The most commonly used assisted fertilization techniques
In recent years, we have witnessed a significant surge in couples or single women turning to assisted fertilization. This makes it even more crucial to understand the various assisted fertilization techniques available and identify which are the most commonly used and efficient.
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Assisted fertilization techniques are typically divided into first, second, and third-level procedures. The first level includes artificial insemination, which involves introducing male sperm, after being processed in a lab, into the uterine cavity. This is done in tandem with ovulation monitoring, to facilitate the natural meeting of the two gametes. This method is recommended for couples where the woman has ovulation issues or when the man has conditions of low sperm motility or concentration.
In vitro fertilization
One of the most widespread procedures in Italy, as well as abroad, is undoubtedly in vitro fertilization. This treatment involves the union of gametes outside the woman’s body. The embryo is then transferred to the uterus later on. It is essential to differentiate between IVF (in vitro fertilization with Embryo Transfer) and the ICSI technique. The latter stands for intracytoplasmic sperm injection and is suggested when sperm have significant motility issues.
IVF is recommended when there has been no positive outcome with artificial insemination, or when the woman has significant damage to her Fallopian tubes or advanced endometriosis. If the issue revolves around sperm quality, IVF can also be conducted using a donor’s sperm. This kind of fertilization relies on ovarian stimulation, which can last anywhere from 10 to about 20 days. The egg retrieval is then done under sedation in an operating room. Once the eggs are retrieved, they are placed on a culture dish and surrounded by sperm to be fertilized by the partner’s sperm. Of the embryos obtained, only the best are transferred to the patient’s uterus. This process is painless and swift.
The intracytoplasmic sperm injection falls under in vitro fertilization. The initial steps are the same as IVF. However, with the ICSI technique, the sperm is directly injected into the egg using a small cannula.
ICSI is recommended when the sperm quality is poor, when the male partner has difficulties achieving ejaculation, or has undergone a vasectomy.
Heterologous fertilization based on the egg donation technique involves an assisted fertilization method where the sperm or egg does not come from the intended parents but belongs to a third-party donor.
Heterologous fertilization with donor sperm
If fertility issues arise from the male partner, such as in cases of absence of sperm, it’s possible to proceed with heterologous fertilization using donor sperm. Samples related to the donation undergo a 6-month quarantine to rule out the presence of sexually transmitted diseases. Furthermore, as is also done with egg donation, the entire family and clinical history of the donor is retraced. This is done to eliminate the risk of genetic diseases. Only after conducting these essential procedures is the sample used for fertility treatments.
Currently, fertility preservation techniques are available. These offer the opportunity to delay pregnancy, for instance, when a patient has an oncological condition. With this method, mature eggs can be cryopreserved to be used later, maintaining the same likelihood of a positive outcome as at the time of vitrification.