BIOL124 - Lecture 12 - Infertility (Causes and treatments)

What is the definition of infertility?

The absence of a clinical pregnancy after an appropriate duration of attempting conception by regular intercourse

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What is the cause of infertility in males?

Sperm production is in low numbers, low motility and unhealthy appearance.

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What is the cause of infertility in females?

Blocked fallopian tube, abnormal/no ovulation, Polycystic Ovarian Syndrome (PCOS), Uterine problems

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If someone has a low sperm count, what options do they have?

Artificial insemination using concentrated, pooled or donor sperm.

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If someone has uterine damage or inability to sustain pregnancy, what options do they have?

Hormone therapy with progestins, insertion of zygote or cleavage stage into uterus of surrogate mother.

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If someone has impaired transport of oocyte sperm, or zygote,

Collect oocytes and sperm, then fertilize in uterine tube (GIFT), fertilize in vitro and insert zygote in uterine tube (ZIFT), fertilize in vitro and insert cleavage stage into uterine tube or uterus.

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If someone has inadequate oocyte production or abnormal oocytes, what options do they have?

You could stimulate oogenesis with fertility drugs, or obtain oocytes from suitable donors.

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What is the criteria for normal seminal fluid?

Volume greater than 2.0ml, sperm count greater than 20 million per ml, at least 50% of sperm show forward movement within 60 min of ***********, at least 30% of sperm have normal morphology, at least 75% of sperm are live, fewer than 1 million wbc.

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Why are multiple sperm required for successful fertilisation?

.

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How can a low sperm count be counteracted?

Sperm can be concentrated by centrifugation. It can be washed to remove inhibitory factors such as dead sperm and white blood cells. Intrauterine insemination can be conducted.

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What is GIFT?

Gamete intrafallopian transfer

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What is the process of GIFT?

1.) Oocytes collected from stimulated ovaries 2.) Mixed with prepared sperm 3.) Inserted into oviduct

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What is ZIFT?

Zygote Intrafallopian Transfer

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What is the process of ZIFT?

1.) Oocytes collected from stimulated 2.) Mixed with prepared sperm and sperm allowed to fertilise Oocytes 3.) Inserted into oviduct.

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What is Azoospermia?

It is the absence of motile sperm

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How can one get around Azoospermia?

Artificial insemination by donor (AID), sperm collected from an anonymous donor, these are screen for HIV, hepatitis, cytomegalovirus, are frozen in a sperm bank.

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If someone has functional sperm, what can be done?

Surgical sperm extraction

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What happens in IVF?

Cumulus cells are removed after 16-18 h, by pipetting. Eggs are checked from pronuclei and polar bodies. They are checked at 24 hours for cleavage. Embryos are transferred to the uterus at 2 or 5 days.

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What is ICSI?

Intracytoplasmic sperm injection - it is when a single sperm is injected into the egg. You can also inject spermatid nuclei but this is controversial.

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What is ROSNI?

Round spermatid nuclei injection - this can be used when there are no mature sperm present but there is a low success rate and difficult to identify round spermatids.

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What is PGD?

Preimplantation genetic diagnosis

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What is PGD performed on?

Blastocyst embryo

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BIOL124 - Lecture 12 - Infertility (Causes and treatments)

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