Scientific advancements have made it possible for us to treat a large percentage of couples with infertility, provided they come and seek help in time. It is a rapidly evolving field and newer techniques provide us deeper insights into the causes of infertility and treat these causes more effectively
Infertility affects an estimated 15 per cent of couples globally and is even more pronounced in developing countries like India. As per WHO, one in four couples in reproductive age in India face difficulty in getting pregnant. Since this comes with a lot of emotional and social stigma, a majority of couples are reluctant to discuss their fertility issues openly. This hampers the possibility of timely diagnosis and treatment, according to Dr Parul Katiyar, fertility consultant, Nova IVF.
Scientists all over the world have been working tirelessly to find treatments to overcome infertility issues and the biggest breakthrough was the birth of Louise Brown on July 25, 1978 in England. She was the first baby to be born after successful IVF treatment in the world after years of efforts from Dr Patrick Steptoe, Robert Edwards and their team.
Louise Brown’s birth is one of the biggest landmarks in the field of infertility treatment. Over these 42 years, more than eight million children have been born through various “Assisted Reproductive Techniques” including IVF as well as several other advanced techniques have evolved since then. To mark the greatest innovation in the field of reproductive medicine this day, 25th July is celebrated as the World IVF day every year.
What are the common causes of infertility?
Women have always been considered as the bearer of infertility, however this is just a myth as in the current scenario male face several issues as well. The common causes of infertility include medical reasons like fallopian tube blockage, ovulatory dysfunction, endometriosis, etc, in women and poor sperm quantity or quality in men. The other important cause for infertility includes lifestyle issues such as increasing marital age, postponement in childbearing, stress, consumption of alcohol and tobacco, besides unhealthy diet.
What does Assisted Reproductive Technology (ART) mean?
ART includes all fertility treatments in which both eggs and embryos are handled. In general, ART procedures involve surgically removing eggs from a woman’s ovaries, combining them with sperm in the laboratory, and returning them to the woman’s body. This mainly includes In Vitro Fertilisation (IVF), ICSI, cryopreservation of gametes (egg or sperm) or embryos, PGT (Preimplantation Genetic Testing). Through these procedures, many couples with otherwise untreatable infertility have given birth to healthy babies.
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Types of assisted reproductive techniques
In Vitro Fertilization (IVF)
The union of sperms and eggs is one of the most important steps for pregnancy, however there are many factors that hinder this process of fertilisation in the body leading to infertility. IVF is a method of assisted reproduction in which the woman’s eggs and man’s sperms are fertilised outside the body in a laboratory dish, which is why it is also called a ‘test tube baby’. One or more of these fertilised eggs (embryos) are then transferred in the woman’s womb, so that they can stick in the uterine lining and grow. It is one of the most commonly used ART procedures and is used to overcome infertility due to many causes like blocked fallopian tubes, endometriosis and even when the cause of a couple’s infertility is not known.
Intracytoplasmic Sperm Injection (ICSI)
This is a special technique of assisted reproduction that is most useful for male factor infertility where the sperm count or quality is very poor. This mainly involves the same initial steps as for IVF, except that for the process of fertilisation, a special needle is used to inject the sperms inside the egg. Therefore, eliminating the need for millions of sperms to fertilise the egg and pregnancy can be achieved even with very low sperm count.
Cryopreservation of Gametes/Embryos
Cryopreservation or freezing is a technique in which the embryos, eggs and sperms are frozen in liquid nitrogen at -196 degree centigrade for prolonged periods. This is very useful for couples undergoing IVF treatment who have spare embryos left after the embryo transfer. Cryopreservation makes future ART cycles simpler, less expensive, and less invasive than the initial IVF cycle, since the woman does not require ovarian stimulation or egg retrieval. Once frozen, embryos may be stored for prolonged periods, and live births have been reported using embryos that have been frozen for almost 20 years. Another very important role of cryopreservation is to preserve the eggs or sperm. This is done most commonly in young women and men who are about to undergo treatments or procedures that may affect their future fertility, such as chemotherapy for cancer.
Preimplantation Genetic Testing (PGT)
Preimplantation Genetic Testing (PGT) is an early form of prenatal genetic diagnosis where abnormal embryos are identified, and only genetically normal embryos are used for implantation. This technique is a boon for couples who are either carriers of or suffer from genetic disorders that can be passed to their offspring. It involves removal of some cells from the embryo, subjecting these cells to specific genetic tests in order to identify the presence of any genetic alterations in chromosome number or genes. This enables the identification and selection of genetically healthy embryos, thus improving the chances of a healthy pregnancy.
To conclude, scientific advancements have made it possible for us to treat a large percentage of couples with infertility, provided they come and seek help in time. It is a rapidly evolving field and newer techniques provide us deeper insights into the causes of infertility and treat these causes more effectively.
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