Several forms of treatment have evolved from the original IVF technique developed in the late 1970s. These treatments all go by their short names, or acronyms, with which you soon become familiar. Here's an explanation of what these acronyms mean and the treatments involved:
1 IVF, in-vitro fertilisation: In-vitro fertilisation literally means
'fertilisation in glass' and the term was coined because in the early days the eggs and sperm were placed in glass test tubes where fertilisation and early embryo development took place (hence the name test-tube baby). These days, shallow plastic dishes are used instead, but the procedure remains much the same. The dish of eggs and sperm is placed in an incubator, which keeps the environment as close as possible to the conditions in a woman's body. All going well, after a few days the eggs fertilise and form embryos, and one or two of these embryos are placed in the woman's uterus.
1 ICSI, intracytoplasmic sperm injection: IVF works only when the male partner has a normal or next-to-normal sperm count. (I tell you what's considered a normal sperm count in Chapter 1.) Scientists tried for a long time to work out how to help couples with male factor infertility and finally, in the early 1990s, they succeeded. ICSI helps many couples with male fertility problems. Instead of a sperm having to fight its way into the egg to fertilise it, the embryologist gives the sperm a helping hand. Using a so-called micro manipulator, the embryologist holds an egg still with a fine glass pipette called — you guessed it — a holding pipette. She or he then 'catches' a single sperm and injects it into the centre of the egg (the cytoplasm) using an extremely fine needle. The process from hereon is then the same as for IVF.
1 GIFT, gamete intrafallopian transfer: GIFT was launched in the 1980s as a more 'natural' version of IVF. Instead of fertilisation happening outside the woman's body in a dish, the woman's eggs are retrieved from her ovaries and 'sandwiched' between two layers of sperm in fine tubing. This tubing is fed into one of the woman's fallopian tubes, where the eggs and sperm are left to fertilise.
GIFT can be used only in couples with unexplained infertility but is rarely used these days, mainly because the woman undergoes a surgical procedure (laparoscopy) to place the eggs and sperm in her fallopian tube. However, GIFT can be an option for couples who don't want to use IVF for religious reasons, providing the woman's fallopian tubes are in working order.
1 PESA, percutaneous epididymal sperm aspiration, and MESA, microsurgical epididymal sperm aspiration: Although some men produce sperm, the tubes that move the sperm from the testicles to the ejaculate may be either blocked or absent. Doctors can overcome this problem using one of two procedures to obtain sperm for ICSI:
• PESA: The doctor uses a needle to aspirate sperm-containing fluid from the epididymis, a duct on top of the testes where sperm is stored prior to ejaculation.
• MESA: The doctor extracts fluid from the epididymis by making a small incision in the scrotum.
The embryologist then locates the sperm in the fluid and performs ICSI.
^ PGD, pre-implantation genetic diagnosis: Some families suffer genetic conditions that cause severe health problems. Embryologists can screen embryos to find the embryos that are free of the defective genes, allowing couples to use only the healthy embryos. (I discuss PGD in more detail in Chapter 16.)
^ TESA, testicular sperm aspiration, and TESE, testicular sperm extraction: If a more severe male factor problem is evident, the doctor can perform one of two procedures to obtain sperm for ICSI:
• TESA: The doctor uses a fine needle to take microscopic pieces of tissue from the testis; this procedure is also called a testicular biopsy.
• TESE: The doctor surgically removes tissue from the testicles; this procedure is also called an open testicular biopsy.
The embryologist then dissects the small pieces of tissue under a microscope looking for sperm to use for ICSI.
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A Beginner's Guide to Healthy Pregnancy. If you suspect, or know, that you are pregnant, we ho pe you have already visited your doctor. Presuming that you have confirmed your suspicions and that this is your first child, or that you wish to take better care of yourself d uring pregnancy than you did during your other pregnancies; you have come to the right place.