Treatments for Infertility

1. Treatments for Infertility Infertility treatments and Contraception are based on the Biology of fertility

2. Learning Outcomes Ovulation can be stimulated by drugs that prevent the negative feedback effect of oestrogen on FSH secretion. Other ovulatory drugs mimic the action of FSH and LH. These drugs can cause super ovulation that can result in multiple births or be used to collect ova for IVF programmes. Artificial insemination is particularly useful where the male has a low sperm count. Several samples of semen are collected over a period of time. If a partner is sterile a donor may be used. Intracytoplasmic Sperm Injection – if mature sperm are defective or very low in number ICSI can be used. In this technique the head of the sperm is drawn up into a needle and injected directly into the egg to achieve fertilisation.

3. Stimulating Ovulation Sometimes there is a failure of the pituitary gland to secrete adequate FSH or LH Ovulation can be stimulated by - drugs that mimic the normal action of FSH and LH - drugs that prevent the negative feedback effect of oestrogen on FSH secretion These drugs can be so effective that they bring about ‘Super Ovulation’ which can lead to multiple births Super ovulation can be used to collect ova for IVF

4. Artificial Insemination This involves the insertion of semen into the female tract by some means other than sexual intercourse It is particularly useful where a male has a low sperm count Several samples of semen are collected and each is preserved (freezing) until required They are then defrosted and released together into the partner’s cervical region during her fertile period

5. The average sperm count in men is 20 to 150 million per millilitre of semen Low sperm count classified as fewer than 20 million sperm per millilitre of semen Artificial insemination is used to treat problems with sperm count Sperm are placed inside the uterus, near an oviduct using a catheter

7. Donor Semen If a partner is sterile, artificial insemination can be used to insert the semen of a donor who has a normalsperm count into the female reproductive tract

8. Intracytoplasmic Sperm Injection (ICSI) This technique is employed when a man’s sperm count is low or, many of the mature sperm are defective The procedure involves drawing a healthy sperm into a needle and injecting it directly into an egg – to achieve fertilisation

11. Try these questions . . . . • How can ovulation be stimulated? • What is artificial insemination? • When would donor semen be used? • Outline the procedure ICSI

12. Answers . . . . • Drugs that mimic the normal action of FSH and LH and drugs that prevent the negative feedback effect of oestrogen on FSH secretion • This involves the insertion of semen into the female tract by some means other than sexual intercourse • If a partner is sterile, artificial insemination can be used to insert the semen of a donor who has a normal sperm count into the female reproductive tract • The procedure involves drawing a healthy sperm into a needle and injecting it directly into an egg – to achieve fertilisation

13. 1. How can ovulation be stimulated? Drugs that mimic the normal action of FSH and LH and drugs that prevent the negative feedback effect of oestrogen on FSH secretion 2. What is artificial insemination? This involves the insertion of semen into the female tract by some means other than sexual intercourse 3. When would donor semen be used? If a partner is sterile, artificial insemination can be used to insert the semen of a donor who has a normal sperm count into the female reproductive tract 4. Outline the procedure ICSI The procedure involves drawing a healthy sperm into a needle and injecting it directly into an egg – to achieve fertilisation