A number of patients become pregnant with intensive cycle monitoring and super ovulation with the gondrotopin as well as intrauterine insemination or fallopian tube sperm perfusion. Gamete Manipulation In-Vitro Fertilization.
In vitro Fertilization (IVF)
In IVF, the female egg is inseminated with approximately 3 drops of sperm solution from the male partner. Usually the patient is given fertility drugs to increase the number of eggs that are produced at ovulation. The eggs are isolated from the aspirated follicles and allowed to rest in the incubator for a while before insemination. The inseminated eggs are kept in an incubator in the IVF laboratory for about 3 days. The fertilized embryos will rapidly divided into the 2-cell, 4-cell and the 8-cell stages at which point about 3 or 4 good embryos are selected and transferred into the uterus through the cervix. IVF is a good treatment option when the fallopian tubes are blocked or in endometriosis as well as when the male partner has low sperm count.
In some couples fertilization during IVF does not come easily. Consequently, there are several echniques. that would ensure fertilization based on the laboratory assessments of the sperm and egg. They include high concentration sperm insemination, microdrop insemination, media enhancements and more.
Several culture techniques have been developed to ensure that fertilization takes place in the IVF laboratory. There are also several gamete manipulations that can be utilized for the aid of the fertilization process. They include embryo development with a Blastocyst culture and cytoplasmic transfer.
When the infertility in the couple is due to very low sperm count, the technique of intracytoplasmic sperm injection provides a solution to getting pregnant. Under a very specialized microscope one sperm cell is aspirated from the very few ones, and it is injected directly into the egg cytoplasm. This ensures fertilization in significantly high numbers.
Assisted Development / Assisted Hatching This procedure is usually reserved for patients over the age of 38, as well as, patients with prior unsuccessful IVF attempts. Patients in this category would normally produce eggs at stimulation in an IVF cycle and could have some embryos transferred at the 4 cell or 8 cell stages, however they would not get pregnant after the transfer. This is because the embryos would stop dividing at this stage as it has refused to hatch. Using micromanipulation. techniques enables doctors to drill a small hole in the zona pellucid lining. Now, embryos that would ordinarily have ceased to grow at the hatching stage have a better chance of further development in the uterus. There are a significant number of patients who are able to carry their pregnancy to term by using this procedure.
Cryopreservation Of Oocytes And Embryos
The excess embryos can be preserved for years of freezing the embryos in straws and then storing them in liquid nitrogen tanks. They can be thawed when needed.
Pr e-Implantation Genetic Diagnosis (PG D) Patients who have genetic disorders like sickle cell can now have the disease gene eliminated from the children at conception. When embryos are fertilized, the process of pre-implantation genetic diagnosis can eliminate genetic disorders. One or two blastomeres can be removed from the fertilized embryos. The technique of fluorescence in-situ hybridization (FISH) is employed to analyze the chromosomal abnormalities while another technique; the polymerase chain reacting (PCR) is used to detect sickle gene disorder. Simply put, a couple with genotype HbAS would expect to have offspring with AS, SS, and AA. With PGD we can select just the AA embryos for insemination, there producing AA babies.