Reproductive Technology to solve infertility problems.

Some important techniques are as follows.

1. Test Tube Baby:

The fusion of ovum and sperm is done outside the body of woman,
to form a zygote which is allowed to divide to form embryo.

This embryo is then implanted in uterus where it develops into a

foetus which in turn develops into a child. This is called test tube
baby. In this method, ova from the wife/donor female and sperms
from the husband/donor male are induced to form zygote in the
laboratory.

The zygote is allowed to divide forming 8 blastomeres. The zygote

or early embryo is transferred into the Fallopian tube (ZIFT—Zygote
Intra Fallopian Transfer). If the embryo is with more than 8 blas-
tomeres it is transferred into the uterus (IUT – Intra Uterine
Transfer) to complete its further development.

Thus this is in vitro fertilization (IVF – fertilisation outside the body

in almost similar conditions as that in the body) followed by embryo
transfer (ET). Embryo formed by in vivo fertilization (fusion of
gametes within the female) can also be used for such transfer.
Success Rate:
Implantation of embryo takes place in the uterus where it develops
into a foetus which forms a child. The mother will give birth to a
normal child on the completion of gestation. This is test tube baby.
It is to be noted that the baby is not reared in the test tube. The
success rate of this technique of producing test tube babies is less
than 20%.

First Test Tube Baby:

The first test tube baby Louise Joy Brown, was born to Lesley and
Gilbert Brown on July 25, 1978, in Oldham, Lancashire, England
with the help of Dr. Patrick Steptoe and Dr. Robert Edwards. Dr
Robert Edwards got 2010 Nobel Prize for developing a technique for
production of test tube baby. Later on test tube babies were also
born in other countries. India’s first test tube baby was born on
August 6, 1986 at K.E.M Hospital, Mumbai. Her name is Kum
Harsha.

The credit for India’s first test tube baby goes to Dr Indra Hinduja.
Some persons claimed that India’s (Asia’s) first and world’s only
second test tube baby was born in Kolkata on 3 October 1978.
Previously, her name was Durga (now her name is Kanupriya
Agarwal). The man behind this pioneering effort was Dr Subhas
Mukherjee.

2. Artificial Insemination Technique (AIT):

Different methods are used in artificial insemination, but
intrauterine insemination (IUI) is very common. IUI is either AIH
(artificial insemination husband) or AID (artificial insemination
donor). However, AIH is commonly used.

Just near the time of ovulation, about 0.3 ml of washed and

concentrated semen having at least 1 million sperms from husband
is introduced artificially through a flexible polyethylene catheter
into the vagina or into uterus called intra-uterine insemination or
(IUI). Washing in culture media removes the proteins and
prostaglandins from semen.

Best results are obtained when the motile sperm count is more than
10 million. The fertilising capacity of spermatozoa (sperms) is for
24-48 hours. The procedure may be repeated 2-3 times over a
period of 2- 3 days.

The result varies in different centres, ranging 20-40 per cent. IUI
along with super ovulation gives higher.

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When husband sperms are defective, AID (Artificial Insemination

Donor) method is used. In this method semen is taken from semen
bank.

3. Gamete Intra Fallopian Transfer (GIFT):

GIFT was first described by Asch and colleagues in 1984. It is a
more expensive and invasive procedure than IVF (in vitro Fertili-
zation) but its results are better than IVF. In this technique, both
the sperm and unfertilised oocytes are transferred into the
Fallopian tubes. Fertilization then takes place in vivo (inside the
body of the female).
For GIFT technique normal Fallopian tubes are required. The
indications are the same as in IVF except the tubal factor. Best
result is obtained in unexplained infertility but the result is poor in
male factor abnormality.

In this procedure the super ovulation is done as in IVF. Two

collected oocytes along with about 200,000-500,000 motile sperms
for each Fallopian tube are placed in a plastic tube container. It is
then transferred through laparoscope and inserted 4 cm into the
distal end of the Fallopian tube where the combination is injected.
The overall success rate through this procedure is 27-30 per cent.

4. Intra Cytoplasmic Sperm Injection (ICSI):

It was first described by Van Steirteghem and colleagues in 1992 in
Belgium. The following conditions cause infertility. Severe
oligospermia, obstruction of efferent duct system in male, presence
of sperm antibodies, congenital absence of both vasa efferentia and
vasa deferentia in male, failure of fertilization in IVF, hardened
zona pellucida unexplained infertility, etc.

In this procedure first sperms are obtained through ejaculation.

Sperms can be recovered by TESE (Testicular sperm extraction) or
by MESA (microsurgical epididymal sperm aspiration) techniques.

In this technique one single spermatozoon or even a spermatid is

injected directly into the cytoplasm of an oocyte by micropuncture
of the zona pellucida. This procedure is done under a high quality
inverted operating microscope. Micropipette is used to hold the
oocyte while the spermatozoon is injected inside the cytoplasm of
the oocyte (ooplasm) by an injecting pipette.
ICSI is very effective as compared to other micromanipulation
techniques like SUZI (sub-zonal insemination). ICSI is very effective
to reduce the need of AID. The fertilization rate through ICSI is
about 60-70 per cent. However, pregnancy rate through this
procedure is 20-40 per cent.

5. Zygote Intra-Fallopian Transfer (ZIFT):

In this technique zygote or early embryo (with up to 8 blastomeres)
is transferred into the Fallopian tube.

6. Intra Uterine Transfer (IUT):

If the embryo is with more than 8 blastomeres, it is transferred
from the laboratory to the uterus to complete its further
development.

All these methods require extremely high specialised persons and

expensive instruments. Therefore, there are only few such centres in
the country and hence their benefits are obtained only by limited
persons. Emotional, social and religious factors interfere in the
adoption of these methods.

In India there are so many orphaned and destitute (without food,

clothes and other necessary things) children. Adoption of these
children is one of the best methods for couples looking for
parenthood. Our laws also permit legal adoption.

Surrogate Mother:
A developing embryo is implanted in the uterus of another female.
A woman who substitutes or takes the place of the real mother to
nurse the embryo is called surrogate mother. Embryo transplants
are more useful in animals than in humans.