Exercises: Treatments for Infertility

Define infertility and state two possible causes in women and two in men.

Name the hormone-based treatment used to stimulate ovulation in women who do not ovulate regularly, and state which natural hormone its action resembles.

Give one-sentence definitions of artificial insemination, IVF and ICSI.

Describe the main steps of in vitro fertilisation (IVF), from hormone stimulation of the ovaries to the transfer of embryos into the uterus.

A couple is told that the man has a very low sperm count and poorly motile sperm.

1. a) Suggest which treatment (artificial insemination, IVF or ICSI) is most appropriate and explain why.

1. b) Describe how ICSI is performed.

1. c) State one reason why IVF may fail even if fertilisation occurs.

A clinic in Dublin reports that out of 400 IVF cycles in women under 35, 140 resulted in a live birth.

1. a) Calculate the success rate as a percentage.

1. b) Give two reasons why success rates fall with the age of the woman.

1. c) Explain why clinics usually transfer only one embryo at a time.

Fertility drugs used in ovarian stimulation can cause ovarian hyperstimulation syndrome and multiple births.

1. a) Explain how the drugs influence FSH and LH levels to produce several mature follicles.

1. b) Explain why multiple pregnancies carry a higher risk for mother and babies.

1. c) Evaluate strategies that fertility clinics use to reduce these risks.

Compare artificial insemination, IVF and ICSI in terms of where fertilisation occurs, what the technique overcomes, cost and likelihood of success. Choose the best technique for each case, justifying your answer:

1. a) A woman has blocked fallopian tubes.

1. b) A woman's partner has normal sperm count but is unable to ejaculate in intercourse.

1. c) A man has very few viable sperm.

Discuss the ethical, social and legal issues raised by assisted human reproduction, with reference to the freezing and disposal of surplus embryos, use of donor gametes, the right of the child to know its origins, and access and funding in Ireland.