Assisted reproductive technology in reproductive medicine — possibilities and limitations

Abstract

Infertility has become an increasingly common health problem and has been estimated to affect approximately 10% of women in the reproductive age. Due to its high prevalence, it has been deemed a social disease by the World Health Organization (WHO). The causes of infertility are numerous and vary from person to person. As for treatment, the three main therapeutic strategies include pharmacological therapy, surgical therapy -mostly endoscopy, and assisted reproductive technology (ART). Recent decades have witnessed great progress in ART, resulting in successful treatment of the previously untreatable cases, particularly in the field of fertility preservation, preimplantation screening for aneuploidy, uterine transplantations and mitochondrial replacement techniques as prevention against a number of severe diseases. Regardless, ART treatment does not guarantee pregnancy and live birth. The success rate is much smaller as compared to the failure rate, it being among its most important limitations. Embryo implantation is an extremely complex process and represents the most critical step of the reproduction process in humans. Attempts to evaluate endometrial receptivity and strategies for its correction have been discussed. The search for new effective predictors of an individual prognosis remains a crucial challenge for the contemporary reproductive medicine.

Astaxanthin improves the developmental competence of in vitro-grown oocytes and modifies the steroidogenesis of granulosa cells derived from bovine early antral follicles

“…Assisted reproductive technologies (ARTs) including in vitro maturation (IVM), the in vitro fertilization (IVF) of oocytes, and in vitro culture (IVC) for the production of transferable embryos are uniquely desirable for improving the breeding of animals and also for the perpetuation programs of wild and endangered species. Moreover, the isolation and IVC of ovarian follicles to obtain fertilizable oocytes and further embryo development have been regarded as a propitious strategy to strive against infertility issues (Hansen 2014;Szamatowicz 2016;Kushnir et al 2017).…”

The ameliorating effects of Bushen Tiaoxue Granules and Kunling Wan on impaired angiogenesis and endometrial receptivity in rats following controlled ovarian hyperstimulation

“…49 However, some failure in ART has been identified, which is related to vascular dysfunction. 50,51 The rat ovarian hyperstimulation is an useful model in studying how the induction of superovulation affects VEGFA levels and endometrial receptivity to blastocyst implantation. 4 Using this model, the current research proved that BTG and KW, the two Chinese the endometrial thickness and microvessel density.…”

Psychosocial aspects of infertility and its treatment

“…Szamatowicz enumerates 3 groups of infertility treatment methods: pharmacological, surgical and assisted reproductive techniques (ART) [3]. The last group includes the in vitro fertilization (IVF), which is a fertilization of an ovum in laboratory environment and implantation of the zygote in a woman's uterus as well as intracytoplasmic sperm insertion (ICSI) which precedes the implantation of the embryo in the woman's body [3].…”

“…In 2009, 15% of marriages struggled with unintentional lack of children [3]. In the face of such a large scale of the notion and the number of afflicted people, it is worthwhile to focus on the probable psychological consequences connected with infertility.…”

“…It is defined as an inability to conceive a child despite annual sexual intercourse with average frequency of 3-4 per week without using any contraceptives or an occurrence of multiple pregnancies, everyone of which terminated by miscarriage [3]. Unintentional infertility may be caused by a feminine factor (about 45-65% of all cases), a masculine factor (about 25-45%) or be a problem of both partners (about 10%) [4].…”