IVF

In Vitro Fertilization ( IVF) :

(IVF); is the period when an egg is artificially fertilized by the sperm, outside the body.

 

IVF is the most famous among assisted reproductive technologies. Today, there are many new techniques developed in addition to the conventional in vitro fertilization method and is used to treat different causes of infertility.

IVF is a procedure for fertilization of female egg cell (oocyte) and male sperm cells (sperm) outside the body under laboratory conditions carefully crafted, selection of a certain number of fertilized egg cells (embryo) transfer into the uterus.

 

 

Gender Selection

The desire to choose the sex of the unborn child is probably as old as history itself. Warlike societies, in particular, prefer male children to inherit the throne. In modern times, however, girls are increasingly becoming the preferred sex. Throughout history, people have tried countless methods for sex selection (Gender selection) but almost none of them have been successful. Sexual positions, timing intercourse according to seasons, trying different food and food preparations are all very unscientific ways for determining the sex of the baby. Some methods might increase the probability of conceiving a certain sex but none is guaranteed to be successful. Currently, the most reliable way for choosing the sex of the baby is through a method called Preconception Gender Selection (PGS). This is a process where the embryo obtained has genetic testing on a cell removed from the embryo at the 8 cell stage. Sex selection is only done on embryos that have been obtained during infertility treatment. Other techniques are deemed either ineffectual or unethical.

 

As is commonly known, X and Y are the sex chromosomes. A male has 46 chromosomes and an X and Y chromosome and this is written as 46, XY. Women have two X chromosomes and this is shown as 46, XX, a gamete from a woman contains 23 chromosomes: 22 chromosomes plus one X chromosome. Male gametes have either one X or Y chromosome in addition to the 22 other chromosomes to make a total of 23. While eggs carry the X chromosome only, there are two types of sperm cells, ones that carry the X and ones that carry the Y chromosome. One can deduce from this that the sex chromosome that’s on the sperm cell determines the gender of the baby. One can either determine the sex of the baby by sperm-separating technique or by testing the embryo and selecting the embryos with the desired sex to transfer back into the uterus.

 

 

Oocyte (Egg) Donation

Once it is established that a couple’s infertility is due to the female’s lack of eggs there are three options to choose from. The couple can both accept this and look for other sources of happiness. They can apply to the appropriate initiations to start the adoption process. The third option for couples is to use a donor egg.

 

Oocyte donation differs from the other options because the baby that is born carries half of the genetic makeup of the family. Also, the parents experience the psychosocial changes resulting from sharing the pregnancy and delivery. The source of the donor egg is usually at an age where chances of chromosomal anomalies are very low. However, the age of the donor does not protect the mother from complications during her pregnancy. The age of the woman carrying the baby and her overall health affects how the pregnancy will progress.

 

The first baby born as a result of oocyte donation was done three years after the first IVF baby was born. Initially, oocyte donation was intended for women who experience premature menopause; gradually the procedure became a solution for older women. Even if ovaries stop egg production, the uterus retains its capability of carrying a baby to term. The uterus can be reprogrammed with oral or injectable drugs to prepare the organ for implantation and pregnancy. Chances of pregnancy are similar to a younger woman using her own eggs. Sometimes pregnancy rates can even be higher for these women.

 

Oocyte Donation:

  • Premature menopause or other factors causing cessation of egg production, such as hereditary diseases, endometriosis, surgery done on the ovaries resulting in significant loss of ovarian tissue.
  • Several failed attempts at IVF or recurrent miscarriage caused by poor egg quality or poor embryo development.
  • Infertile couples where the woman is not permitted to use drugs necessary to induce oocyte production.
  • Older women who have entered menopause. Arguments against oocyte donation usually focus on these types of patients. A 65-year-old Romanian woman is the oldest woman recorded to have a baby through this method.

 

 

Embryo Donation

There are some situations where the couples have both male and female factor infertility. Where the woman doesn’t produce eggs and the man does not produce sperm. In these cases one can find a sperm donor as well as an oocyte donor and transfer the resulting embryo to the recipient’s uterus. This method is suggested for couples who know that they cannot get pregnant with either of their own gametes. Some couples choose this treatment even if only one is diagnosed as infertile.

Embryo Donation:

 

Female:

  • Women who undergo premature menopause and cease oocyte production or women who lack egg production because of a genetic predisposition, past illnesses, endometriosis and/or loss of ovarian tissue after surgery on ovaries.
  • Recurrent miscarriage due to poor quality oocytes, or embryos after repeated infertility treatments
  • Infertile women whose use of drugs to induce ovarian stimulation are not allowed

Male:

  • If sperm is not found in the ejaculate or testicular tissue
  • A genetic disease that might be passed on to the children
  • If the mother has Rh immunity and the father is Rh (+)
  • If the male has a sexually transmitted disease such as HIV

 

 

 

Donors

Despite advances in modern medicine, it is still not possible to synthetically produce eggs or sperm. If a woman does not produce eggs or cannot become pregnant with her own eggs due to a genetic defect, her only option is to obtain eggs from a donor.

 

If you are young and healthy, aware of the problems that infertile people experience, you can become a donor. Donors do receive a fee but research has shown that egg donors also donate blood regularly and have an altruistic nature If you feel that you would like to donate eggs then please continue reading.

 

 

 

 

Surrogacy

A surrogate mother is a woman who agrees to get pregnant for someone with the intention of giving the child to another family to raise. Surrogate comes from the Latin word: subrogare which means to substitute. Conventionally the surrogate mother is pregnant with her own biological child where the purpose is to give the child up to another family. Normally pregnancy is achieved by artificial insemination where sperm from the prospective father of the recipient family is used. The recipient family is thus the biological father and his wife.