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=What are the different solutions for these infertile people and the issues ?=
=What are the different solutions for these infertile people and the issues ?=


There are four solution proposed to infertile people :  
They are two solutions for infertile people:  
:*In Vitro Fertilization (IVF)
:*Vivo Method
:*Adoption


'''1. Assisted conception techniques
'''2. Adoption'''''
Here are some Assisted conception techniques: 
<br>'''IVF classical method'''
This technique was developed in the 1970's. First the women are given fertility drugs to stimulate the production of eggs, to increase the chances of success and, they (the eggs) would be surgically removed from the ovaries.
After the removal, the women are given hormones to prepare her to pregnancy. The eggs are fertilized with the sperm in a laboratory and then the embryos implanted in the mother uterus.
'''
<br>Intra-cytoplasmic Sperm Injection'''
This technique is almost the same as IVF but it includes ICSI.  Intra-cytoplasmic Sperm Injection consists in injecting the sperm in the egg, this is particularly useful for men for whom the classical method would fail.
<br><br>'''Intra-Cytoplasmic Morphologically-selected Sperm Injection (IMSI)'''
This technique is the same as ICSI but the sperm are selected morphologically to have only the better ones. This consists in examining sperm under a high-magnification microscope in order to choose those with a shape and size that indicates good genetic quality. Then they are injected in the egg.
'''
<br>Intrauterine insemination'''
Intrauterine insemination (IUI) is another method, it involves the introduction of selected sperm directly into the uterus.
This increases the number of healthy sperm who may reach the fallopian tubes and fertilize an egg.
(Sperm washing, selection of healthy and strong sperm, can be used in IVF techniques also.)
IUI is generally accompanied by ovarian stimulation in order to increase the egg production and improve the rate of success. Sometimes egg selection may be needed too, to have only the healthiest ones.
<br>'''What are the risks?'''
They are many risks with assisted conception techniques, for women undergoing IVF there can be some side effects from fertility drugs or eggs retrieval.
There are two main side effects for women:
<br>'''1.Ovarian hyper-stimulation syndrome'''
OHSS is not common but a known side effect of IVF. This is when the fertility drugs are too successful and ovaries can not deal with a number so high of eggs. If the overstimulation is severe it can produce blood clots and maybe also ovaries damage.
<br>'''2.multiple births'''
This occurs because more than one embryo is put back in the womb with IVF, in order to increase the chances of success. Multiple births increase problems during pregnancy or labour. Because of that NICE recommends a maximum of two embryos are put back into the womb during the treatment.
<br>'''What are the chances of success?'''
The success rate of IVF is determined to  the age of the woman undergoing the treatment. Younger women tend to have healthier eggs which increase the chances of success.
Here are some statistics from the UK
28% for women who are under 35 years of age,
24% for women who are between 35-37 years of age,
18% for women who are between 38-39 years of age, and
11% for women who are between 40-42 years of age.
'''
'''<br> Some ethical questions'''
Coming soon.


{{co|make a short list of those for solutions and then describe each on them}}--[[Utilisateur:Pierre.brawand|Pierre.brawand]] 24 janvier 2009 à 14:27 (MET)


The first solution is the in Vitro Fertilization (IVF). This consists in a fertilization outside the female's body. Sperm cells and mature ovas are taken from the parents' bodies and are feconded in an test tube. 48 hours later, the eggs are replaced in the uterus of the mother. As each egg has a few chances to cause a pregnancy, the more eggs are injected, the more chances the mother has to beecome pregnant. But this can also cause multiple pregnancies for the younger women, which could be hard for the mother, and involve a cesarean.  <br>This method is ethically controverted. As all the pre-embryos created cannot grow in the uterus, some are destroyed or frozen for further experiments or donations. But the people who estimate that the pre-embryo has the same rights as any human being say this is murdering.
{{co|definitely not enough on IVF. You should describe this in a much precise manner and discuss also some ethical questions here.}}--[[Utilisateur:Pierre.brawand|Pierre.brawand]] 24 janvier 2009 à 14:27 (MET)
Another solution is the in vivo method, which consists in stimulating the ovaries and taking sperm cells and one ova from the parents. Then, these gametes are put in contact with eachother and reinjected in the female's body.{{co|What is the difference with IVF??? I don't see this as different...}}--[[Utilisateur:Pierre.brawand|Pierre.brawand]] 24 janvier 2009 à 14:27 (MET)
The artificial fertilization is useful when the male doesn't have enough sperm cells or when the spermatozoides don't have the mobility to reach the uterus. Therefore the sperm cells are taken from the male and directly reimjected in the female's uterus. This can also be done with donated cells, and may be injected into another woman, who will carry the embryo instead of the future mother.
<br>Lastly, the adoption method is proposed when all the solutions above didn't work.
<br>Lastly, the adoption method is proposed when all the solutions above didn't work.


