Summary

Here is a summary of the key concepts discussed during this chapter.

Overview

• ART involves the sophisticated treatment and processing of human eggs and sperm to help you become pregnant.

• Which treatments you receive will depend on a variety of issues, including your health and that of your partner, your concerns and desires, and your particular fertility situation.

• If you are seriously considering assisted reproduction, you must understand what medical conditions you have and why natural conception has not worked for you.

• You must understand the risks, benefits, pros, and cons of each technique.

Intrauterine Insemination (IUI)

• IUI is a procedure in which your doctor inserts washed and concentrated sperm directly into your uterus at the time that coincides with your ovulation.

• This technique significantly increases the number of sperm that can make it into your fallopian tube to fertilize the egg(s).

• Many fertility specialists use ovulation-inducting medication along with the IUI procedure to increase your odds of becoming pregnant.

• Individual rates will vary, but overall the pregnancy rate of IUI is between 10 and 18 percent per cycle when combined with ovulation-induction medication.

In Vitro Fertilization (IVF)

• IVF is a procedure in which your ovaries are stimulated to produce eggs, the eggs are removed and fertilized with the man's sperm in a laboratory, and the resulting embryos are transferred into your uterus several days later.

• The IVF technique is performed in various stages:

• Ovulation stimulation

• Egg retrieval

• Semen collection and preparation

• Fertilization

• Embryo monitoring

• Embryo transfer

• Follow-up afterward

• Cryopreservation afterward

• Individual rates will vary, but overall the pregnancy rate of IVF is between 25 and 50 percent per cycle.

Intracytoplasmic Sperm Injection (ICSI)

• ICSI is a special fertilization technique that is sometimes used along with the other ART procedures. It involves the injection of a single sperm directly into the center of an egg.

• The resulting embryos are placed back into your uterus, using the same techniques as for IVF.

• ICSI is particularly beneficial for men with severe male factor infertility issues including:

• Extremely low sperm count

• Poor sperm quality

• Presence of antisperm antibodies

• History of poor fertilization during one or more prior IVF attempts

• Any reason why the man's sperm cannot easily penetrate the woman's egg

• The ICSI technique is performed in various stages:

• Ovulation stimulation

• Egg retrieval

• Semen collection and preparation

• Fertilization

• Embryo monitoring

• Embryo transfer

• Follow-up afterward

• Cryopreservation afterward

• Individual rates will vary, but overall the pregnancy rate using ICSI is about 30 percent per cycle. This is a significant achievement because ICSI is primarily used in cases of severe male infertility.

• Sometimes sperm can't be collected using the routine methods. This may be because of a birth abnormality, serious injury, or previous vasectomy.

• New microsurgical techniques have been developed to obtain sperm directly from the testicles or the epididymis.

Embryo Assisted Hatching

• The technique is based on the idea that thinning or making a small hole in the embryo's outer shell may help the embryo to successfully implant in your uterine lining.

• This technique may be used in conjunction with your IVF or ICSI procedure.

• Some fertility specialists use this hatching technique with all of their IVF patients, but others reserve assisted hatching for certain patient situations, such as:

• Older women using their own eggs

• Couples with poor quality embryos

• Embryos that have a thick outer shell

• Couples who have failed implantation in previous IVF or ICSI cycles Cryopreservation

• Cryopreservation is the technology of using subzero freezing on human cells. They can remain frozen indefinitely, but most people choose to eventually thaw and implant them for another pregnancy.

• This technique is currently being used to freeze sperm and embryos.

• Thus far, cryopreservation techniques for unfertilized human eggs have not been very successful. Scientists are currently working to find a freezing technique that will work well on unfertilized human eggs.

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