etc. The various procedures of ART are:  

• IVF-ET: in vitro fertilization and embryo transfer. 
• ICSI: Intracytoplasmic Sperm Injection  
• GIFT: Gamete Intrafallopian Transfer 
• ZIFT: Zygote Intrafallopian Transfer  
• IUT: Intra-Uterine Transfer
• IUI: Intra-Uterine insemination

1) IVF- ET: in vitro fertilization and embryo transfer. 

This is one of the most commonly used procedures. Eggs are combined with partners sperm in a dish in a laboratory. Once fertilization has occurred, the resulting embryos develop for 3 to 5 days before being placed in the uterus.  

2) ICSI: Intracytoplasmic Sperm Injection 

One of the partners' sperms is placed inside the egg with a microscopic needle, rather than many sperms positioned close to the egg as in IVF, in a dish in a lab. Once fertilization occurs, the resulting embryo is placed in the uterus.  

3) Gamete Intra Fallopian Transfer (GIFT): 

The ovum from the donor is collected and transferred into another female who cannot produce one but can provide conditions for fertilization and further development. 

4) Zygote Intra Fallopian Transfer (ZIFT):  

• ZIFT is an infertility treatment used
  when there is a blockage in the fallopian tubes
  which prevents the fertilization of egg by the
  sperm.
• In this method, egg is removed from
  woman’s ovary. Fertilization of the egg with
  sperms is brought about outside the body under
• sterile conditions to form zygote by the process
  called in vitro fertilization (IVF). The zygote
  is then transferred to fallopian tube for further
  development.  

5) Intra-Uterine Transfer (IUT):  

Embryos with more than 8 blastomeres can be transferred directly into the uterus. 

6) Artificial insemination (AI) technique: 

In this technique, the semen collected either from the husband or a healthy donor is artificially introduced either into the vagina or into the uterus (IUI – intra-uterine insemination) of the female. 

7) IUI (Intra Uterine Insemination):

In this technique the process is somewhat like that of artificial insemination, the only difference is that the sperms are introduced into the uterine cavity instead of cervix.

8) Donor egg or Embryo:  

If one is unable to conceive using her own eggs, an egg donated by another woman is mixed with her partner’s sperm and the resulting embryo is implanted in the uterus. This procedure can also be done with a donated embryo or sperm.  

9) Surrogacy or use of a gestational carrier: 

 Another woman carries an embryo or a donor embryo to term.  

Infertility in men: 

Azoospermia is defined as the lack of spermatozoa in the ejaculated semen at least two times and affects about 1% of the population. Extraction of micro-testicular sperm (TESE) Microsurgical sperm retrieval from the testicle entails making a small midline incision in the scrotum and seeing one or both testicles. The seminiferous tubules are dilated under the microscope, and a tiny portion of testicular tissue in areas of active sperm production is removed, improving sperm yield compared to traditional biopsy approaches. 

10) Sperm Bank / Semen Bank:

A sperm bank or semen bank is a place that collects, stores, and provides human sperms/semen. The semen is provided by healthy males called sperm donors. The sperms are stored in the sperm bank by the cryopreservation method (at low temperature).

11) Adoption:

• Adoption is a legal process by which a couple or a single parent gets legal rights, privileges, and responsibilities that are associated with a biological child for the upbringing of the adopted child.
• An adoptive parent should be medically fit and financially able to take care of the adopted child.
• A person wishing to adopt a child must be at least 21 years old, but there is no legal upper age limit for adoption.