Infertility

Encyclopedia of Medicine, Apr 06, 2001 by Rosalyn S. Carson-DeWitt

Assisted reproductive techniques include in vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), and zygote intrafallopian tube transfer (ZIFT). These are usually used after other techniques to treat infertility have failed.

In vitro fertilization involves the use of a drug to induce the simultaneous release of many eggs from the female's ovaries, which are retrieved surgically. Meanwhile, several semen samples are obtained from the male partner, and a sperm concentrate is prepared. The ova and sperm are then combined in a laboratory, where several of the ova may be fertilized. Cell division is allowed to take place up to the embryo stage. While this takes place, the female may be given drugs to ensure that her uterus is ready to receive an embryo. Three or four of the embryos are transferred to the female's uterus, and the wait begins to see if any or all of them implant and result in an actual pregnancy.

Success rates of IVF are still rather low. Most centers report pregnancy rates between 10-20%. Since most IVF procedures put more than one embryo into the uterus, the chance for a multiple birth (twins or more) is greatly increased in couples undergoing IVF.

GIFT involves retrieval of both multiple ova and semen, and the mechanical placement of both within the female partner's fallopian tubes, where one hopes that fertilization will occur. ZIFT involves the same retrieval of ova and semen, and fertilization and growth in the laboratory up to the zygote stage, at which point the zygotes are placed in the fallopian tubes. Both GIFT and ZIFT seem to have higher success rates than IVF.

It is very hard to obtain statistics regarding the prognosis of infertility because many different problems may exist within and individual or couple trying to conceive. In general, it is believed that of all couples who undergo a complete evaluation of infertility followed by treatment, about half will ultimately have a successful pregnancy. Of those couples who do not choose to undergo evaluation or treatment, about 5% will go on to conceive after a year or more of infertility.

• Books
• Hornstein, Mark D., and Daniel Schust. "Infertility." In Novak's Gynecology, edited by Jonathan S. Berek. Baltimore: Williams and Wilkins, 1996.
• Martin, Mary C. "Infertility" In Current Obstetric and Gynecologic Diagnosis and Treatment, edited by Alan H. Cecherney and Martin L. Pernoll. Norwalk, CT: 1994. Periodicals
• Intrator, Nancy. "What To Do If You Can't Get Pregnant." Cosmopolitan (December 1995): 154 .
• Mastroianni, Luigi, et al. "Helping Infertile Patients." Patient Care (October 15, 1997): 103 .
• Rosenbaum, Joshua. "Beat the Clock: Treatments for Infertility." American Health (December 1995): 70 .
• Trantham, Patricia. "The Infertile Couple." American Family Physician (September 1, 1996): 1001 . Organizations
• American Society for Reproductive Medicine. 1209 Montgomery Highway, Birmingham, AL 35216-2809. (205)978-5000. http://www.asrm.com.
• International Center for Infertility Information Dissemination. http://www.inciid.org.