Assisted reproductive technologies (ART) are used to help people who have difficulty in achieving natural pregnancy. Dr. Gautam Allahbadia discusses current assisted reproductive technologies, including indications for use, recommended techniques, common complications, and the value of a coordinated interprofessional team in the field of reproductive medicine. Dr Gautam Allahbadia, Dubai based IVF expert imparts knowledge on the art and science of assisted reproductive techniques.
In 1978, a woman had an unstimulated menstrual cycle, and doctors performed a laparoscopic retrieval of a single oocyte from the ovary. The oocyte was then fertilised in vitro and transferred into her uterus as an embryo. Since then, IVF technology has advanced and become more widely available around the world. This review will go over current techniques in assisted reproductive technologies, as well as indications and risks. IVF is by far the most common ART procedure and will be extensively discussed, as will related techniques such as cryopreservation and intracytoplasmic sperm injection (ICSI).
The ovaries, fallopian tubes, and uterus are critical components of female anatomy in understanding ART. The ovaries are the third component of the hypothalamic-pituitary-ovarian (HPO), a complex feedback loop that regulates the female menstrual cycle. The female gonads are the ovaries, which are paired oval-shaped structures that develop embryologically from the mesonephric ridge before descending in the pelvis. Oocytes mature and develop in the ovaries. The ovary is also responsible for the production of the female hormone estradiol and progesterone. The ovaries have two peritoneal attachments: the ovarian ligament and the ovarian suspensory ligament. “The ovarian ligament is the ligament that connects the ovary to the uterus. The ovary’s suspensory ligament connects the ovary to the pelvic sidewall and houses the ovary’s neurovascular supply. Understanding this anatomy is essential for comprehending the transvaginal approach to oocyte retrieval,” says Dr Gautam Allahbadia, Mumbai based IVF expert.
The uterus reacts to hormone fluctuations produced by the HPO axis. It is located in the pelvic region, between the bladder and the rectum. It is made up of the corpus (the uterus’s body) and the cervix, which connects the uterus to the vagina. The uterine body is divided into three layers: perimetrium, myometrium, and endometrium. The endometrium is divided into two layers: functionality and basalis. With each menstrual cycle, the functionalis layer undergoes cyclical hormonal changes to prepare for implantation. Endometrial glandular proliferation occurs when oestrogen levels rise during the follicular phase of the menstrual cycle. Progesterone levels rise during the luteal phase, causing secretory changes in the endometrium. Dr Gautam Allahbadia informs that if an embryo does not implant during the cycle, estrogen and progesterone levels fall, causing the functionalis layer to degrade and slough off with menstruation.
The most widespread utilised assisted reproductive technology is In Vitro Fertilization. It begins with the collection of oocytes from the ovary, is followed by in vitro fertilisation, and concludes with the transfer of the resulting embryo into a uterus. It entails the following steps: controlled ovarian stimulation, oocyte retrieval, fertilization, embryo culture, and embryo transfer. “Preimplantation genetic testing and intracytoplasmic sperm injection may also be part of the procedure. Cryopreservation with vitrification is then used to freeze excess embryos or for egg or embryo fertility preservation,” mentions Dr Gautam Allahbadia, Dubai based IVF expert.
Controlled ovarian stimulation, Gonadotropin-releasing hormone (GnRH) antagonist cycles, GnRH agonist cycles, Oocyte retrieval, fertilisation, preimplantation genetic testing, In vitro maturation, embryo transfer, and cryopreservation are some of the techniques of Assisted Reproductive Technology.
Individuals and couples who are infertile, have a history of gonadotoxic therapies, or have deleterious genetic conditions can benefit from assisted reproductive technology (ART).
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