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Assisted conception IUI and IVF The following methods are currently available
for assisted conception. IUI (intrauterine insemination)
A fine catheter is inserted through the cervix into the uterus to place a sperm sample directly
into the uterus. The sperm is washed in a fluid and the best specimens are selected.
This procedure must be done when ovulation occurs. The woman may be given a low dose
of ovary stimulating hormones. IUI is more commonly done when the man has
a low sperm count, decreased sperm motility, or when infertility does not have an identifiable
cause. The procedure is also helpful for males suffering from severe erectile dysfunction.
IVF (in vitro fertilization) IVF in
action Sperm are placed with unfertilized eggs in
a Petri dish; the aim is fertilization of the eggs. The embryo is then placed in the
uterus to begin a pregnancy. Sometimes the embryo is frozen for future use (cryopreserved).
Louise Joy Brown, born in England in 1978, was the world’s first IVF baby. Before IVF
is done the female takes fertility drugs to encourage the ovaries to produce more eggs
than normal. Time-lapse imaging triples the chances of
having a baby for couples undergoing IVF treatment, researchers reported in Reproductive BioMedicine
Online (May 2013 issue). Described as a “major breakthrough”, time-lapse imaging became available
in 2013 in the UK for monitoring the development of IVF embryos before they are implanted in
the womb. In an Abstract in the journal, the authors
wrote “Time-lapse imaging of human preimplantation IVF embryos has enabled objective algorithms
based on novel observations of development (morphokinetics) to be used for clinical selection
of embryos.” With this new technique, the scientists could
develop a way of accurately identifying which embryos are more likely to have aneuploidy
(abnormal chromosomes). Embryos with aneuploidy are much less likely to be successfully implanted.
The researchers, from CARE Fertility, said further large-scale studies are needed to
confirm their findings. Researchers from Mount Sinai Hospital in Toronto,
Canada, reported in CMAJ that IVF is more successful if the woman has sufficient levels
of vitamin D. A study published in the Journal of Clinical
Endocrinology & Metabolism (JCEM) found that women who are deficient in vitamin D are half
as likely to conceive using IVF compared with women without vitamin D deficiency.
ICSI (Intracytoplasmic sperm injection) A single sperm is injected into an egg to
achieve fertilization during an IVF procedure. The likelihood of fertilization improves significantly
for men with low sperm concentrations. Donation of sperm or egg
If there is either no sperm or egg in one of the partners it is possible to receive
sperm or eggs from a donor. Fertility treatment with donor eggs is usually done using IVF.
In the UK and a growing number of countries the egg donor can no longer remain anonymous
– the offspring can legally trace his/her biological parent when reaching the age of