Version du 25 janvier 2009 à 19:52

--PaulineL 13 janvier 2009 à 15:42 (MET) and Debora; Marjorie & Nour --DeboraA 20 janvier 2009 à 16:11 (MET) and Pauline, --DeboraA 25 janvier 2009 à 16:59 (MET)

What is infertility ?

Infertility is the unability for a couple to have a child after one year of unprotected sexual rapport.
For women, this means that they cannot conceive, while for men this consists in an unability to impregnate.


What is the difference between infertility and sterility?

Infertility is biologically the inability for a man or a female to produce gametes, while sterility is the total incapacity to produce naturally. In medical usage, sterility usually refers to inability to produce a live child, while infertility is measured by failure to conceive after 1 year without contraception.

What are the causes of infertility and the different symptoms?

There are many causes of infertility. Below are listed some main ones :

  • Women
  • age
  • sexually transmitted diseases
  • genital damages/abnormalities
  • anovulatory cycle (no ovulation)
  • anorexia or bulimia
  • smoking, drugs, alcohol
  • Men:
  • smoking, drugs, alcohol
  • overheating of the testicles caused by exercise, hot water, tight clothing, excessive sitting (truck drivers) and other conditions and situations
  • sexually transmitted diseases
  • use of some medications (antihypertensives, antidepressants, male hormones, cancer treatment)
  • genital damages/abnormalities


There is different explanation of infertility :

  • The woman can have problems of ovulation:
  • Fallopian tubes obstruction: Some people have Fallopian tubes that are blocked. It may be due to a blockage or damages in one or both fallopian tubes
  • Age-related factors:
  • The man can also be infertile, what reduces twice the chance to manage to have a baby naturally:
  • Men and women can have uterine problems:
  • There are infertility's case that are unexplained:

What are the different solutions for these infertile people and the issues ?

They are two solutions for infertile people:

1. Assisted conception techniques

2. Adoption


Here are some Assisted conception techniques:



IVF classical method

This technique was developed in the 1970's. First the women are given fertility drugs to stimulate the production of eggs, to increase the chances of success and, they (the eggs) would be surgically removed from the ovaries. After the removal, the women are given hormones to prepare her to pregnancy. The eggs are fertilized with the sperm in a laboratory and then the embryos implanted in the mother uterus.
Intra-cytoplasmic Sperm Injection This technique is almost the same as IVF but it includes ICSI. Intra-cytoplasmic Sperm Injection consists in injecting the sperm in the egg, this is particularly useful for men for whom the classical method would fail.

Intra-Cytoplasmic Morphologically-selected Sperm Injection (IMSI) This technique is the same as ICSI but the sperm are selected morphologically to have only the better ones. This consists in examining sperm under a high-magnification microscope in order to choose those with a shape and size that indicates good genetic quality. Then they are injected in the egg.


Intrauterine insemination Intrauterine insemination (IUI) is another method, it involves the introduction of selected sperm directly into the uterus. This increases the number of healthy sperm who may reach the fallopian tubes and fertilize an egg. (Sperm washing, selection of healthy and strong sperm, can be used in IVF techniques also.) 

IUI is generally accompanied by ovarian stimulation in order to increase the egg production and improve the rate of success. Sometimes egg selection may be needed too, to have only the healthiest ones.


What are the risks?

They are many risks with assisted conception techniques, for women undergoing IVF there can be some side effects from fertility drugs or eggs retrieval. There are two main side effects for women:
1.Ovarian hyper-stimulation syndrome

OHSS is not common but a known side effect of IVF. This is when the fertility drugs are too successful and ovaries can not deal with a number so high of eggs. If the overstimulation is severe it can produce blood clots and maybe also ovaries damage.


2.multiple births This occurs because more than one embryo is put back in the womb with IVF, in order to increase the chances of success. Multiple births increase problems during pregnancy or labour. Because of that NICE recommends a maximum of two embryos are put back into the womb during the treatment.


What are the chances of success?

The success rate of IVF is determined to the age of the woman undergoing the treatment. Younger women tend to have healthier eggs which increase the chances of success.

Here are some statistics from the UK

28% for women who are under 35 years of age, 24% for women who are between 35-37 years of age, 18% for women who are between 38-39 years of age, and 11% for women who are between 40-42 years of age.
Some ethical questions

Coming soon.



Lastly, the adoption method is proposed when all the solutions above didn't work.

References

http://pedsinreview.aappublications.org/cgi/content/full/20/8/e28
http://www.101lifestyle.com/health/infertility/infertility.html
http://www.chu-toulouse.fr/-l-infertilite-
http://www.ncbi.nlm.nih.gov/pubmed/12268268
http://www.emedicinehealth.com/infertility/article_em.htm
wordnet.princeton.edu/perl/webwn
http://www.andrologia.org/eng/maschile_engl.htm

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