Infertility & Reproductive

Technology
CHELSEA POLIGRATIS
KRISTOFER THUENER

Infertility
Short and sweet
-Infertility is the inability to conceive when desired.
To be exact
-The strict definition of infertility is that a couple who has regular,
unprotected sexual intercourse for 1 year and cannot conceive.
Primary
-Infertility is considered primary if conception has never occurred.
Secondary
-Infertility is considered secondary if there has been one or more
pregnancies before infertility.

Causes: General
Many factors that cause infertility are unknown:
-Some couples have a problem that makes it unlikely that they would
conceive, yet they have several children
-But others have no identified problem but can not conceive
Coital Frequency
Age
Tobacco Use
Environmental
Medical problems
Drugs & chemicals

Causes: Male
Abnormal Sperm
Abnormal Erections
Abnormal Ejaculation
Abnormal Seminal Fluid

Causes: Female
Disorders of Ovulation
Abnormal Fallopian Tubes
Abnormal Uterus, Cervix, or Ovaries
Hormone Abnormalities

Evaluation of infertility
Male testing:
Semen analysis
Endocrine tests
Ultrasonography
Testicular biopsy

Social & psychological

implications
Assumption of fertility
Psychological reactions:
Shock
Guilt
Isolation
Depression
Stress on the relationship

Treatment
Medications
Surgical Procedures
Therapeutic Insemination
Surrogate Parenting
Advanced Reproductive Techniques

Reproductive technology (ARTs)

Assisted Reproductive Therapies (ARTs)

Therapy

Description

Therapeutic Insemination

Donor sperm is placed in the uterus or fallopian tube.

In vitro fertilization (IVF)

Ova is recovered via laparoscopy or transvaginally; then the ova is fertilized with sperm, and
two days later transferred to the uterus.

Gamete intrafallopian transfer

(GIFT)

Oocytes are retrieved into a catheter that contained prepared sperm: up to two ova are
injected into each fallopian tube. The women must have at least one open tube.

Tubal embryo transfer(TET) (AKA:

Zygote intrafallopian transfer
(ZIFT)

Ova are fertilized as in IVF but are transferred to the fallopian tube as soon as fertilization
occurs. The resulting embryos enter the uterus normally for implantation

Donor oocyte

Multiple ova are retrieved from a women. They are fertilized and placed in the prepared uterus
of the infertile women.

Surrogate mother

A women allows her ova to be inseminated by the partner or another donor. She then carries
the fetus and agrees to relinquish the infant after birth.

Gestational surrogate

Infertile couple undergoes IVF, but the resulting embryos are placed in the prepared uterus of a
women who has agreed to carry the fetus for them. The women does not donate any of her
genetic components.

Intracytoplasmic sperm injection (ICSI) Sperm are inserted directly into the ova.

Fertility
medications
Primary treatment for women with
ovulation disorderssome are taken
orally and some are injected
In general, they promote ovulation
Many used safely & successfully for
more than 30 yearsbut can also
increase your chance of multiple
births, creating more risk for
complications (miscarriage &
premature labor)
About 10% of women who take
Clomid have multiples (mostly
twins), as do 10-40% of women who
take gonadotropins

Artificial insemination
Sperm is inserted directly into a womens
cervix, fallopian tubes, or uterus.
-Intrauterine Insemination is the most
common
-Common treatment for men whom have low
sperm count
Pregnancy rate for Artificial Insemination is
not as high as other advanced procedures.
It is a simple procedure with very few side
effects.

In vitro fertilization
(IVF)
Process of fertilization by manually combining an egg & sperm in
a laboratory dish, then transferring the embryo to the uterus
5 basic steps in IVF & embryo process
Most women can resume normal activities the next day, but
symptoms to report include: vaginal bleeding, pelvic pain, blood
in the uterine, fever over 38 C (100.5 F)
Some risks include bleeding, infection, & damage to the bowel
or bladder upon egg retrieval; multiples pregnancy w/ increased
risk of premature delivery & low birth weight; psychological
stress & emotional problems are common
Cost for a single IVF cycle can range from at least $12,000$17,000
Success rate depends on reproductive history, maternal age,
cause of infertility, & lifestyle factors

ZIFT/GIFT
GIFT (gamete intrafallopian transfer) & ZIFT (zygote
intrafallopian transfer) are modified versions of IVF
Process goes more quickly
Same success rates as IVF so GIFT or ZIFT may be
a good idea for women who havent been able to
get pregnant w/ normal IVF
Both require a surgical procedure, so IVF is almost
always the preferred choice in clinicsaccounts for
at least 98% of all ART procedures performed in the
U.S., while GIFT & ZIFT make up less than 2%
Costs between $10,000-$15,000

GIFT (Gamete intrafallopian

transfer)
Initial process is same as IVFinvolving
injectable hormones to start super ovulation
& to ripen developing eggs
Eggs & sperm are placed in the fallopian
tubes via laparoscopy, which requires general
anesthesia
With luck, one of the eggs will become
fertilized in the fallopian tubes by the sperm
& move on to the uterus, where it will mature
Typically, more eggs are used to ensure
pregnancyincreasing the risk of multiple
births

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ZIFT (Zygote intrafallopian

transfer)
Assisted reproduction is also done in the
fallopian tubes
But insteadinvolves sperm & egg to be
mixed together in the lab And given time
to fertilize before being placed in the
fallopian tubes
In this sense, ZIFT is closer to traditional IVF
But like GIFTrequires treatment with
hormones & is performed by laparoscopy
Advantage allows for fertilization to be
confirmed before the eggs are inserted into
the fallopian tubesfewer eggs are usually
used which lowers the risk of multiples
pregnancy

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Consideration of cultural, spiritual

and/or legal/ethical aspects
Legal aspects:
Assisted Reproduction can be used by
couples to avoid genetic anomalies.
Parental rights can be legally challenged. A
child may have up to five parents!
A sperm donor, an egg donor, a
gestational surrogate, and the parents
who will raise the child.
Cultural aspects:
Unnatural processes
Conservative Christians and Orthodox Jews
oppose ARTs, same outlook as abortion
Nadya SulemanOctomom

References
Leifer, Gloria. Introduction to Maternity & Pediatric Nursing. St. Louis, MO:
Elsevier/Saunders, 2011. Print.
Todd, Nivin. "Artificial Insemination Benefits, Risks, Side Effects, and More."
WebMD. WebMD, n.d. Web. 01 Dec. 2014.
Vorzimer, Andrew. "An Iminent Culture War Over Assisted Reproductive
Technologies?" The Spin Doctor RSS. N.p., 20 July 2012. Web. 03 Dec. 2014.

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