Infertility and assisted reproductive technology (ART) - with emphasis on In Vitro Fertilisation (IVF). A literary study reviewing the epidemiology, pathology, investigation and treatment (with complications) of both male and female infertility.
Causes of infertility in women include hostile cervical mucus, sexually transmitted diseases such as Chlamydia, pelvic inflammatory disease, endometriosis, tubal dysfunction, problems with ovulation, polycystic ovary syndrome, hormonal imbalance and idiopathic infertility.
Male infertility is an area that has only been researched over the past few years. Exact causes of male infertility are still not known, however, some causes which have been identified include: Exposure to heavy metals, extreme heat, excessive use of alcohol and tobacco, childhood diseases such as mumps, infections, congenital deformities, varicoseles, hormonal imbalance and failed reversal of vasectomy. The investigation of infertility in both genders, treatment with medicines and surgical procedures/evaluations are reviewed.
IVF is used as a panacea (universal treatment) for nearly all infertility problems. The medical indications for IVF, patient selection criteria that optimise IVF success, patient preparation for IVF, medications and hormone stimulation protocols that are used during the IVF cycle, the oocyte retrieval procedure, spermpreparation, insemination, method of cultivation, embryotransfer and luteal phase support are reviewed. The most severe complication in ART is the ovarian hyperstimulation syndrome, which might follow controlled ovarian hyperstimulation. The syndrome may lead to significant morbidity and even mortality.
Intracytoplasmatic sperm injection (ICSI) is a relatively new technique, primarily developed and used in couples where azoospermia or severe oligospermia has been diagnosed. One was concerned for major birth defects.