Human Biology - Chapter 14 Technologies are available to assist in reproduction

What is infertility?

Defined as being unable to become pregnant despite frequent unprotected sex over the period of at least a year

What percentage of infertility is attributed to problems with sperm?

About 40% of infertility is due to problems with sperm.

What percentage of infertility is due to problems in the female reproductive system?

Another 40% of infertility is due to problems in the female reproductive system.

What percentage of infertility is caused by a combination of male and female factors?

The remaining 20% of infertility is due to a combination of male and female factors.

What are the essential qualities sperm must possess to fertilize an egg?

Able to swim forward, in excessive amounts, be able to penetrate the zona pellucida and corona radiata

How can problems with sperm qualities impact the chances of pregnancy?

Problems with sperm qualities can greatly reduce the chance of pregnancy by hindering their ability to fertilize an egg.

What are some factors that may result in male infertility?

Factors include semen flowing into the bladder, the development of antibodies against sperm by the male's immune system, blockages in the male reproductive tract (especially the vas deferens), and hormonal imbalances affecting sex drive and sperm production.

What happens to the number of healthy eggs in females as they get older?

The number of healthy eggs remaining decreases as females get older, greatly reducing the chance of pregnancy, especially after the age of 36.

What is Polycystic Ovarian Syndrome (PCOS), and how does it affect fertility?

PCOS is a hormonal condition where the ovaries contain many partially formed follicles that fail to mature, preventing the release of eggs and making fertilization impossible, thus affecting fertility.

What is Hyperprolactinemia, and what can cause it?

Hyperprolactinemia is a condition characterized by high levels of the hormone prolactin. It may occur in people with pituitary tumors, hypothyroidism, and PCOS, leading to intermittent or lack of ovulation.

What happens once a female has gone through menopause in terms of ovulation?

Once a female has gone through menopause, she will no longer be ovulating, making pregnancy impossible.

What is early menopause, and how does it affect fertility?

Early menopause, also known as primary ovarian insufficiency, occurs when some females experience menopause before the age of 40, rendering them unable to get pregnant from that time onward.

How can cancer treatments impact fertility in women?

Cancer treatments may cause primary ovarian insufficiency and infertility. In women younger than 30, this may be temporary, and fertility might return after treatment. However, the older a woman is, the less likely her fertility will return.

What percentage of women does endometriosis affect?

Endometriosis affects approximately 10% of women.

What is endometriosis, and where do the cells of the endometrium grow in this condition?

Endometriosis is a painful condition where the cells of the endometrium grow outside the uterus.

How can endometriosis affect fertility?

Endometriosis can affect fertility by causing scar tissue or distortion of the uterine tubes, which may block the egg's release or pathway through to the uterus.

What are fibroids, and where do they typically grow in the uterus?

Fibroids are benign growths that typically grow in the muscular part of the uterus.

Do fibroids commonly affect fertility, and if so, how?

Fibroids only affect fertility if their location distorts the uterine cavity or blocks the uterine tubes.

What can cause blockages of the uterine tubes, leading to fertility issues? (in terms of STIs)

Blockages of the uterine tubes can be caused by infections like gonorrhea or chlamydia, as well as damage from conditions like ectopic pregnancies.

How can problems with the menstrual cycle impact fertility?

Problems with the menstrual cycle can affect fertility by influencing the implantation of the blastocyst.

What role do hormonal imbalances play in fertility issues?

Hormonal imbalances can reduce the development of the endometrium and its maintenance, which can impact fertility.

What factors determine the method of treating infertility?

The method of treating infertility depends on the underlying cause of the issue.

Can infertility problems sometimes be corrected to enable natural conception?

Yes, in some cases, infertility issues can be corrected, allowing couples to conceive naturally.

What techniques are used when natural conception is not possible due to infertility?

When natural conception is not possible, techniques are used to assist fertilization and the maintenance of pregnancy.

How can microsurgery help address infertility issues?

Microsurgery can be used to solve some infertility problems by opening blocked uterine tubes and sperm ducts, as well as by removing fibroids or endometriosis.

What is ovulation tracking, and how is it done?

Ovulation tracking involves identifying the most fertile time in a female's menstrual cycle. This can be done through a series of blood tests that monitor luteinizing hormone levels.

When does the surge in luteinizing hormone occur in relation to ovulation?

