What are the assisted reproductive techniques used to overcome the problem of infertility?

 What are the assisted reproductive techniques used to overcome the problem of infertility?


In 1978, the world witnessed the birth of the first “test-tube baby”. Since then, assisted reproduction technology (ART) technology has exploded. Recent optimizations for in vitro fertilization (IVF) delivery, including the use of minimal stimulation protocols and gonadotropin-releasing hormone (GNRH) agonist cycle triggers, are increasingly being leveraged to maximize patient safety.

As these related applications of ART become more and more used, it is the responsibility of society to ensure that they provide these resources in a morally responsible and impartial manner.

 In this article, we will talk about the old and recent technologies used in ART to overcome infertility. 1978, the world witnessed the birth of the first “test-tube baby”. Since then, assisted reproduction.

Introduction

In July 1978, the world witnessed the birth of Louise Brown. This is the first successful pregnancy by in vitro fertilization (IVF) performed by the doctor. Robert Edwards and Patrick Steptoe. Since then, advances in assisted reproductive technology (ART) have undergone explosive development and growth. What many perceived as a controversial medical curiosity in 1978 has radically changed the prognosis of couples suffering from infertility and is increasing the proportion of births worldwide. Much of ART’s progress has increased success rates and offered a wide range of options for couples undergoing treatment.

Technological advances currently being developed and completed have the potential to transform the field of ART into the future in even more dramatic and exciting ways. Some of these technologies, focusing on a genetic assessment of developing embryos or cryopreservation of oocytes, impact people’s health care with or without a diagnosis of infertility. increase. This article discusses some of the latest innovations in ART and how these technologies will affect the future.

The roots of ART

Artificial insemination In 1779, an Italian priest and physiologist named Lazzaro Spallanzani, who proved in the laboratory that sperm contained nuclei and cytoplasm16, showed the need for sperm for fertilization. For the first time, they established embryos develop through physical contact between egg cells and sperm cells20. 

With this new discovery, Spallanzani fertilized the dog21. He also conducted experiments showing that sperm can be inactivated by cooling and later reactivated22. Another important discovery was the discovery of Karl Ernst Von Veil, who discovered mammalian eggs in 1827 and contributed significantly to embryology16. In Russia, a pioneering effort by Ivanov (1922) 23 to establish AI as a practical process has begun. 

This development by Ivanov led to further advances in technology and stimulated research outside Russia in other Western countries23. However, while animal AI quickly became an industry, it took several years to bring this technology to humans. Eleven years after Spallanzani’s experiment, they made the first successful AI attempt on women. The first documented report on the use of AI was by Scottish surgeon Dr. John Hunter, in the late 1770s.

Evolution of IVF

IVF has literally changed the field of infertility since its introduction in 1978. Initially, the techniques required to perform IVF were immature and the pregnancy rate was relatively low. However, important milestones for completing IVF, such as controlled ovarian hyperstimulation, support for the luteal phase, and the use of improved media, were rapidly developing.

Other significant advances soon followed the development of intracytoplasmic sperm injection (ICSI), assisted hatching, and the description of optimized ET techniques. These advances have improved both ART-related success rates and the number of infertility treatment candidates.

Advancement in Laboratory

Perhaps the most important factor in the dramatic improvement in IVF pregnancy rates over the last 1015 years has been a technological change in embryology laboratories. Of these changes, the integrity of the embryo culture medium was probably the most important.

 In fact, pregnancy rates have skyrocketed since introducing the medium formulation entitled “Human Tubal Fluid” in 1985. Since that time, there has been essentially some improvement in the embryo's composition culture medium, which is continuously improving IVF results. Various other changes are constantly being evaluated to optimize the embryology laboratory. One such change that is the subject of much research today is the optimal oxygen concentration in the embryo incubator.

Insights on IVM

In vitro maturation (IVM), the ability to mature oocytes in the laboratory is another technique currently being completed in many centers. IVM is a method of recovering immature human oocytes, as currently described, and then completes the transition from prophase I to metaphase II, including extruding the first polar body, in vitro.

 Over the last decade, there have been many changes to the IVM protocol, including preparation with hCG, follicle-stimulating hormone (FSH), and/or luteinizing hormone (LH), and specific changes in the IVM oocyte medium. Procedures for obtaining oocytes for IVM are also ongoing. These changes have led to some relatively small studies reporting IVM pregnancy rates, albeit lower than the IVF cycle. IVM does not seem to have the following major risks compared to the IVF cycle: B. Embossing error to bring it.

They often cite techniques that can eliminate the risk of OHSS in patients with PCOS as the major advantage of IVM. 

The Contribution of cryopreservation

Perhaps the most important advancement in embryological experimental techniques in recent years lies in cryopreservation. The concept of gamete cryopreservation is not new. In 1942, the cryopreservation of mammalian sperm cells and subsequent resuscitation were first described. It achieved the application of cryopreservation to in vitro fertilized embryos relatively early in 1983 when the first pregnancy because of cryopreserving embryos was reported.

 Since then, the process of cryopreservation of embryos has developed. For example, they currently expose embryos to low concentrations of glycerol and sucrose-supplemented propanediol before cryopreservation to reduce intracellular water levels. These compounds result in a reduction in intracellular ice crystal formation that may be associated with cryopreservation. New vitrification techniques require lower concentrations of these compounds, thus theoretically minimizing potential embryotoxicity concerns.

At the last

The extent of recent advances in assisted reproductive technology is overwhelming. ART has had a great impact on medicine since its introduction in 1978. Today’s mature and horizon-visible techniques have the potential to extend the use of ART to a wide range of sections of society, with or without a diagnosis of infertility. For couples with infertility, these advances promise to further improve the effectiveness, convenience, and availability of infertility treatment while reducing costs through economies of scale and other efficiencies. 

Reference-https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/Assisted-reproductive-technology-IVF-and-ICSI


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