Latest Medical Resources

The first “test tube baby” French, Amandine, celebrated its 25th anniversary in early 2007. Each year, more than 12 000 babies born using the techniques of in vitro fertilization in France. When and how to benefit from this technique? All the details on that little nudge from nature.

In human fertilization “naturally” occurs in the fallopian tube of the woman after sex and during ovulation. For that to happen, this fertilization requires a sufficient number of motile sperm capable of walking from the cervix to the fallopian tube after passing through the uterus. It also requires that the tube is perfectly permeable, and its open end in the abdomen, called flag, could attract the oocyte during ovulation. Folds arranged inside the tube and fine movements of the tube itself then allows the oocyte to progress in the trunk to meet the sperm. The oocyte is indeed unable, unlike the sperm to travel alone. After fertilization of the ovum by a spermatozoon, it is again the movements of the trunk that advance the very early embryo into the uterus where it implants after about a week.

A Strange Place to Meet

Many diseases can affect these complex mechanisms and in vitro fertilization or IVF was initially developed to allow women whose fallopian tubes are altered to conceive children. The idea was simple: organize the meeting sperm – egg cells in laboratory (in vitro) and thus promote fertilization, and then transfer into the uterus the embryos obtained.

Since 1982, year of birth of the first “test tube baby” French, indications of IVF have gradually evolved to no longer be limited only to cases of abnormalities of the fallopian tube. Currently, women who use IVF “classical” (ie without the use of micro-sperm injection or ICSI – Intracytoplasmic Sperm Injection), a little less than one in only two patients had tubal . The causes of tubal abnormalities (that is to say related to the tubes) are varied sequel of genital infections, adhesions after surgery, ectopic pregnancy … In one third of cases; impairment of sperm from the husband is associated.

The abnormal semen analysis alone are indications to perform a conventional IVF in 20% cases, while the tubes are perfectly healthy. Other indications of conventional IVF are also endometriosis (a disease characterized by the presence of an abnormal endometrium on the peritoneum of the pelvis and ovaries essentially causing a decrease in fertility) and unexplained causes of infertility. In this case, the use of in vitro fertilization usually occurs after several unsuccessful attempts to single stimulation of ovulation then intrauterine insemination.

ICSI: IVF assisted?

A profound change occurred in the early 90s with the help of ICSI (Intra-Cytoplasmic Sperm Injection). Still called “assisted IVF, this technique is to conduct a micro-injection of sperm into an egg during in vitro fertilization. It is intended primarily for couples with male infertility isolated or not. This infertility is most often a low concentration or complete absence of sperm in semen (he must then have recourse to testicular samples). In all in vitro fertilization performed in France in 1998, more than half of ICSI.

One Response to “IVF: Why? For whom?”