The surge in luteinizing hormone occurs just before ovulation.

How can blood tests help a couple determine the best time for conception?

Blood tests can monitor luteinizing hormone levels to identify the most fertile period for a couple, increasing their chances of conception.

How long does sperm remain viable in the uterine tubes, and how long does an egg survive?

Sperm can remain viable for two to three days in the uterine tubes, while an egg only survives for 24 hours.

What is the ideal timing for insemination to maximize the chance of conception?

The highest chance of conception occurs through insemination before ovulation.

What are the two types of drugs used to induce the development of follicles in cases of infertility due to low hormone levels?

Clomiphene and hormone injections of FSH are used to induce follicle development.

How does Clomiphene work in treating infertility related to low hormone levels?

Clomiphene stimulates the body to produce more FSH (follicle-stimulating hormone) to induce follicle development.

What is the purpose of hormone injections of FSH in infertility treatment?

Hormone injections of FSH are used to increase blood levels of the hormone, aiding in the development of follicles.

What hormone is used to trigger ovulation once the follicle has matured?

Human chorionic gonadotrophin (hCG) is used to trigger ovulation once the follicle has matured.

Why might females affected by hyperprolactinemia require treatment to lower their prolactin levels?

Lowering prolactin levels is necessary for females with hyperprolactinemia to enable ovulation.

How can oral medication help in restoring normal levels of prolactin for females experiencing infertility due to hyperprolactinemia?

Oral medication is available to restore normal levels of prolactin, which, in turn, helps restore ovulation in females with hyperprolactinemia.

What is Artificial Insemination, or Intrauterine Insemination (IUI)?

Artificial insemination, or IUI, is a process where sperm is released into the uterus via a catheter inserted through the cervix, increasing the chance of pregnancy by helping sperm reach the uterine tubes.

How is the sperm introduced into the uterus during IUI?

The sperm sample is injected into the uterus through a catheter, allowing it to move naturally through the uterine tubes, potentially fertilizing an egg.

What are the advantages of using IUI for artificial insemination?

IUI provides control over the sperm being inseminated, whether it's from the male partner or a donor. Sperm is collected, analyzed, processed, and concentrated to ensure high-quality sperm are used.

Can sperm for IUI be collected and frozen for storage?

Yes, sperm can be collected earlier, frozen, and then thawed under controlled conditions before insemination, making it convenient for various situations.

What are the circumstances that would benefit from IUI?

IUI is beneficial for couples facing issues such as low sperm count, decreased sperm motility, ejaculation dysfunctions, cervical scarring, hostile cervical mucus, same-sex couples, single females, and when sperm is stored due to a male's absence or medical treatment.

What is the success rate of pregnancy using IUI for suitable females per cycle?

The success rate for suitable females achieving pregnancy using IUI is approximately 10–20% per cycle.

What is the overall success rate of pregnancy using IUI over three to six cycles?

On average, over three to six cycles, there is an 80% chance of getting pregnant using IUI.

What is the success rate of IUI for couples with no fertility issues, and how does it vary with the woman's age?

The success rate for couples with no fertility issues using IUI ranges from 96%, on average, for women under 25 years of age to 78% for women who are 37 years old, indicating a relatively high success rate.

What is Gamete Intrafallopian Transfer (GIFT)?

GIFT is a reproductive procedure performed when there are normal uterine (or fallopian) tubes and adequate sperm. It involves several steps to facilitate fertilization.

What is the first step in the GIFT procedure?

The first step involves hormonal treatment to stimulate the female to produce more than one egg.

What happens after hormonal treatment in GIFT?

After hormonal treatment, both the sperm and egg are collected and analyzed.

What is the next step in the GIFT procedure after analyzing sperm and eggs?

The next step involves mixing the collected sperm and eggs together in a laboratory setting.

How is the sperm and egg mixture introduced into a woman's reproductive system in GIFT?

In GIFT, the sperm and egg mixture is injected into the woman's uterine tubes during laparoscopic surgery.

What is the desired outcome of the GIFT procedure after injecting the sperm and egg mixture?

The hope is that the sperm will naturally fertilize the egg and then move down the uterine tube before implanting in the uterus.

Why has the frequency of GIFT procedures decreased over time?

Advancements in other assisted reproductive technologies have led to a decrease in the frequency of GIFT procedures.

What are some disadvantages of the GIFT procedure?

