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

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Infertility Facts

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

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

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Tubal blockage

Due to:
Endometriosis, scar tissue from STD, previous surgery

Treatment: surgery If surgery unsuccessful, IVF, GIFT and ZIFT are best options

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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

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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/buysperm-online.html Forever Copyright @

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ICI / IUI, contd.

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

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

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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

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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)

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IVF Protocol, contd.

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.ht m

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IVF Protocol, contd.

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/sampleivfcal endar.htm

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IVF, contd.

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?
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GIFT and ZIFT

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GIFT = gamete intrafallopian transfer useful for tubal blockage ova are collected and inserted into oviducts below point of blockage husbands sperm are placed in oviduct

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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)

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Others
Ovarian stimulation protocol Surrogate pregnancy Adoption

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