The term medically assisted procreation includes all the methods or techniques based on the manipulation of reproductive cells (gametes) that will allow infertile couples to conceive a child. Bioethical laws dating from July 29, 2004 govern these techniques.
What are the functions of MAP?
-the fight against infertility or sterility-compensation for acquired sterility -prevent transmission to a child with a serious illness-desires of unconventional parenting-to compensate the effect of menopause in the context of early menopause
What are the principles of the different techniques of MAP?
-techniques of scheduled intercourse: : hormonal monitoring (usually by urine test) can detect imminent ovulation and allows the couple to have intercourse at the time of maximum fertility.-techniques of induced ovulation: A slight hormonal stimulation treatment and forced activation by a single hormone injection (eg HCG) can improve the quality of the ovulation in the increase in the number of oocytes and by having intercourse at the time of maximum fertility.-techniques of intrauterine insemination (or artificial))-This involves artificially injecting the sperm prepared more or less at the time of ovulation into the uterine cavity. This sperm can come from a spouse or a donor. The terms so used are respectively:-intrauterine insemination with husband's sperm (AIH)intrauterine insemination with donor semen (AID)-The purpose of this technique is to facilitate the meeting of sperm-oocyte in the female genital tract.-How does it work? In most cases, ovulation is controlled by stimulation / activation. 36 hours after ovulation induction, intrauterine insemination of a small amount of prepared sperm will be performed.-vitro fertilization (IVF)-Fertilization is performed in the laboratory, ie outside the female genital tract, then there will be a transfer of the embryo (s) into the womb. The goal of IVF is to reproduce in laboratory the early stages of embryo development.-How does it work?-Firstly:-On the one hand, ovarian drug stimulation +triggering of ovulation + oocyte retreival by vaginal guided ultrasound--From the other retreival and optimization of sperm the same day as oocyte retrieval.-Secondly:-Day 1: fertilization by contacting each oocyte collected with about 100,000 sperm..-Day 2: monitoring by microscope fertilization or not?-Day 3: qualitative review of embryo, then transfer of 2 to 3 embryos in utero.-J15 dose of bétaHCG (pregnancy hormone)-microinjection of intra cytoplasmic sperm: ICSI (intra cytoplasmic sperm injection) or IMSI-As the title mentions, this technique is the injection of sperm directly into the oocyte cytoplasm, followed by embryo transfer (s) into the womb.-The purpose of ICSI is to short-circuit the steps of fertilization (sperm penetration into the oocyte)-How does it work?-Sperm are collected either by ejaculation or by sampling intratesticular. sampling -The oocytes are collected from the woman like an IVF.-Direct injection of sperm into the oocyte aspirated.-Embryo transfer in 48 hours-embryo transfer-Previously frozen embryos obtained either by IVF or ICSI are thawed and implanted.-It is also possible to freeze embryos by IVF in couples where the woman has to undergo a sterilizing treatment.-freezing ovaries-In the context of potentially sterilizing treatment for women without a partner, it is possible to take samples of ovaries to produce follicles and later eggs in vitro.
What are the indications of the different techniques?
-The intrauterine insemination or artificial IA) overcomes the problems associated with ejaculation in the mucus, which prevents the sperm from circulating well.-In vitro fertilization (IVF) bypasses the problems associated with lack of contact between egg and sperm. Problems with tubal patency, in particular.-ICSI bypasses the problems of fertilization, and infertility in men
What are the main complications of MAP techniques?
-Complications related to ovarian stimulation: ovarian hyperstimulation syndrome (thrombotic arterio-venous) twists annexes on hyperstimulated ovaries.-psychological parental impact, by separation between reproductive and sexual union.-complications of egg retrieval (perforation of organs abdominopelvic, vascular risk of wound)-increased risk of ectopic pregnancy-Multiple pregnancies-ethical problems posed by excess embryos
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Victor Hugo