There are several infertility problems that can be helped with the new technology.

Male infertility problems

Low sperm count and congenital absence of the sperm duct can be helped by the new technology. In this situation, men who were born with missing sperm ducts, today, are now able to have children of their own by ART procedure.

Female infertility problems

An ovulation. This occurs in 10% of most cases of infertility. This female may go through a menstrual cycle but she is not ovulating, that is, not producing eggs. It is now possible to control this process externally by administering various hormones to the patient. This is done after a very careful analysis of the patients’ hormonal status and deficiencies.

Tubal blockage

The tubes that carry the egg to the site of fertilization may be blocked or restricted in their movement. This may result in failure to conceive, even though the patient may be ovulating normally. Blocked tubes occur in about 20% of infertility cases.

Immunology

This includes cervical hostility. In this situation, the woman’s cervix recognises the sperm as a hostile foreign body (antigen) and immediately produces antibodies to kill the sperm. Invariably, most of the sperm cells are destroyed just at the cervical entrance and do not pass beyond the cervix.

Hormonal factors.

Apart from the hormones that control ovulation directly, some hormones can indirectly affect ovulation. Prolactin, a stress hormone, is one of such hormones. The elevation of this hormone can cause the secretion of milk in the breast of a non-pregnant woman.

Endometriosis

This is an inflammation usually around the uterus and sometimes in the ovary and the tubes. It makes the process of fertilization very difficult. A history of painful intercourse should suggest endometriosis. It can be confirmed with a laparoscopy.

Unexplained infertility

In about five per cent of the cases there would be no reason found for the infertility. The wife and the husband can both be perfectly normal, and all of the known causes are ruled out, yet they do not get pregnant.

The new technologies

Assisted Reproductive Technology as useful as it has been proven, is not necessary for every couple. A proper evaluation should be conducted by the specialist to ensure that the most efficient and cost effective procedure is used to help the couple become pregnant. Each individual is different.

Assisted reproduction

Assisted Reproductive Technologies (ARTs) has now gone beyond in vitro fertilization (IVF) and intra cytoplasmic sperm injection.

In Vitro Fertilization

In IVF, the female is inseminated with approximately 3 drops of sperm solution from the male partner. Usually, the patient is given fertility drugs to increase the number of eggs that are produced at ovulation. The eggs are isolated from the aspirated follicle and allowed to rest in the incubator for a while before insemination. The inseminated eggs are kept in the incubator in the IVF laboratory for about 3 days. The fertilized embryo will rapidly divide into the 2-cell, 4-cell and 8-cell stages at which point about 3 or 4 good embryos are selected and transferred into the uterus through the cervix.

IVF is a good treatment option when the fallopian tubes are blocked or in endometriosis and when the male partner has low sperm count.

Micro manipulation

When the infertility in the couple is due to very low sperm count, the technique of intra cytoplasmic sperm injection provides a solution to getting pregnant. Under a very specialised microscope one sperm cell is aspirated from the very few ones, and it is injected directly into the egg cytoplasm.

Assisted Development/Assisted Hatching

The procedure is usually reserved for patients over the age of 38, as well as patients with prior unsuccessful IVF attempts. Patients in this category would normally produce eggs at stimulation in IVF cycle and could have some embryos transferred at the 4-cell or 8-cell stages. However, they would not get pregnant after the transfer. There are a number of patients who are able to carry their pregnancies to term by using this procedure.

Cryopreservation of oocytes and embryos

The excess embryos can be preserved for years by freezing the embryos in straws and then storing them in liquid nitrogen tanks. They can be thawed when needed.

Pre-Implantation genetic testing

Patients who have genetic disorders like sickle cell can now have the disease gene eliminated from the children at conception. When embryos are fertilized, the process of pre-implantation genetic diagnosis can eliminate genetic disorders. Simply put, a couple with genotype HbAS would expect to have offspring with AS, SS, and AA. With PGD we can select just the AA embryos for insemination, thereby producing AA only babies.

Prof. Oladapo Ashiru