Clinical embryology; assisted reproduction in the laboratory

5 important questions on Clinical embryology; assisted reproduction in the laboratory

When has a couple infertility issues?

No pregnancy after > 12 months of unprotected coitus

Treatment options for a couple with infertility issues?

  1. Induction of ovulation -> the induction of ovulation with hormones
  2. intra uterine insemination -> ovulation detection/induction and when ready a motile fraction of semen is inseminated in the uterine cavity
  3. IVF/ICSI
  4. cryopreservation
  5. fertility presevation for man and women

Influencing factors for infertillty for men:

  • Scrotal temperature
  • Intoxication --> chemtherapy, antibiotics, alcohol, smoking, drugs
  • Radiotherapy
  • Psychological stress
  • Excessive sports
  • Overweight
  • Period of abstinence --> storing the semen for more than 5 days will give more dead sperms than living sperm when ejaculating
  • Age

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ICSI and indications for ICSI

an injection of 1 sperm cell in the oocyte, you break the zona pellucida and oolemma otherwise it does not work.
  • Needs to be done slow otherwise the oocyte degenerates
  • indications for ICSI:
    • severe male factors (V.C.M. < 2* 10^6
    • nor fertilization previous IVF-attampt
    • surgically retrieved sperm -> PESA, TESE
    • when using frozen oocytes

Ovarian tissue (auto)transplantation (OTT)

reinsertion after thawing ovarian cortical strips and fragments. This leads to regrowth of the ovary.

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