Treatment of Infertility Flashcards
what is assisted conception treatment (ACT)?
any treatment for infertility which involves gamates outside the body main types - donor insemination - intra-uterine insemination - IVF - intra-cytoplasmic sperm injection
indications for ACT?
couples with infertility who wish to conceive where at least one partner has no biological children
same sex couples in the absence of infertility diagnosis
can be done to preserve fertility in cancer patients, patients undergoing gender reassignment
can be used to prevent transmission of blood viruses like HIV
can be used to allow pre-implantation diagnosis of certain inherited disorders
look at criteria for IVF/ICSI.
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how many cycles of IVF/ICSI can you get on the NHS?
3
“where there is a reasonable expectation of a live birth”
age limit on IVF/ICSI?
treatment cycles must be started by females 40th bday and all subsequent frozen transfers completed before 41st bday
can you get IVF/ICSI if youre over 40?
one full cycle will be offered if theyve never had IVF before and theres no evidence of poor ovarian reserve
what is HFEA?
government regulator responsible for regulating treatment and research around assisted conception and use of embryos
types of ACT available?
intrauterine insemination
IVF
ICSI
surgical sperm aspiration
what is intra-uterine insemination and when can it be done?
sperm is directly placed into uterus to facilitate fertilisation
only possible when sperm and semen are healthy and ovulation is taking place and no tubal disease
how is IUI performed?
cycle can be natural or hormonally stimulated
prepared semen in inserted into uterine cavity at time of ovulation
indications for IUI?
sexual disorders (ED, ejaculation disorders, sexual pain) female same sex relationships (donor sperm) male same sex relationships (surrogacy)
what is IVF?
number of sperm are placed into petri dish with the oocyte
successful sperm undergoes capacitation and fuses with zone pellucida eventually fertilising the ovum and creating a zygote
indications for IVF?
unexplained infertility for >2 years
pelvic disease (tubal disease, endometriosis, fibroids etc)
anovulatory infertility
what is ICSI?
one sperm cell is immobilised and injected directly into the cytoplasm of oocyte
bypasses stages of sperm travelling to ovum, capacitation etc
when is ICSI the preferred option over IVF?
in cases where there are low numbers of sperm, reduced sperm motility or abnormal sperm morphology