When a couple has had a full infertility diagnostic, including ultrasonic scanning, hysterectomy, hormone testing, spermogram, genetic investigations, laparoscopic hysterectomy, compatibly tests, etc., and the cause of the infertility is still unknown (it happens in 10 per cent of the cases), they can use a method of extracorporal fertilization (fertilization in vitro).
Extracorporal fertilization is now in wide application by many childless
families. This procedure includes the stimulation of an ovary to have the ovule, and the ovum fertilization by spermatozoon. The stimulation is provided from the second day of the menstrual cycle by using pills and injections. Usually doctors advise clomiphene, in combination with human gonadotropins, and medications that will stimulate hormone release by hypophysis. Such stimulation is necessary to have several ovules at the moment of ovulation.
Ultrasonic scanning is performed from the eighth till the fourteenth day of the menstrual cycle to monitor a process of follicles developing and ovules maturing. The last injection that defines the moment of final follicle maturity, is made during the period from the tenth to the sixteenth day of the menstrual cycle. 36 hours after the injection, a doctor will extract all the ovules from the follicles of the ovary (through the vagina, or abdominal wall by a special needle). During the same day, the ovules are fertilized by spermatozoon of husband (or by spermatozoon of a donor - at the request of both partners).
In the case of low sperm activity, the doctor will make an incision in the ovule external membrane. If the sperm count is very low, the doctor will introduce it directly into the ovule in embryo adoption.
Forty hours after the effective fertilization of the ovules, three or four of the embryos are introduced into the uterine cavity through the vagina and the uterus neck during the process of embryo adoption. Three weeks after the embryo adoption the embryos number is tested by ultrasonic scanning.
The average success rate of embryo adoption is 18-25 per cent for one
couple during one cycle. In some cases an embryo donation is possible. It is used when an extracorporal fertilization is not successive, but a woman wishes to bear a child herself. Or when a woman is not infertile, but she is not able, or cannot bear a child. Then a couple can resort to the help of a surrogate mother. It is legal in many countries nowadays, but still the couple can face many problems.
There is still another possibility. For example, a couple is not infertile. At the moment, they do not have any children and plan to have them in the future. But they are afraid that in the future, they might suffer from some illness that is dangerous for a child, or, will make them to become infertile. For example, they are going to work in a dangerous industry, i.e. their present job deals with their working with radioactive materials. Or, the wife or husband is going to have an operation, or a treatment that might affect their reproductive organs (i.e. chemotherapy etc). In such a case, they can store their ovule and spermatozoa, or embryo, for some time. They apply to a special medical institute, have a special examination, and give their material for storage in a cryobank. The ovule and spermatozoa can be stored for 5-10 years. Embryo storage is also possible for 10 years maximum.
So nowadays science can offer people many methods to improve their
life, health and to solve many of their problems, including infertility.