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It is a fact that many couples and singles after being diagnosed infertile and undergoing treatments like ovulation induction, intrauterine insemination or reproductive surgery fail to have a baby of their own. Assisted reproductive technologies (ART) could be an answer in such cases.
The treatment includes In -Vitro Fertilization (IVF), egg donation, surrogacy and other clinical procedures with are targeted at providing a satisfying solution to the issue and get the best possible outcome. Since all these medical procedures require finesse and a high level of medical expertise they can be expensive, demand a lot of focused and dedicated effort and an in depth groundwork.
It is hence advisable you get acquainted with the ART procedures to get into a stress free mental framework before you actually embark upon a surrogacy program.
Preimplantation Genetic Diagnosis
It is imperative that genetic disorders detected in embryos need to be properly identified through Pre-implantation Genetic Diagnosis (PGD) before transfer. This ensures implantation of healthy embryos to the uterus. In place of the current practice of post conception diagnostic procedures aka amniocentesis or Chronic Villus sampling that may lead to termination of pregnancy, PGD method could be employed. PGD is done together with IVF and advised in case there is a chance of an embryo being affected by a specific genetic condition. Applicable for both fertile and infertile couples, PGD permits only normal embryos to pass into the uterus. As a consequence, the chances of undesirable results of pregnancy termination and miscarriage are dramatically mitigated. This avoids disastrous physical and mental conditions of parents facing a miscarriage even after positive prenatal diagnosis.
Embryos created through IVF procedure are genetically tested for X and Y chromosomes for sex selection. The next step is to implant the embryo of selected sex.
Intracytoplasmic Sperm Injection
There is a latest alternative to IVF and equally effective method known as Intra Cytoplasmic sperm injection which helps achieve fertilization. This method brings success especially when the husband has a low sperm count or the quality of sperm is inferior. For mothers who fail to conceive with previous IVF assistance or have a low egg count or have defects in egg quality, ICSI could be an answer.
The eggs are kept in an incubator after removal of the follicular fluid. On the same day itself later these eggs are to be fertilized by sperms. From the sperm sample given by the male, the healthiest sperm is extracted and in case sperm is not handy a sperm retrieval procedure may be suggested like testicular biopsy or micro dissection testicular sperm extraction (TESE) or percutaneous sperm aspiration (PESA) which is applied roughly at the time of egg retrieval.
For direct fertilization of mature eggs, ICSI technique is applied. An embryologist pin points and selects the best single sperm with the aid of a microscope, and with a small glass needle directly injects it into the cytoplasm of an egg. Prior to reaching blastocyst phase it is medically recommended to nurture the embryos for five to six days.
Additional Advanced Technologies
A slow down of ovarian function causing a drop in egg quality is quite common among females falling in the age group of 30 yrs to 40 yrs, which often leads to infertility. Ovarian function wears out with age facing a drop in efficiency in which case quality eggs from a young donor could trigger an excellent treatment.
This is a mode of child birth where the surrogate mother gives her consent to become pregnant and deliver the child in pursuance to a contract with an intending couple unable to have a baby of their own. The gestational carrier or the genetically related female would be the surrogate mother of the baby she delivers after being implanted with an embryo.
In a few specific cases before the transfer takes place Assisted Hatching method is employed. Prior to implantation in the uterus an embryo hatches out of a protein coating known as the Zona Pellucida. The shell of zona pellucida can be dissolved with the aid of laser or a chemical.
Females over 38yrs of age and with extremely thick Zona Pellucida often meet with failure in IVF procedure tried previously, and for them AH is a frequently applied successful technique.
Percutaneous Epidydimal Sperm Aspiration and Testicular Sperm Extraction (PESA & TESE)
Sperm produced in testicles doesn’t necessarily find a way out through ejaculation. Vasectomy could be a possible cause where an obstruction in the sperm duct blocks the passage and consequently the outflow of sperms from testicles is restricted.
Intervention of a urologist is required in this case where he removes the sperms by placing a needle into the tube or into the testis and then drawing it cautiously. The patient obviously needs to be anesthetized and can give a positive result when performed together with ICSI.
In order to make the embryos thrive in the laboratory environment for transferring at a later date, they need to be frozen through cryopreservation. It is imperative that the embryos need to be frozen till they survive for blastocyst stage. These embryos are frozen in liquid nitrogen till a later date when thawed. The preparation of a frozen embryo and procedure for transfer is simple and cheap. However, the success rate for conceiving is discouraging. Only those embryos surviving till the blastocyte stage should be selected for freezing to maximize the probability of success in a thaw cycle.