GIFT has a lower pregnancy rate compared to other techniques, and it requires surgical intervention.

Why might some couples still prefer GIFT despite its disadvantages?

Some couples prefer GIFT because fertilization occurs naturally, making it a preferred option for those with religious or ethical objections to other assisted reproductive techniques.

What is the primary purpose of in vitro fertilisation (IVF)?

IVF is primarily used to overcome various fertility issues, including blocked uterine tubes, ovulation disorders, endometriosis, fibroids, low sperm quality or production, and unexplained infertility.

What role does hormonal treatment play in the IVF process?

Hormonal treatment is used in IVF to stimulate the ovaries, promote the development of multiple follicles, control ovulation, and prepare the uterine lining.

How is the development of follicles monitored during IVF?

The development of follicles is monitored during IVF through a series of blood tests and ultrasounds.

How are eggs collected during the IVF procedure?

Eggs are collected during the IVF procedure by using a needle that passes through the vagina to reach the ovaries.

What happens to the collected eggs in IVF after retrieval?

After retrieval, the collected eggs are mixed with sperm in a suitable environment at 37°C to maximize their chances of fertilization and development.

How long does it typically take for an embryo to be inserted into the uterus in IVF?

An embryo is usually inserted into the uterus approximately two to six days after the eggs' collection.

What are the regulations in Australia regarding the number of embryos transferred per IVF cycle?

In Australia, there are regulations limiting the number of embryos that can be transferred per IVF cycle to reduce the risk of multiple pregnancies.

Why might IVF have a low chance of success if there is a problem with the sperm?

If there is a problem with the sperm, it is unlikely to fertilise the egg unassisted, reducing the success rate of IVF.

What is Intracytoplasmic sperm injection (ICSI)?

ICSI is a procedure similar to IVF, where a sperm is injected directly into an egg to achieve fertilization.

What is done to ensure the suitability of eggs in the ICSI process?

After collecting the eggs, they are examined to determine if they are suitable for fertilization during the ICSI procedure.

What is one potential concern associated with using ICSI to overcome male infertility?

One concern is that the male infertility may be due to a genetic disorder, and using ICSI may pass the genetic defect onto the offspring.

How can the potential genetic risk of ICSI be mitigated?

To mitigate the genetic risk associated with ICSI, it is recommended that children born from ICSI are examined by a pediatrician, and genetic testing can be done before ICSI to identify any genetic defects in the male partner. If a genetic defect is found, alternative options may be considered.

What are some of the strict regulations regarding donors in Australia?

In Australia, strict regulations for donors include counselling for both donors and recipients, cooling-off periods, and health screening.

What is the option for a female who cannot conceive or carry a baby in Australia?

If a female cannot conceive or carry a baby, they may consider surrogacy, where another woman carries the child for the duration of the pregnancy.

Are there strict laws regarding surrogacy in Australia?

Yes, there are very strict laws regarding surrogacy in Australia, although they may vary between states.

What is the limitation on payments to surrogates in Australia?

In Australia, it is not legal for the surrogate or birth mother to be paid beyond expenses arising from the pregnancy.

What is the traditional method of achieving a surrogate pregnancy in Australia?

Traditionally, a surrogate pregnancy in Australia was achieved by artificial insemination of the father's sperm, making the surrogate mother genetically related to the child.

What is the more common method of surrogacy in Australia?

In Australia, the more common method of surrogacy is gestational surrogacy, where in vitro fertilization (IVF) is used to produce an embryo that is then inserted into the surrogate.

What is the typical time limit for storing frozen embryos in Australia?

The typical time limit for storing frozen embryos in Australia is five years.

What are the three options available when a couple no longer needs their frozen embryos in Australia?

The options for unused frozen embryos in Australia are to dispose of them, donate them to other people/couples, or donate them for research.

Questions 14.1 HERE

What is the basic principle behind ultrasound imaging of the foetus?

Ultrasound uses inaudible, high-frequency sound waves to produce an image of the foetus.

How is the ultrasound probe typically positioned for imaging a pregnant woman's foetus?

A probe is placed on the abdomen of the pregnant woman.

What do ultrasound waves do when they encounter foetal tissues during imaging?

Sound waves are reflected by the foetal tissues to obtain a visual 'echo' of what is inside the uterus.

What is the role of a computer in the ultrasound imaging process?

