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Home Gynecology and Obstetrics

Assisted productive techniques (ART)

Dr.Galal Baligh by Dr.Galal Baligh
May 23, 2020
in Gynecology and Obstetrics
182 8
0
ASSISTED REPRODUCTIVE TECHNIQUES

ASSISTED REPRODUCTIVE TECHNIQUES

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1 1. Artificial insemination:
1.1 Indications:
1.2 Technique:
2 2. IVF & ET (in vitro fertilization & embryo transfer).
2.1 Indications:
2.2 Technique:
3 3. GIFT (gamete intrafallopian transfer).
3.1 Indications:
3.2 Technique:
4 4. ZIFT (zygote intrafallopian transfer) (not widely used).
4.1 Indication: failure of IVF.
4.2 Technique: sperm is injected into subzonal space through a hole made in zona pellucida.
5 6. ICSI (intracytoplasmic sperm injection).
5.1 Indications:
5.2 Technique:

 

1. Artificial insemination:

Indications:

A. Male causes:

a) Failure of deposition of semen e.g. hypospadius.

b) Oligospermia. c) Asthenospermia.

B. Female causes:

a) Hostile cervical mucus

b) Severe RVF (external os).

c) Vaginismus.

Technique:

1. Induction of ovulation, then rupture follicle by hCG when the follicle is 18 mm or more in diameter.

2. Processed semen (0.5 ml) is injected inside the uterine cavity 12-36 hours after rupture of follicle using special catheter

3. The injection maybe in any where of genital tract e.g. intracervical, intrauterine (the commonest), intratubal, intrafollicular & intraperitoneal.

N.B.: Processed semen: preparation of semen for selection of highly motile sperms& removal of PGs that may cause uterine contractions.

ASSISTED REPRODUCTIVE TECHNIQUES
ASSISTED REPRODUCTIVE TECHNIQUES

2. IVF & ET (in vitro fertilization & embryo transfer).

Indications:

A. Male causes: oligospermia.

B. Female: 1. Tubal factor of infertility. 2. Cervical factor of infertility. 3. Immunological infertility. 4. Endometriosis.

C. Unexplained infertility.

ASSISTED REPRODUCTIVE TECHNIQUES
ASSISTED REPRODUCTIVE TECHNIQUES

Technique:

1. Induction of ovulation: as artificial insemination.

2. Multiple ova are aspirated using U/S directed needle under local or general anesthesia (32 hours after HCG injection)

3. Fertilization: prepared semen added to the aspirated ova in a culture media.

4. Embryo transfer: 8-cell stage is transferred to uterus by transcervical catheter.

3. GIFT (gamete intrafallopian transfer).

Indications:

A. Male infertility: abnormal semen i.e. semen prepared then injected.

B. Female causes: endometriosis externa & hostile cervical mucus.

C. Failure of IVF.

Technique:

1. Induction of ovulation: as IVF.

2. Aspiration of ova: as IVF.

3. Mixed gametes (ova and sperms) are injected into ampullary part by laparoscope.

4. ZIFT (zygote intrafallopian transfer) (not widely used).

♦ As GIFT but gametes kept some time forming zygote which is injected into tube.

5. SUZI(subzonal sperm injection)

Indication: failure of IVF.

Technique: sperm is injected into subzonal space through a hole made in zona pellucida.

6. ICSI (intracytoplasmic sperm injection).

Indications:

1. Failure of IVF for 3 cycles.

2. Male causes: marked oligospermia <80,000 in the specimen & immotile alive sperms.

3. Anti-sperm antibodies.

Technique:

single sperm (nuclear material) is injected into the cytoplasm of the oocyte by micropipette under microscopy at the site 3 o’clock.

Tags: Infertility
Dr.Galal Baligh

Dr.Galal Baligh

OB-GYN Specialist

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