Infertility - Alternative forms of conception
Alternative Forms of Conception
There have been a number of breakthroughs for couples experiencing difficulty in conceiving. There are methods for overcoming problems in sperm production, egg production, and fertilization.
In certain cases of infertility, drug therapy may be used to correct the problem. For example, Metrodin, a drug containing a natural hormone, is used to stimulate egg development. Pergonal, another hormonal drug, may be used to promote egg or sperm development. Pills containing clomiphene citrate, a nonsteroidal drug, are used to stimulate ovulation. Drug therapy combined with intercourse, artificial insemination, or IVF (in vitro fertilization) may produce a pregnancy.
Artificial insemination is the nonsurgical insertion of sperm into the vagina or uterus. This technique can be done to provide a more concentrated sperm count from the father or provide sperm from a donor if the man is infertile. It is mainly successful on women who are not experiencing infertility problems themselves.
IVF is the procedure in which an egg is fertilized by a sperm in a laboratory glass dish. Typically in this process a woman is treated with drug therapy to stimulate egg production. Eggs are then drawn from the ovaries and placed in the dish with the man's sperm in order to be fertilized. After approximately two days, several fertilized eggs are implanted in the woman's uterus. More than one egg is implanted because it is likely that not all will develop. Remaining fertilized eggs can be frozen for future implantation in the woman. The success rate for a pregnancy is about 20 percent.
GIFT (gamete intrafallopian transfer) is a procedure in which a doctor inserts both the eggs and the sperm into a woman's fallopian tube for fertilization inside the woman's body. The resulting fertilized egg then travels to her uterus, as in the natural process of conception. The success rate for this method is about 25 percent.
ZIFT (zygote intrafallopian transfer) combines aspects of IVF and GIFT. In this procedure, the eggs and sperm are combined in the laboratory. Then the fertilized eggs are inserted in the fallopian tube so that they may travel to the uterus as they would in natural conception. The success rate is about 25 percent.
ICSI (intracytoplasmic sperm injection) is a laboratory procedure in which a doctor injects a single sperm into a single egg for fertilization. The fertilized egg is then implanted in the woman's uterus. This procedure is especially useful for men with low sperm counts, low sperm motility, or sperm that cannot penetrate the egg on their own. The success rate with this method is about 25 percent.
Donor or Frozen Eggs and Sperm
Donor eggs, donor sperm, or both donor eggs and sperm may be used in fertilization techniques. Donor eggs and sperm are donated by healthy women or men whom the parents may or may not know. Technological advances have also made it possible to freeze sperm or eggs for later attempts at pregnancy.
If a woman is unable to carry a fetus to term in a pregnancy, an alternative is to have another woman carry the fetus. Depending on the type of fertility problem, the surrogate mother may carry the egg of the infertile mother or a donor egg. The egg may be fertilized by the father or by donor sperm. In some cases the surrogate provides the egg and undergoes one of the above fertilization techniques with the father's sperm. A surrogate may be a relative, friend, or hired woman. The legal involvement is complicated and the necessary arrangements require serious discussions.