The doctor feeds the reflected sounds, or echoes, into a computer to produce a screen image of the foetus for study.

List some of the purposes for which ultrasound images of the foetus are used.

Ultrasound images can be used to monitor the growth and development of the foetus, confirm pregnancy, estimate the stage of pregnancy, determine the number of foetuses, identify abnormalities of the cervix or uterus, and more.

What is one limitation of foetal ultrasound imaging?

It cannot diagnose all abnormalities, and further tests may be required for more specific information if an abnormality is detected.

At what stage of pregnancy is amniocentesis typically performed?

Amniocentesis is carried out between the 16th and 20th weeks of pregnancy.

What is the purpose of amniocentesis?

Amniocentesis is performed to examine living cells from the fetus in amniotic fluid for biochemical defects and abnormalities in the number of chromosomes or chromosome structure.

How is amniocentesis performed?

Amniocentesis involves using an ultrasound to guide a needle through the abdominal wall into the amniotic cavity, and approximately 10–20 mL of amniotic fluid is removed for analysis.

What are some potential risks associated with amniocentesis?

Amniocentesis carries a small risk of infection, miscarriage, or damage to the baby.

Why is amniocentesis typically performed on pregnant women?

Amniocentesis is performed on women who are thought to be at a higher risk of delivering a child with a birth defect.

What are some of the disorders that can be detected by amniocentesis?

Amniocentesis can detect disorders such as Down syndrome, cystic fibrosis, neural tube defects (e.g., spina bifida), phenylketonuria, Tay-Sachs disease, Duchenne muscular dystrophy, and sickle cell disease.

What is Chorionic Villus Sampling (CVS) and how does it obtain a specimen of fetal cells?

CVS is a prenatal diagnostic procedure that collects fetal cells from the chorion, one of the fetal membranes. This is typically done using a thin catheter or needle, either through the cervix or abdominal wall, and the collected cells are examined for genetic and biochemical abnormalities.

What is the advantage of CVS over amniocentesis in terms of timing?

CVS can be performed between 9 to 19 weeks of pregnancy, while amniocentesis is typically done after 15 weeks. CVS allows for earlier testing.

Why is the speed of obtaining results an advantage of CVS compared to amniocentesis?

The fetal tissue obtained through CVS can be tested more quickly than the amniotic fluid collected through amniocentesis. This reduces the time between the testing procedure and the examination of results, which is crucial in cases involving potential birth defects that may require pregnancy termination.

What is the disadvantage of CVS in terms of the risk of miscarriage?

CVS carries a 2% risk of miscarriage following the procedure, which is higher compared to some other prenatal testing methods like amniocentesis.

What can CVS be used to detect, and what can it not diagnose?

CVS can be used to detect genetic disorders and biochemical abnormalities in the fetus. However, it cannot diagnose conditions like spina bifida, which typically require other diagnostic methods such as ultrasound or blood tests.

What is a non-invasive prenatal test (NIPT)?

NIPT is a blood test of the mother's blood that screens for certain genetic disorders in the developing baby.

Is NIPT a diagnostic test?

No, NIPT is a screening test. It identifies an increased chance of certain disorders but does not confirm whether the baby definitively has the disorder.

What genetic disorders can NIPT screen for?

NIPT can screen for Down syndrome (trisomy 21), Edwards syndrome (trisomy 18), Patau syndrome (trisomy 13), and Turner syndrome.

When can NIPT be performed during pregnancy?

NIPT is typically available from approximately 10 weeks of gestation onwards.

What is the next step if NIPT shows an increased chance of an abnormality?

If NIPT suggests an increased chance of a genetic disorder, further diagnostic tests like amniocentesis or chorionic villus sampling are recommended to confirm the diagnosis.

What is foetal monitoring, and when does it typically occur?

Foetal monitoring is the regular recording of a baby's heart rate to detect indicators of stress. It usually takes place during labor and birth.

What methods are commonly used for foetal monitoring during labor and birth?

Foetal monitoring is typically done using ultrasound and electrocardiography.

What is electrocardiography, and how is it used in foetal monitoring?

Electrocardiography is a procedure for recording electrical changes in the heart. In foetal monitoring, it records the baby's heart rate.

What is the record generated by electrocardiography called?

The record generated by electrocardiography is called an electrocardiogram (ECG).