Assisted reproductive technology (ART) is the abbreviation for human assisted reproductive technology (ART), which refers to the use of medical aids to enable infertile couples to obtain a pregnancy, and includes two major categories: artificial insemination (AI) and in vitro fertilization-embryo transfer (IVF-ET) and their derivative technologies.
Part I: What is IVF?
”IVF” is the common name for the in vitro fertilization-embryo transfer (IVF-ET) technique. “IVF is not a baby that is actually grown in a test tube. Instead, several eggs are removed from the woman’s ovaries, combined with the man’s sperm in a laboratory to form an embryo, which is then transferred to the woman’s uterus where it can implant and become pregnant. Because normal conception requires the sperm and egg to meet in the woman’s fallopian tube, the two unite to form a fertilized egg, which then returns to the uterine cavity to continue the pregnancy. Therefore, IVF can be simply understood as the replacement of the fallopian tube by a laboratory test tube and is called “in vitro fertilization”.
At present, IVF (in vitro fertilization) is mainly used for infertility caused by incompetent fallopian tubes or ovulation difficulties in the female partner and oligozoospermia or azoospermia in the male partner. “The average success rate of IVF is about 40%, and the younger the woman, the higher the success rate. Studies have shown that offspring born through IVF are almost as healthy as those born from natural pregnancies. Currently, tens of thousands of IVF babies are born worldwide each year.
Types of IVF.
(i) First-generation IVF (in vitro fertilization-embryo transfer, IVF-ET) is a technique in which the sperm and eggs of a couple with infertility are removed, fertilized and developed into embryos in the culture medium of an in vitro dish, and then selected to be transferred into the uterine cavity of the patient for implantation to achieve pregnancy. It is suitable for.
1.Female tubal infertility: The female partner has obstacle in transporting gametes (sperm and eggs) due to tubal factors, including bilateral tubal blockage, tubal agenesis (removal), tubal effusion, tubal sterilization or severe pelvic adhesions that lead to loss of tubal function, etc., especially if conception fails even after surgical unblocking and plastic surgery.
2. Ovulation disorder of the female partner.
3. Endometriosis of the female partner.
4.Male infertility: such as infertility due to few, weak, deformed sperm or male causes of compound factors.
5.Infertility of unknown cause.
6.Immune infertility.
(II) Second generation IVF (intracytoplasmic single sperm injection, ICSI) is the direct injection of a single sperm into the oocyte plasma to fertilize it with the help of a microscopic operating system. As a derivative technology of IVF-ET, ICSI is mainly used to treat severe male infertility. It is suitable for.
1, severe oligospermia, weak and teratogenic spermatozoa.
2, azoospermia: azoospermia caused by dysplasia or obstruction of the vas deferens, azoospermia caused by testicular failure or testicular dysplasia and dead spermatozoa and other diseases.
3. Unexplained infertility: These patients may have sperm and egg fertilization disorders that are currently undetectable.
4.Immune infertility. If it is clear that the infertility is caused by anti-sperm antibodies, ICSI is feasible.
5, First generation IVF (in vitro fertilization-embryo transfer, IVF-ET) without fertilization or with low fertilization rate.
6. Abnormal sperm acrosome.
(3) The third generation of IVF (pre-implantation genetic diagnosis, PGD) is mainly used for various genetic diseases with clear etiology, such as monogenic diseases and chromosomal translocations, etc. PGD is to avoid the birth of children with genetic defects, based on in vitro fertilization-embryo transfer technology, combined with embryo microscopic operation, molecular genetics and molecular biology and other technologies, one or two cells are removed from the obtained embryos for genetic diagnosis and selection of sperm acrosome. cells for genetic diagnosis and the selection of healthy embryos for transfer into the uterine cavity. It is the earliest form of prenatal diagnosis and an effective way to guide the development of human assisted reproduction technology toward eugenics. It is suitable for.
1.Monogenic diseases: such as thalassemia, progressive muscular dystrophy, etc.
2, sex-linked genetic diseases: such as hemophilia, G-6PD deficiency, etc.
3, chromosomal structure and number abnormalities: rosette translocation, balanced translocation, etc. .
4.High-risk groups who may give birth to abnormal children: women of advanced age (≥37 years old); those who have repeatedly failed IVF; those who have habitual miscarriages with chromosomal normalities in both spouses or those who have given birth to children with chromosomal abnormalities.
Cost of IVF.
The cost of doing IVF generally includes the following three parts.
1. The cost of ovulation-promoting drugs for the female partner, which can vary greatly due to the use of imported and domestic drugs, ranging from about 5,000 to 15,000 yuan. In addition, the older you are, the greater the amount of medication used, the higher the cost.
2.The cost of surgery and laboratory operation, the cost of this part varies depending on the different treatment methods.
3. The cost of treatment for the male partner’s oligospermia or azoospermia, the cost of this part varies according to different treatment methods.
The total cost of IVF: 30,000~40,000 RMB for the first generation of IVF (in vitro fertilization-embryo transfer, IVF-ET), 40,000~50,000 RMB for the second generation of IVF (intracytoplasmic single sperm microinjection, ICSI), and 60,000~70,000 RMB for the third generation of IVF (pre-implantation genetic diagnosis, PGD).
Part 2: What is artificial insemination?
Artificial insemination (AI) is the insertion of semen into the reproductive tract of a woman through non-coital means. Depending on the source of the sperm, AIH (artificial insemination by husband) or AID (artificial insemination by donor) is classified. Among them, intrauterine insemination (IIUI) is the more frequently used method with a high success rate and has become the preferred method of artificial insemination for infertile women with patent fallopian tubes.
The basic prerequisites for IUI include sufficient sperm in the male partner’s semen, and at least one of the female partner’s fallopian tubes is open and the ovaries on that side are ovulating normally. Therefore, IUI cannot be performed in patients with azoospermia.
Indications for artificial insemination by husband (AIH)
1, mild to moderate male partner sperm or semen abnormalities, such as oligospermia, weak spermia, teratozoospermia, oligo-weak teratozoospermia, severe reduction in semen volume, long liquefaction time or non-liquefaction of semen.
2, male partner sexual dysfunction, such as hypospadias; spinal cord injury; retrograde ejaculation; functional ejaculation disorders, such as penile erectile dysfunction, premature ejaculation, and non-ejaculation.
3, female party cervical factors, such as cervical stenosis, cervical mucus thickening, cervical mucus scarcity.
4.Ovulation disorder of the female party.
5.Mild to moderate endometriosis in the female side.
6. Immune factors, such as positive anti-sperm antibodies in male semen and positive anti-sperm antibodies in female (cervical, blood).
7. Unexplained infertility.
Cost of artificial insemination.
The cost of artificial insemination generally includes the following three parts. The first is the cost of ovulation promotion drugs for the female. The second is the cost of surgery and laboratory operation, such as semen washing and optimization treatment. The third is the cost of treatment for sperm/semen abnormalities or sexual dysfunction in the male partner, which varies depending on the treatment method.
Total cost of doing artificial insemination: 3,000 to 8,000 RMB.