Infertility facts

1. Infertility facts affects 1 in 6 married couples of childbearing age definition: have engaged in unprotected coitus for 1 year and haven�t become pregnant

2. Infertility Facts can be due to: failure to conceive, loss of conceptus origin of problem: 35% female 35% male 20% both partners 10% unexplained

3. Failure to ovulate often caused by low body fat or stress GnRH surge may be inadequate

4. Tubal blockage Due to: Endometriosis, scar tissue from STD, previous surgery Treatment: surgery If surgery unsuccessful, IVF, GIFT and ZIFT are best options

5. Causes of male infertility low sperm count (oligospermia) or absence of sperm (azoospermia) male may produce antibodies to his own sperm accessory glands / ducts may malfunction

6. Intracervical or intrauterine insemination (ICI / IUI) Artificial insemination definition: sperm introduced into female reproductive tract by means other than coitus (near cervix or in uterus) sperm can come from donor / sperm bank or from husband Example of a sperm bank: http://www.spermbankcalifornia.com/buy-sperm-online.html

7. ICI / IUI, cont�d. usually, several ejaculations are pooled 60,000 babies / year born in US. as result of artificial insemination often used when male has low sperm count or antibodies present in ejaculate

8. In vitro fertilization �test - tube babies� 1st performed in 1978 (Louise Joy Brown) often performed on infertile women with tubal blockage

9. IVF Protocol GnRH agonist (e.g. Lupron) for 7 days FSH agonist (follistim, Gonal-F, Repronex) until follicles measure 17-20 mm in diameter (8-14 days) hCG given to induce egg maturation Egg retrieval (transvaginally) 34-35 h later

10. IVF protocol sperm and ova added to dish; fertilization occurs 12-14hrs. eggs transferred to new dish and cell division occurs embryos squirted into uterus (optimal stage: blastocyst) Preimplantation genetic diagnosis (PGD)

11. IVF Protocol, cont�d. 3 to 5 embryos are injected to increase chances of pregnancy woman given progestagen to prevent miscarriage Example of prices: http://www.advancedfertility.com/ivfprice.htm

12. IVF Protocol, cont�d. new variations / improvements: Intracytoplasmic sperm injection (ICSI) use of frozen embryos 27,000 attempts made per year; 18.6% successful (success rates are increasing) http://www.advancedfertility.com/sampleivfcalendar.htm

13. IVF, cont�d. Ethical questions: will it lead to selective breeding? up to what stage can research be done? if embryo dies in vitro, is it abortion, murder? what should be done w/ unwanted embryos? should government regulate research?

14. GIFT and ZIFT GIFT = gamete intrafallopian transfer useful for tubal blockage ova are collected and inserted into oviducts below point of blockage husband�s sperm are placed in oviduct

15. GIFT and ZIFT woman is treated with hormones to prevent miscarriage 28% successful ZIFT = zygote intrafallopian transfer ZIFT is like IVF, only zygotes (1 cell stage) are inserted below blockage in oviduct (24% success rate)

16. Others Ovarian stimulation protocol Surrogate pregnancy Adoption