Medically Assisted Human Reproductive Technologies

Reasons for Infertility in Male and Female:

Male Infertility:

1. Sperm Disorders:

   • Low sperm count (oligospermia).
   • Poor sperm motility.
   • Abnormal sperm morphology.

2. Erectile Dysfunction:

   • Difficulty achieving or maintaining an erection.

3. Varicocele:

   • Enlargement of veins within the scrotum, affecting sperm production.

4. Genetic Factors:

   • Chromosomal abnormalities affecting sperm production.

Female Infertility:

1. Ovulatory Disorders:

   • Irregular or absent ovulation.
   • Conditions like polycystic ovary syndrome (PCOS).

2. Structural Issues:

   • Blocked fallopian tubes.
   • Uterine abnormalities impacting implantation.

3. Endometriosis:

   • Growth of endometrial tissue outside the uterus.

4. Age-related Decline:

   • Decreased ovarian reserve with age.

5. Hormonal Imbalances:

   • Disruptions in hormonal regulation affecting fertility.

   Artificial Insemination - Intrauterine Insemination (IUI):

   Process:

6. Sperm Preparation:

   • Collection and preparation of sperm to concentrate motile, healthy sperm.

7. Insemination:

   • Insertion of prepared sperm directly into the uterus.
   • Timed with the woman's ovulation cycle.

8. Enhancing Sperm Motility:

   • Helps overcome natural barriers to fertilization.

Indications:

• Unexplained infertility.
• Mild male factor infertility.
• Cervical mucus abnormalities.

In Vitro Fertilization and Embryo Transfer (IVF-ET):

Conventional IVF:

1. Ovulation Stimulation:

   • Controlled ovarian hyperstimulation to produce multiple eggs.

2. Egg Retrieval:

   • Aspiration of mature eggs from the ovaries.

3. Fertilization:

   • Eggs and sperm combined in a laboratory dish.

4. Embryo Culture:

   • Monitoring and culturing embryos for a few days.

5. Embryo Transfer:

   • Implantation of selected embryos into the uterus.

Types of IVF:

1. Gamete Intrafallopian Transfer (GIFT):

   • Fertilized eggs are transferred to the fallopian tubes for natural implantation.

2. Zygotic Intrafallopian Transfer (ZIFT):

   • Early-stage embryos (zygotes) are transferred to the fallopian tubes.

3. Tubal Embryo Stage Transfer (TET):

   • Embryos are cultured for a longer period before transfer into the fallopian tubes.

Intra-Cytoplasmic Sperm Injection (ICSI):

1. Microinjection:

   • Single sperm injected directly into an egg.

2. Indications:

   • Severe male infertility.
   • Previous IVF failure.

Assisted Hatching:

1. Thinning the Zona Pellucida:

   • Making a small hole in the protective outer layer of the embryo.

2. Facilitates Hatching:

   • Aids the embryo in breaking out for implantation.

3. Indications:

   • Advanced maternal age.
   • Previous failed IVF attempts.