Molecular Infertility Molecular Infertility

TreatmentTreatment

Bhawna DhawanMedical Biotechnology

What is infertility? What is infertility?

�Infertility means not being able to get pregnant after one year or six months of trying ; if a woman is 35 or older who can get pregnant but are unable to stay pregnant may also be infertile.

�Infertility is not always a woman’s problem, man can too have problems. About 1/3 of infertility cases are caused by women’s problem, another 1/3 are due to men and another 1/3 are mixture of both and unknown problems.

Common Infertility reasons:Common Infertility reasons:

In Females

o. Ovulation problems

o. Hormonal problems

o. Scarred ovaries

o. Premature menopause

o. Tubal infections

o. Immunological problems

o. Endometriosis

In Males

o. Low sperm count

o. Poor sperm quality

o. Abnormal sperm morphology

o. Hormonal imbalance

o. Genetic factors

o. Immunological problems

o. Nutritional factors

Genetic Aspects of infertilityGenetic Aspects of infertility

� Various genetic factors influence the abnomalities of reproductive system. It may include chromosomal mutation , abnormalities in the genes , X- linked ; Y-linked disorders , mosaicism and various epigenetic factors . Endocrine and immunological factors are very much responsible for genetic factors as they control the gametogenesis and spermatogenesis .

Infertility TreatmentsInfertility Treatments

There are many ways to treat infertility; it can be through oral medicine , surgery , artificial insemination or by means of a

Assisted Reproductive Technology. Treatments are done even by combination of all these factors. Infertility treatments can be of small or long duration depending upon the type and reason of infertility. These treatments are both helpful and healthier for couples.

Assisted Reproductive TechnologyAssisted Reproductive Technology

� Assisted reprodutive technology work for the treatment of infertility. It helps the infertile couples in order to fulfil their dreams of getting their off-springs . ART works by removing eggs from woman’s body, then eggs are mixed with sperms to make embryos. Then embryos are put back in woman’s body . ART can be expensive and time consuming but has allowed many couples to have children. ART can be of various types :

Intrauterine inseminationIntrauterine insemination

� IUI is an infertility treatment that is often called infertility insemination . In this procedure, the women is injected with specially prepared sperms. Sometimes women is also treated with medicine that stimulates ovulation before intrauterine insemination.

IUI TREATMENT IUI TREATMENT

In vitro fertilizationIn vitro fertilization

� In vitro fertilization process is defined as the process in which the egg is fertilised outside by giving sperm outside the body. This is done when all the treatments get failed . There are various methods and steps involved in this type of fertilisation. There is use of test tubes, petridishes , beakers.

……IVF ( in vitro fertilization)IVF ( in vitro fertilization)

� In vitro fertilization treatment is given to both females and males infertility. In females this may overcome the problems of fallopian tube . In males the problem of sperm quality can be overcome by giving (ICSI) Intracytoplasmic sperm injection. It has its role when even the sperm count is low. In vitro fertilization can play its role in women who have crossed their menopause . In vitro fertilization can be combined with preimplantation genetic diagnosis (PGD) in order to overcome genetic disorders.

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GIFT / ZIFTGIFT / ZIFT

� Gamete intrafallopian transfer and zygote intrafallopian transfer are prefered techniques over IVF as it works faster. In ZIFT zygote are placed in fallopian tube within 24 hours. In GIFT the sperm and egg are mixed together and then implanted in fallopian tube and by luck one of the egg get fused. These are prefered more to IVF as its success rate is high and these can be used even when there is mild male infertility too.

Psychological treatmentPsychological treatment

� Mostly psychological treatment is given by counseling and marriage therapy . Men are not much likely to seek psychological help rather than woman but psychological treatment is much important while dealing with male infertility. A lot of men think that there are numerous disincentives to psychological treatment rather than its potential benefits mostly infertility linked to behavioral factors.

Success Rate..Success Rate..

� Success rate depend and varies on many factors. Some things that effect the success rate of infertility treatment includes success of ART , age factor , reason of infertility , some diseased factors, some hormonal and immunological related disorders also effect the success rate.(write more)

CommonCommon and Ethical problemsand Ethical problems� The legal status of embryos fertilized in vitro and not transfered in vivo.

� Anti-abortion opposite to the destruction of embryos not transferred in vivo.

� High cost treatments are out of financial reach for some couples .

� Different religious opinions on infertility� And its treatment.� IVF results have lead to increase in multiple births , provoking ethical analysis because of link between multiple pregnancies, premature birth, and a host of health problem.

� ART is not possible for women suffering with cancer.