These procedures aim to achieve fertilization and pregnancy by artificial means. The sperm and egg are united to facilitate their merger, i.e. fertilization.
Artificial insemination (AI) is the deposition of sperm previously treated, i.e. selected and capacitated, inside the female genital tract. This technique can be performed with sperm from the couple, called artificial insemination by husband (AIH) or frozen sperm from an anonymous donor (cryopreserved), which is called artificial insemination by donor (AID).
In Vitro Fertilization (IVF) is the fertilization of two gametes (sperm and eggs) outside the womb, in the laboratory. IVF requires:
– A pre ovarian stimulation to achieve a multiple follicular response
– Puncture of these follicles and oocytes uptake
– Washing, selection and sperm capacitation
– The union of gametes or fertilization in the laboratory
– Implanting the embryo in the uterus in order to achieve an evolutionary gestation.
It is a special type of FIV by injecting a single sperm into the oocyte. It is the intra-cytoplasmic micro-injection of sperm. It is the most commonly used reproduction technique and the most efficient in cases of infertility due to a male problem, as it takes very few normal sperm to achieve a pregnancy.
Although techniques are effective and results can vary depending on the experience of the reproduction centre, the best success rates in cases of severe male factor infertility are those using ICSI techniques, and are generally around 50% of gestations. They are definitely not infallible techniques.
The first objective will be to attempt to correct the problem in the male so that these techniques are not necessary. In the case where this is not possible, the first objective will be to retrieve sperm for reproduction and ensure that sperm are of the highest quality to achieve a better success rate using the technique. On the other hand, the male patient should be explored and studied as far as possible to ensure that there are no secondary genetic abnormalities.
More recently, techniques have been developed that allow a better selection of sperm, such as IMSI with ICSI sperm selection using a high magnification microscope.
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