Types & Advanced Procedures of Assisted Reproductive Technology


    The following processes of Assisted Reproductive Technology are not necessary for every couple. A proper evaluation should be conducted by the specialist to ensure that the most efficient and cost effective procedure is used to help the couple become pregnant as each individual is different.

ASSISTED REPRODUCTION
    Assisted Reproduction Technologies (ARTs) is more than just in vitro fertilisation (IVF) and intra cytoplasmic sperm injection. There are numerous number of clinics giving these services in the United States and other countries. Patient preparation and counselling good infertility clinics recognise that, dealing with infertility or high risk pregnancy can be very stressful.
 
    Patient preparation and counseling services were established to provide a range of mental health services to patients needing emotional support and guidance during difficult times. It includes a thorough evaluation not a detailed questionnaire, which has been prepared to bring all the possible factors that could cause infertility in couples. Patients are made to realise that they are not alone with their problems.

ENDOCRINE MANAGEMENT OF INFERTILITY
    The evaluation of the endocrine panels and the treatment of any abnormal hormone is very helpful in some cases of infertility.

Male Assessment
    The male sperm is thoroughly evaluated for its fertility potential. There are other spermatozoa enhancer and technique to improve sperm quality to facilitate fertilisation.

Super Ovulation
    The fact that many patients find it difficult to ovulate create a need for giving additional hormones to such patients to increase ovulation. A good numbers of patients would become pregnant after intercourse at ovulation without any traditional procedure; some would require other procedure such as Artificial Insemination.

INTRAUTERINE INSEMINATION
     A number of patients become pregnant with intensive cycle monitoring and super ovulation with the gonatrophins as well as intrauterine insemination or Fallopian tube sperm perfusion, In vitro fertilisation (IVF). In IVR, the female 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.

    Several methods are available for the improvement of sperm to facilitate fertilization. The eggs are isolated from the aspirated follicle and allowed to rest in the incubator for a while before insemination.  The eggs that have been inseminated are properly stored in IVF laboratory incubator for an average of 70 hours or three days thereabouts for an Assisted egg fetilization.

    The fertilised embryo will rapidly divide into the 2-cell, 4-cell and 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 on endometriosis and when the male partner has low sperm count.

ASSISTED FERTILIZATION
   We found out that, when artificial fertilization is done for some couples during in vitro fertilization, fertilization seldom occur . Consequently, there are several techniques that would ensure fertilisation based on the laboratory assessments of the sperm and eggs. They include high concentration sperm insemination, micro -drop insemination, media enhancements and more.

EMBRYO DEVELOPMENT
    Several culture techniques have been developed to ensure that fertilisation takes place in an IVF laboratory.  Some other approaches with involve gamete manipulations can be adopted to aid fertilisation. They include embryo development with a blastocyst culture and cytoplasmic transfer.

MICRO MANIPULATION (ICSI)
    When the infertility in the couple is due to very low sperm count, the technique of intra cytoplasmic 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 fertilisation is significantly high numbers.

ASSISTED DEVELOPMENT/ ASSISTED HATCHING
    The procedure is usually reserved for patients over the age of 38, as well as patients with prior unsuccessful IVF attempts. Patients that are in this group could  produce eggs when stimulated during IVF cycle and could transfer some embryos during the four-cell or eight-cell stages.

    However, they would not get pregnant after the transfer because the embryos will not divide further at this stage as it does not hatch. However, some doctors can use micromanipulation techniques to drill a  hole in the zona pellucid lining of the patient. Now, the embryo that would originally have ceases to grow at the hatching stage has a better chance of further development in the uterus.

    There are a number of patients who are able to carry their pregnancies to term by using this procedure.

CRYOPRESERVATION OF OOCYTES AND EMBRYOS
   The excess embryos can be preserved for years by freezing the embryos in straws and then storing them in liquid nitrogen tanks. They can be thawed when needed.

 Pre-implantation Genetic Diagnosis:  couples battling with some genetic disorders like sickle cell Anaemia now have the chance to get rid of the disease gene from the babies after conception. When the embryos get fertilized, the process of pre-implantation genetic diagnosis can eliminate genetic disorders. A few blastomeres can be removed from the embryos that are fertilized.

    The technique of Fluorescence in-situ Hybridisation (FISH) is employed to analyse the chromosomal abnormalities, while another technique, the polymerase chain reacting is used to detect sickle gene disorder. We can conclude that, if a couple has genotype HbAS has the chance to produce offspring that would have AS, SS, and AA.

     With the diagnosis of Pre-implantation genetics, a doctor can select the AA embryos for artificial insemination and the couple will  produce AA babies.









































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