Article

Generally, couples facing infertility can first explore medication or surgical options. If these methods prove ineffective, more advanced assisted reproductive technologies (ART) can be employed to facilitate the successful union of sperm and egg, leading to pregnancy.

Medication Treatments

Hormonal therapies, including both oral and injectable medications, are used to correct hormonal imbalances within the body, thereby inducing ovulation.

Surgical Treatments

For women, surgical intervention may be necessary if reproductive organ abnormalities contribute to infertility. Conditions like infections or endometriosis can be treated through laparoscopic surgery to remove endometrial tissue and separate adhesions affecting the fallopian tubes and ovaries. In cases of azoospermia in men, surgical techniques can retrieve sperm directly from the testis or upper vas deferens for intracytoplasmic sperm injection (ICSI).

Assisted Reproductive Technologies

These advanced artificial techniques typically involve stimulating the development of multiple follicles with medication, followed by retrieval of mature eggs for artificial fertilisation.

1. Intrauterine Insemination (IUI)

   This method involves introducing sperm into the uterine cavity using artificial means, which can improve the chances of conception over three to four cycles. It is suitable for cases where the male partner has generally normal sperm and the female partner's fallopian tubes are unobstructed, with a success rate of about 15%. The procedure involves:

   • Stimulating follicle maturation and ovulation with medication.
   • Conducting 2-3 transvaginal ultrasound examinations to monitor follicle development.
   • Collecting semen, washing it, and using a fine catheter to place selected active sperm into the uterine cavity, allowing sperm to swim naturally into the fallopian tubes to fertilise the egg.

   • Conducting a pregnancy test.

      

2. In Vitro Fertilisation (IVF)

   In this process, sperm and eggs are cultured outside the body until they form embryos, which are then implanted back into the uterus. This method is appropriate for those with blocked fallopian tubes, poor sperm quality, or unexplained infertility. The procedure entails:

   • Using medication to induce ovulation and possibly suppress internal hormone production.
   • Performing transvaginal ultrasounds to monitor follicle maturation.
   • Retrieving the eggs and collecting sperm on the same day.
   • Fertilising the eggs with sperm.
   • Transferring the embryo back into the uterus 2-3 days post-fertilisation.

   • Conducting a pregnancy test.

      

3. Gamete Tubal Transfer (GIFT)

   Similar to IVF, but the fertilisation occurs within the body. Selected eggs and sperm are placed back into the fallopian tubes via laparoscopy, allowing for natural fertilisation. This method is suitable when the fallopian tubes are open.

    

4. Intracytoplasmic Sperm Injection (ICSI)

   This involves extracting the female egg and using precision instruments to inject a single sperm directly into the egg's cytoplasm under a microscope. The fertilised egg then develops into an embryo, which is placed back into the uterine cavity. This innovative technique addresses severe male infertility, such as poor sperm quality.

    

5. Zygote Intrafallopian Transfer (ZIFT)

   If the patient's fallopian tubes are clear, the fertilised egg can be injected with sperm and then placed back into the fallopian tube through laparoscopic surgery.