Treatment for infertility is assisted reproductive technology (ART). It covers reproductive procedures that use both a woman’s egg and a man’s sperm. It operates by removing eggs from the body of a woman. The eggs are subsequently combined with sperm to form embryos. After that, the embryos are transferred to the uterus into the woman’s body. The most popular and efficient kind of ART is In Vitro Fertilization (IVF).
Donor eggs, donor sperm, or already frozen embryos are used in ART procedures. It may also include the use of a surrogate or gestational carrier. A surrogate is a woman who bears a child for a couple using the sperm of the pair’s male partner. A gestational carrier conceives a child with an egg from the female partner and sperm from the male partner.
Intrauterine Insemination is a procedure that is almost as popular as IVF. The key distinction between IUI and IVF is that at ovulation, sperm is injected into the woman’s womb, hence the word “insemination.” When a man’s sperm has trouble reaching the egg—often due to poor motility, but occasionally due to chemical incompatibility between the man’s sperm and the woman’s vaginal fluids—IUI is most successful.
IVF or IVF-ICSI
Every IVF cycle consists of many phases, each of which occurs at a different time during the course of four to six weeks. ART treatment methods typically comprise the following steps:
1. Ovarian Stimulation
2. Egg & Sperm Retrieval
1- Ovarian Stimulation
A woman with healthy ovarian function produces one egg every month on average. The ovaries are stimulated with precisely controlled hormone dosages supplied by injection to enhance the number of mature eggs accessible for fertilization. Your doctor will use ultrasound scans and blood tests to assess follicular growth and monitor your reaction to these hormone preparations.
2- Egg & Sperm Retrieval
Hormone injections are used to induce the final maturation of the eggs. When the follicles develop, your doctor will extract as many eggs as possible. The physician uses vaginal ultrasonography to guide a needle through the vaginal wall to aspirate mature follicles from the ovary while the patient is under conscious sedation or mild anaesthesia. It is critical that patients follow the clinic’s semen collection procedures in order to acquire high-quality sperm. Keep in mind that sperm collecting techniques for intrauterine insemination and in vitro fertilization may differ between clinics. Additionally, some programmes may require men to take an antibiotic before the IVF process.
After the eggs have been extracted, they are moved to an embryology laboratory, where they are nurtured in settings that support their requirements and growth. Several methods are available for fertilizing eggs and transferring embryos. Some of them are as follows:
In Vitro Fertilization
Ovarian stimulation and egg retrieval are both parts of In Vitro fertilization (ART IVF). A semen sample is obtained shortly before egg extraction. The recovered eggs are combined with motile sperm in a laboratory dish, where fertilization takes place. The fertilized eggs grow in a specific culture medium for 3 to 5 days in a controlled environment before being transferred to the woman’s uterus for possible implantation and embryo development.
Intracytoplasmic Sperm Injection
Male factor infertility can be treated with intracytoplasmic sperm injection (ICSI). Following egg retrieval, each egg is injected with a single sperm. It is also feasible to aspirate sperm straight from the epididymis or testicles, making ICSI a viable option for men who have undergone vasectomies or are missing the vas deferens due to a congenital condition or have azoospermia (no sperms in the semen).
4- Embryo Transfer
Embryo transfer is normally done three or now usually after five days (blastocyst stage) following the oocyte extraction process. The embryos will be placed in the uterine cavity under sonographic guidance after the physician carefully passes a catheter through the cervix into the uterus. This procedure is usually done without anaesthesia, and the patient normally departs the clinic after a brief recovery period. The remaining embryos can be preserved for use in a future ART cycle using frozen embryo transfer.
Cryopreservation allows for the storage of extra embryos for later use. Furthermore, if the uterine lining is not adequate for implantation during a stimulated cycle, cryopreservation allows for transfer during a later menstrual cycle. Cryopreservation can also be used to save embryos for future use by women who are undergoing medical treatments that affect their fertility.
Assisted hatching entails manipulating the embryo in the lab to produce an opening in its outer layer (zona pellucida). This procedure may improve the chances of implantation, especially in women who are past reproductive age.