fertility treatment

• control of fertility 


  natural, pharmaceutical, surgical, barrier methods
• success affected by 


  age, general health, previous pregnancies, social factors, inequalities to care, access to care, socioeconomic factors and education
• reproductive health status is made of

  control of fertility, success and safety
• control of fertility

  • choosing when and size
  • people to who have families who otherwise would experience difficulties
• infertility is defined as

  • 12 months of trying to conceived
  • sex every 2-3 days
• fertility can be multifactorial

  • male
  • female
  • combination
  • unexplained
• irregulated fertility leads to

  infertility
• secondary infertility affected by

  • age
  • underlying health conditions
  • weight change
  • scarring from previous pregnancies
• IUI

  • artificial insemination
  • 15-30% success rate
  • sperm inseminated high up in uterus
• frozen sperm has no effect of IUI
• IVF

  • sperm and egg removed from body
  • fertilisation offered out of the body
  • polar bodies used for genetic testing
• egg quality

  • d1 fertilised egg with 2 pronuclei
  • d2 4 cells
  • d3 6-8 cells
  • d5 blastocyst
  • d6 blastocyst hatches
  • implant day 5-5.5 (before hatching)
• grading blastocysts

  • trophoblast must have number of well-connected cells
  • Inner cell mass must have reasonable number of cells
• sperm collection

  PESA: sperm aspirated from the epidermis

  MESA: collection of sperm with use of microscope directly from the epidydimal tubule

  TESA: sperm aspirated from testes directly through the scrotum

  TESE: biopsy of testes, removal of sperm from biopsy

  Micro-TESE: as TESE but with microscope to identify areas more likely to contain mature sperm
• IVF modification 


  ICSI (intracytoplasmic sperm injection)
• IVF modification 


  frozen embryo transfer (FET)