Embryo Transfer Technology

In vitro fertilization (IVF) is formation of embryo in culture condition. IVF tools have dramatically improved in the years. IVF was initially indicated for women with tubal factor infertility, but in the present scenario, it is the treatment of choice fo

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Abstract

In vitro fertilization (IVF) is formation of embryo in culture condition. IVF tools have dramatically improved in the years. IVF was initially indicated for women with tubal factor infertility, but in the present scenario, it is the treatment of choice for all causes of infertility where the conventional or conservative methods fail. The chapter covers various factors responsible for male and female infertility, technique of in vitro fertilization, preimplantation genetic diagnosis and factors such as ovarian hyperstimulation syndrome, and ethical issues associated with the field.

15.1

Introduction

In vitro fertilization (IVF) is formation of embryo in culture condition. IVF tools have dramatically improved in the years. IVF was initially indicated for women with tubal factor infertility, but in the present scenario, it is the treatment of choice for all causes of infertility where the conventional or conservative methods fail.

15.2

Infertility

Infertility is the inability to conceive after 12 months of unprotected intercourse. In a study prediction based upon fecundability is the probability of achieving pregnancy in one menstrual cycle (20–25 % in healthy young couple). With the fecundability of 0.25, 98 % of

couples should be able to conceive within 13 months. In the modern society, the infertility rates are stable but the number of couples without children has increased. Infertility may be due to reduced conception rates or the need for medical help; however, male factor is responsible in 25 %, female factor in 58 %, and without any reason in 17 %. Initial evaluation of the possible cause of infertility is very important. Initial evaluation requires discussion about the timing and frequency of intercourse, prevalence of risk factors (smoking, alcohol, caffeine, obesity), and finally the investigations (semen analysis in male, confirmation of ovulation in the female, tubal patency in female). Psychological aspects should be assessed, as stress management is essential as it influences the associated processes; counseling may be done if required [2].

© Springer Science+Business Media Singapore 2017 V. Gupta et al., Basic and Applied Aspects of Biotechnology, DOI 10.1007/978-981-10-0875-7_15

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15.2.1 Male Infertility Male factor infertility nowadays can be treated. The reasons and their treatment options are available. In normal condition, there is pulse of luteinizing hormone (LH) in every 1–3 h. Elevated LH suggests primary defect at testicular level, with problems in sperm motility and transport. Low LH suggests defects at hypothalamic–pituitary level. Low testosterone leads to male factor infertility. High follicle-stimulating hormone (FSH) indicates damage to the seminiferous tubules. Patients with primary testicular defects and problems associated with sperm motility are suitable candidates for IVF. Initial treatment is dependent upon sperm concentration and motility. If the sperm count is 15–20 × 106/ml with normal motility, it is mild male factor infertility; if counts ar