There are different ways to manage infertility. Few of them are mentioned below.
ART –Assisted Reproductive Techniques
A general term referring to methods used to achieve pregnancy by artificial or partially artificial means. This reproductive technology used primarily in infertility treatments.
ART procedures involve surgically removing eggs from a woman’s ovaries, combining them with sperm in the laboratory and returning them to the woman’s body or donating them to another woman.”
It is the process by which sperm is placed into the reproductive tract of a female for the purpose of impregnating the female by using means other than sexual intercourse or natural insemination.
Types of Artificial Insemination
- Intracervical Insemination (ICI): It is the easiest way to inseminate. This involves the deposit of raw fresh or frozen semen by injecting it high into the cervix with a needle-less syringe.
- Intrauterine Insemination – (IUI): After washing, sperms are deposited into the female’s uterus by artificial means.
- Intratubal Insemination: IUI can furthermore be combined with intratubal insemination (ITI), into the fallopian tube although this procedure is no longer generally regarded as having any beneficial effect compared with IUI.
It has to be used in conjunction with ovarian hyper stimulation.
- Advanced maternal age causes decreased success rates;
- Women aged 38–39 years appear to have reasonable success during the first two cycles of ovarian hyper stimulation and IUI.
- However, for women aged ≥40 years, there appears to be no benefit after a single cycle of COH/IUI.
It is therefore recommended to consider in vitro fertilization after one failed COH/IUI cycle for women aged ≥40 years.
IVF – IN VITRO FERTILISATION
In vitro fertilization (IVF) is a process by which egg cells are fertilized by sperm outside the body (in vitro).
The process involves hormonally controlling the ovulatory process, removing ova (eggs) from the woman’s ovaries and letting sperm fertilize them in a fluid medium. The fertilized egg (zygote) is then transferred to the uterus with the intent to establish a successful pregnancy.
COS and Drugs in Treatment of Infertility
Controlled Ovarian Stimulation (COS)
The treatment consists of external administration of hormonal agents (GnRH analogues or antagonists) In order to suppress the endogenous pituitary hormone secretion. It also consists of administration off follicular stimulating hormone.
Below medication are the examples of class of drugs with examples for ovarian stimulation.
|Medications for Ovulation Stimulation|
|Aromatase Inhibitor (Letrozole, Anastrazole)|
|Insulin Sensitizing Agent (Metformin)|
|Gonadotropins (HMG, FSH, LH)|
|Prolactin inhibitor (Bromocriptine, Cabergoline)|
|Medications for Ovulation Induction|
|Medications to prevent premature ovulation|
|(GnRH agonists: Leuprolide, Naferelin, Goserelin)|
|(GnRH Antagonists: Ganirelix and Cetrorelix acetate)|