Assisted Reproduction Techniques

The techniques of assisted reproduction (assisted reproductive techniques, ART) include a manipulation of sperm and ova or embryos in vitro with the aim to have a pregnancy occur.

ART can result in a multiple pregnancy, but the risk is much lower than for controlled ovarian hyperstimulation. If a high risk of genetic defects is, the embryo can, often before the transfer and implantation, are examined for defects (preimplantation genetic diagnosis). (.. Editor’s note .: In Germany, this diagnosis according to the law for the protection of embryos – forbidden [Embryo Protection Act EschG after the decision of 24 October 1990].)

The techniques of assisted reproduction (assisted reproductive techniques, ART) include a manipulation of sperm and ova or embryos in vitro with the aim to have a pregnancy occur. ART can result in a multiple pregnancy, but the risk is much lower than for controlled ovarian hyperstimulation. If a high risk of genetic defects is, the embryo can, often before the transfer and implantation, are examined for defects (preimplantation genetic diagnosis). (.. Editor’s note .: In Germany, this diagnosis according to the law for the protection of embryos [Embryo Protection Act – EschG after the decision of 24 October 1990] forbidden.) In vitro fertilization (IVF) IVF is used to treat an infertility which is caused by oligospermia, sperm antibodies, tubal dysfunction, endometriosis or unexplained infertility, are used. The method typically comprises the steps of: Controlled ovarian stimulation: clomiphene either together with gonadotropins or exclusively gonadotropins may be used. In order to prevent premature ovulation, often a gonadotropin-releasing hormone (GnRH) agonist or antagonist is given. If the follicles grown sufficiently, you are zurAuslösung their final maturation and ovulation of human chorionic gonadotropin (hCG). Gain the eggs: About 34 hours after the administration of hCG, the eggs are obtained by direct, usually transvaginal, ultrasound-guided or rarely, laparoscopic needle puncture of the follicles. In some centers, IVF is with natural cycle (in which a single egg is retrieved) offered as an alternative; Pregnancy rates with this technique is lower than the demand of several eggs, but the costs are lower and the success rates are rising. Fertilization: The oocytes are fertilized in vitro. The sperm sample is washed several times, typically in a tissue culture medium, and concentrated on motile sperm, which are then added. Embryo culture: After the sperm were added to the oocytes, they are cultured for about 2-5 days. Embryo Transfer: Only one or a few of the resulting embryos are transferred into the uterine cavity, thereby reducing the possibility of a multiple pregnancy, which is the biggest risk of IVF can be minimized. The number of embryos transferred is determined depending on the age of the woman and the likelihood of response to IVF. Other embryos are frozen in a liquid nitrogen, in order then to be transferred in one of the following cycles. Birth defects are likely to occur more frequently after IVF, but it is not clear whether the increased risk is due to the IVF or factors that contribute to infertility; Infertility itself increases risk of birth defects. But in mid-2014 showed the overwhelming majority of> 5 million after IVF children born in any birth defects. Preimplantation genetic diagnosis (PGD) can be carried out; single blastomere of blastocysts can be tested for certain serious hereditary diseases before transmission (Genetic examination). If the test results are delayed, the blastocyst can be frozen and transferred to a later cycle after the results are known. In women <35 years, it occurs in about 46% of the cycles of ART in pregnancy, and 87% of them are in the US concluded with a live birth (data from 2010). The pregnancy rate decreases with increasing age; in women aged 41 to 42 J by 19.4%, and only about 62% of which are concluded with a live birth. The use of donor oocytes is usually recommended in women> 42 years. Gamete intra-fallopian GIFT is an alternative to IVF, but it is used less and less, because the success rates for IVF have increased. GIFT is used with these words in women most: Unexplained infertility normal function of the ovaries and endometriosis Several eggs and sperm are, like, recovered for IVF, but then – ultrasound controlled transvaginal or laparoscopic – into the distal portion of the tube where fertilization to take place transferred. The rate of live births per cycle in most Infertilitätszentren at 25-35%. Intracytoplasmic Sperm Injection This technique is useful when other methods are not likely, or not successful. There is a serious disease sperm. The eggs are obtained as with IVF. A single sperm is injected into each egg, to avoid fertilization by abnormal sperm. The embryo is then cultured and transferred as for IVF. In the US in 2011 included about two-thirds of all cycles of ART intracytoplasmic sperm injection. The risk of birth defects, after intracytoplasmic sperm injection may be increased, possibly for the following reasons: The procedure itself can damage the sperm, egg or embryo. Semen of men who have mutations of the Y chromosome are used. Most reported birth defects affect the male reproductive system. Other methods Other methods are sometimes used. They include the following tests: A combination of IVF and GIFT intra-fallopian zygote The use of donor eggs transfer of frozen embryos to a surrogate mother Some of these methods take moral and ethical issues (eg legal parenthood with Deputy motherhood, selective reduction of embryos implanted in. the case of multiple pregnancies). (N. D. Talk .: In Germany, all of which are banned this method according to the Embryo Protection Act.)

Health Life Media Team

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