Infertility and assisted reproductive technologies (ART)
Infertility is the inability to have children despite unprotected sexual cohabitation. ART such as IVF with embryo transfer, ZIFT, GIFT, ICSI and artificial insemination can help.
Infertility: the facts first
A couple is infertile if they cannot have children despite unprotected sexual cohabitation. The causes may be physical, congenital, disease-related, drug-related, immunological or even psychological. In India the woman is often blamed, but more often than not, the problem lies with the male partner. Specialised health care units, such as infertility clinics, can diagnose and correct some of these problems.
Assisted reproductive technologies
| Technique | Full form | What is done |
|---|---|---|
| IVF-ET | In vitro fertilisation and embryo transfer | Ova and sperms are collected and fused in the laboratory, in conditions like those in the body. The embryo is then transferred ('test tube baby') |
| ZIFT | Zygote intra fallopian transfer | The zygote or early embryo (up to 8 blastomeres) is transferred into the fallopian tube |
| IUT | Intra uterine transfer | An embryo with more than 8 blastomeres is transferred into the uterus |
| GIFT | Gamete intra fallopian transfer | An ovum from a donor is placed in the fallopian tube of a woman who cannot produce ova. Her body provides the conditions for fertilisation and development |
| ICSI | Intra cytoplasmic sperm injection | A sperm is injected directly into the ovum in the laboratory to form an embryo |
| AI and IUI | Artificial insemination; intra-uterine insemination | Semen from the husband or a healthy donor is placed in the vagina (AI) or the uterus (IUI) |
Do not confuse: ZIFT vs GIFT
Both use the fallopian tube. Embryos formed by fertilisation inside a woman's body can also be transferred to help women who cannot conceive.
Choosing the technique, and its limits
- The man cannot inseminate, or has a very low sperm count → artificial insemination (AI) or IUI.
- Sperms are present but cannot fertilise the ovum on their own → ICSI.
- The woman cannot produce ova, but her tubes and uterus are normal → GIFT with a donor ovum.
- Fertilisation does not happen in the body → IVF, then ZIFT (embryo up to 8 cells into the tube) or IUT (later embryo into the uterus).
- These need very precise handling by specialists and costly equipment, so they are available in only a few centres. Emotional, religious and social factors also hold people back.
- Indian law permits legal adoption. Many orphaned and destitute children need a family, so adoption is one of the best options for couples who want to be parents.
Many Indian couples now visit infertility clinics that offer semen tests, IUI and IVF. Knowing that the cause often lies with the male partner helps end the unfair blame placed on women.
2 marks: “Expand ZIFT and GIFT. Write one difference between them.” Zygote intra fallopian transfer; gamete intra fallopian transfer. ZIFT transfers a zygote or early embryo formed outside the body; GIFT transfers a donor ovum, and fertilisation happens inside the body.
3 marks: “Name and briefly describe three assisted reproductive technologies.” Any three: IVF-ET (fertilisation in the lab, then embryo transfer); ZIFT (embryo up to 8 blastomeres into the fallopian tube); IUT (embryo of more than 8 blastomeres into the uterus); GIFT (donor ovum into the tube); ICSI (sperm injected into ovum); AI or IUI (semen placed in vagina or uterus).
1 marks: “Which technique does your textbook suggest for a man with a very low sperm count?” Artificial insemination (AI), including intra-uterine insemination (IUI).
ZIFT: Zygote into the tube. GIFT: Gamete into the tube. IUT: embryo Into the uterus (more than 8 cells).