ASSISTED REPRODUCTION Fertility Treatments

TREATMENTS FOR INFERTILITY Medically speaking, infertility is defined as the inability to conceive after 12 months of sexual intercourse without contraception. In Canada, roughly 10-15% of couples are infertile. Some couples choose adoption in the event of infertility, but others turn to biotechnology for assisted reproduction. Techniques include: Ovarian stimulation Artificial insemination In vitro fertilization Fertilization by microinjection

OVARIAN STIMULATION Some women have difficulty ovulating. This means that their ovaries never or rarely release an ovum during their ovarian cycle, thus making it very difficult to get pregnant. Ovarian stimulation causes the ovaries to develop one or more ovarian follicle, and ultimately ova, to help increase the chance of pregnancy. How? Hormone injections – specifically FSH, as this is the hormone that develops the ovarian follicle. 10 days of injections are usually needed.

ARTIFICIAL INSEMINATION This procedure is common for couples who cannot conceive because the male sperm have difficulty passing the female cervix, or the sperm count is low, or the sperm have low motility, (ability to move). This technique injects semen directly into the uterus on the day of ovulation.

IN VITRO FERTILIZATION This involves the fertilization of an ovum by a sperm in a lab, in a test tube or petri dish, (outside of the body), rather than in the fallopian tube. After a few days of growth in the lab, the most viable zygotes are implanted in the uterus to continue their growth. Most will not take to the uterus, but the hope is that at least one will.

In vitro is carried out in four steps: Ovarian stimulation to develop multiple mature follicles at one time. As a result, multiple ova are produced. Retrieval of ova and sperm – once ovulation has occurred, the ova will be retrieved. Semen will be collected from the male, as well. Fertilization in the lab – The ova and sperm are placed together in a test tube or petri dish. Transfer of zygotes to the uterus – After a few days in the test tube, the most viable zygotes will be implanted into the uterus. Any others may be frozen and used later if the first attempts fail.

In vitro is also very helpful to couples who have a high probability of passing on a hereditary disease to their children. This way, their gametes can be screened and tested for the chromosomes which carry the disease, and those cells won’t be used.

Benefits Concerns Infertile couples, or same-sex couples are able to have children. Risk of multiple births. High cost of treatment. Risk of embryos being selected only for desired traits – gender, eye colour.

Surrogate Sometimes couples need a functional uterus to carry the baby to term and they bring in another woman to do this. It is not her ovum, she is just carrying to baby for someone else - Mother’s uterus will not support the baby - 2 homosexual men -Etc.

FERTILIZATION BY MICROINJECTION This technique follows the same steps as in vitro fertilization, although rather than harvesting ova, the sperm cells are injected into the ovum while still inside the female. This is done with a microsyringe. This is used when the male has motility issues or a low sperm count, making it difficult for the sperm to reach the ovum in the fallopian tube. In the case of low sperm count, sometimes the sperm has to be directly retrieved from the testicles or epididymis.