ADVANCES IN REPRODUCTIVE TECHNOLOGY, THE ONLY WAY OF FULFILLING COUPLES HOPE OF BECOMING PARENT(S)
It's not an easy journey
The tales of a couple desiring to be parents but have difficulty in achieving that has been one of the difficult times of every physician. Over the years, physicians, relatives and even the couples involved have given up until the recent and ever improving assisted reproductive techniques.
What they didn't tell you
what seemed impossible are now being done, thanks to advanced reproductive technology. You might have come across a News that a 60 year Old woman gave birth to twins, that couples gave birth to triplets after 20 years of marriage. This might not be the whole story. A number of fertility treatments might have been used.
Couples can conceive without aid, some might need just some lifestyle modifications, more time and relaxation together, but that won't work for couples with underlying fertility problems. You might wish to check my post on this:Infertility, causes and approach.
When you need to seek help
It is wiser to seek medical help early than persisting on ones own. A woman under age 39 should seek help after a year of attempting to conceive without success. If she is over 39, the evaluation should be performed after six months of trying to conceive without success.
Basic and thorough evaluation is needed to know the cause of the Infertility, (which could be due to a reproductive problem affecting the female or male partner or combination of both)
before having any treatment, especially aggressive ones. This will avoid jumping into expensive and time consuming treatments, for a minor problem treatable with less cost and intervention.
Assisted reproductive techniques includes:
Ovarian stimulation/ovulation induction
This involves the use of drugs to stimulate the ovaries. One to three cycles of ovarian stimulation can be done. It's a method of treatment for women whose cause of Infertility is anovulation.Intra Uterine Insemination (IUI)
This involves delivering of sperm into the uterine cavity through an inserted catheter. It's method for Lesbians, gays,couples who which to use serogate mother, and for male infertility where sperm washing and concentration is needed.
In- vitro fertilization (IVF)
This is Hope for women with bilateral tubal blockage, primary ovarian failure, unexplained Infertility or when other methods have failed
In IVF, the woman's eggs are harvested, mixed with sperm outside the body, and allowed to fertilize before the embryo is then transferred back into the uterus.
IVF is successful only about 50 percent of the time even in the best of circumstances.
Many women need several treatment cycles before success is achieved, and age is a powerful factor. Higher success rate has been recorded for women less than 40,and less for ages above. For women 43 years and above, donor eggs are preferred.
proceeding to IVF quickly is one of the trends now, whatever a woman's age.
Intracytoplamic sperm injection (ICSI)
Factors contributing to male infertility include abnormal sperm production, motility, blockage of sperm delivery or low sperm production.
ICSI is used for infertility due to male problems. It involves the injection of a single sperm into an egg and this has made a dramatic difference.
Semen/ testicular tissue freezing and eggs /ovarian tissue freezing
Cancer treatments such as chemotherapy and radiation can negatively impact fertility. But thanks to cryopreservation, men, women and even children who have gone through puberty can preserve sperm, eggs, and testicular and ovarian tissue before they start treatment.
Many women postpone motherhood for a variety of reasons, including their career, further education or maybe they have not yet found the right partner. Such Women who know they want to have children later in life can also consider freezing their eggs.
Women can freeze eggs through vitrification [a technology used during the egg and embryo freezing process]. They can be cryopreserved for years, until they are ready to use them
Comprehensive Chromosomal Screening (CCS) and gender selection
This comes into play in Transgender patients and has helped them achieved their dreams of becoming parent(s).
Surgeries
But limits remain
Despite all the advances made, there is still limit and challenges being encountered.
Age
Age still remains a huge factor Especially in women. Favorable outcome and higher success rate being recorded with younger age.
High failure rate
None of the assisted reproductive techniques is 100% effective. Most methods are at most 50-50.
Cost
The cost of fertility work-up and treatment is very high that most people, especially in the developing countries cannot afford it. Most countries also do not get government assistance in any way.
multiple pregnancies
Though couples may see this as a good thing, it increases pregnancy risk/complications.
References
Medweb:New trends in Infertility treatment
International Medical treatment: State-Of-The-Art Advanced/fertility treatment
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