Author Name: Dr. Sarah Zaidi Merchant Mentor Name: Dr. Shipra Nigam on April 08, 2020
INFERTILITY is defined as inability of a couple to conceive even after one year of regular unprotected intercourse. Nowadays, an increasing tendency has been observed among couples to delay childbearing for career, social or other reasons. So, any delay in spontaneous conception puts these couples under lot of stress.
Ever since the first IVF baby was born almost four decades ago, significant developments have occurred in the field of in vitro fertilization (IVF). IVF was initially designed to tackle tubal infertility. However, now IVF is being
widely used for unexplained infertility, infertility related to male factors, endometriosis and ovarian dysfunction resistant to ovulation induction.
ICSI (Intracytoplasmic Sperm Injection), an advancement in IVF, has proved to be a boon for male infertility.
Let us understand as to how IVF is useful:-
1) It is a process where multiple eggs are produced from the ovary with the help of hormonal injections. Normally, in one menstrual cycle, ovary releases only one egg. Availability of more eggs significantly increases the chances of conception. After the eggs mature, they are taken out of the body for fertilization with the sperm.
2) After the fertilization, many embryos are formed. Out of these, certain number of embryos are selected on basis of certain characters.
3) The selected embryos are observed. Day 5 embryo is called blastocyst. It is the blastocyst embryo which is transferred in the mother’s uterus because this stage embryo achieves maximum compatibility with the uterus.
AS IS EVIDENT FROM ABOVE THAT IVF OFFERS ADVANTAGE IN TERMS OF BOTH QUANTITY AND QUALITY.
1) DIMINISHED OVARIAN RESERVE (DOR)- These are patients who have either poor quality or decreased quantity of eggs. The causes of DOR are not much known. IVF has offered significant results in these patients. IVF techniques like high dose gonadotropins use, antagonist protocol, minimal stimulation and embryo pooling, all have proved to be successful.
2) POLYCYSTIC OVARIAN DISORDER (PCOD)— PCOD is one of the leading causes of infertility observed. Here, the egg number is adequate but the eggs are not able to function adequately and hence, are unable to ovulate. Lifestyle modifications, treatment of other concomitant problems (multi-team approach) and ovulation induction drugs are the initial modalities of treatment. IVF-ICSI is used in patients who fail to respond.
3) TUBAL DISORDERS – IVF, as mentioned above, came as treatment of tubal disorders like tubal infections or tubal blocks because IVF procedure does not require functional tubes.
4) UTERINE FACTOR RELATED INFERTILITY — The inner lining of the uterus is called endometrium. It is most essential for implantation.
Many disorders lead to its malfunction. A endometrial thickness of less than 6 mm significantly reduces the chances of pregnancy. HORMONE REPLACEMENT THERAPY FET cycles offer better pregnancy outcomes by improving endometrial receptivity.
In the last four decades, IVF has overcome innumerable barriers thus, allowing infertile couples to achieve the ultimate happiness of the world.
Continuing developments in IVF over the years have improved its efficacy and made it affordable and easily approachable to general public. Developments like ICSI, PESA, and TESE are proving to be boon for male
PGD (Preimplantation genetic diagnosis) is an IVF procedure where embryos are examined for chromosomal abnormalities. This has helped couples with genetic disorders to have children free of these disorders.
Social egg freezing is another advancement in IVF that is being considered for future results.
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