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青年科學家

Third Party Assisted Reproduction

Various definitions have been utilized for Assisted Reproductive Technology (ART), but the definition employed by the CDC is based on the 1992 Fertility Clinic Success Rate and Certification Act. This legislation mandates the CDC to annually publish the ART Success Rates Report. According to this definition, ART encompasses all fertility treatments involving the handling of either eggs or embryos.

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In essence, ART procedures typically entail surgically extracting eggs from a woman's ovaries, fertilizing them with sperm in a laboratory setting, and subsequently transferring them to either the female patient or a gestational carrier, or alternatively donating them to another patient.

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ART encompasses a broad range of procedures, including but not limited to in vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), zygote intrafallopian transfer (ZIFT), tubal embryo transfer, egg and embryo cryopreservation, egg and embryo donation, and gestational surrogacy.

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In Vitro Fertilization

In Vitro Fertilization (IVF) is a procedure within Assisted Reproduction Technology that involves retrieving eggs from a woman's ovaries and fertilizing them outside her body. Following fertilization, the resulting embryos are transferred into the woman's uterus through the cervix. Specifically, IVF refers to the use of artificial methods to fertilize eggs and sperm in vitro, followed by early embryonic development before transferring the embryos to the mother's uterus for further development and birth of a baby.

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Before embryo transplantation, embryos developed through IVF undergo genetic diagnosis and analysis to identify and exclude any chromosomal or genetic abnormalities. This process enables the selection of healthy embryos for implantation, thereby reducing the risk of transmitting genetic diseases. IVF is particularly suitable for patients with preferences for twins or multiple pregnancies, recurrent natural miscarriages, a family history of genetic diseases, or a history of giving birth to children with genetic diseases.

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Egg Freezing

Egg freezing involves extracting and freezing eggs before fertilization occurs. This technology enables the preservation of high-quality eggs, allowing women to plan for their future fertility. It is particularly suitable for patients of childbearing age who do not currently have immediate family plans due to reasons such as being single or other physical considerations, yet still desire to safeguard their future ability to become mothers.

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The egg freezing process includes two primary procedures: Egg retrieval (also known as oocyte retrieval) involves collecting eggs from the ovarian follicles, while egg transfer (also called oocyte transfer) entails placing the retrieved eggs into a woman's fallopian tubes via laparoscopy.

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Fertility typically begins to decline in the late 20s or early 30s, with a more rapid decline occurring after age 35 as egg reserves diminish further. Therefore, the optimal age for egg freezing is generally considered to be between 27 and 34, allowing women to preserve their fertility while their egg quality is still relatively high.

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Sperm Freezing

Sperm freezing and cryopreservation involve the collection, freezing, and storage of sperm. Sperm can be obtained from freshly ejaculated semen or through a testicular puncture procedure.

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Preserving sperm at optimal quality offers men the opportunity to safeguard their existing fertility and serves as an effective fertility insurance option. This approach is suitable for healthy men who do not currently have immediate family plans but anticipate future fertility needs, as well as for male patients with conditions that impact sperm quality and fertility.

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There are numerous reasons to consider sperm freezing, as explained by urologist Amin Herati, M.D., director of the Male Infertility and Men’s Health Clinic at the Brady Urological Institute. "The most common reason is if you need treatment for cancer," says Herati. "After chemotherapy or radiation therapy, there might be very few sperm or no sperm left in the ejaculate (seminal fluid). Alternatively, a surgery such as orchiectomy (removal of the testicles) for testicular cancer means sperm production is no longer possible."

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Certainly, there are several additional reasons why individuals may opt for sperm banking:

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  • Age: As sperm quality tends to decline with age, individuals may choose to freeze sperm as a proactive measure to preserve fertility as they get older

 

  • Medical Procedures or Conditions: Those undergoing medical procedures such as vasectomy may wish to preserve the option of having children in the future. Additionally, certain medical conditions or treatments, such as testosterone therapy or sickle cell therapy, can impact fertility, prompting individuals to consider sperm freezing

 

  • Occupation: Individuals in high-risk occupations, such as military personnel, may opt to freeze sperm to ensure it is available to them or their partners in the event of deployment or occupational hazards

 

  • Posthumous Sperm Retrieval: Family members may choose to collect sperm from a deceased individual for future reproductive purposes. Sperm can be extracted and frozen up to 72 hours after death, providing a possibility for posthumous conception.

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Surrogacy

Surrogacy is a process where a woman carries and delivers a child for a couple or individual. In gestational surrogacy, the surrogate mother is impregnated through in vitro fertilization (IVF).

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For some, becoming parents is a top priority, but if a woman is unable to carry a pregnancy to term, gestational surrogacy may be the best option. A gestational carrier, also known as a surrogate, is a woman who carries and delivers a child for intended parents.

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During the IVF process, doctors create an embryo by fertilizing eggs from the intended mother or an egg donor with sperm from the intended father or a sperm donor. Since the gestational carrier does not contribute the egg, she is not genetically related to the child.

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Following a thorough medical assessment, experts may recommend a gestational carrier for individuals in the following situations:

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  • Women without a functioning uterus

 

  • Women with acquired disorders that render their uterus unsuitable for pregnancy, such as extensive fibroids or scarring of the uterine cavity

 

  • Women with medical conditions that pose significant health risks if they become pregnant

 

  • Women with a history of recurrent pregnancy loss

 

  • Men who are single but desire to have a child

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