Infertility and assisted reproduction

Infertility: a couple has no child even after 2 years of living together with unprotected sex.

Causes vary: physical, congenital, disease, drugs, immunological, even psychological. In India the female is often blamed, but the problem very often lies with the male partner.

Infertility clinics can diagnose and correct some disorders; when correction is not possible, assisted reproductive technologies (ART) can help.

IVF-ET ('test tube baby'): ova from the wife or a donor and sperms from the husband or a donor are made to form a zygote in the laboratory, under conditions close to those in the body; the embryo is then transferred.

ZIFT (zygote intra fallopian transfer): the zygote or an early embryo with up to 8 blastomeres goes into the fallopian tube. IUT (intra uterine transfer): an embryo with more than 8 blastomeres goes into the uterus.

Embryos formed by in-vivo fertilisation (gametes fusing inside a female) can also be transferred to help females who cannot conceive.

GIFT (gamete intra fallopian transfer): an ovum from a donor is placed in the fallopian tube of a female who cannot produce ova but can provide a suitable environment for fertilisation and development.

ICSI (intra cytoplasmic sperm injection): a sperm is injected directly into the ovum in the laboratory to form an embryo.

Artificial insemination (AI): used when the male cannot inseminate the female or has very low sperm counts. Semen from the husband or a healthy donor is placed in the vagina or in the uterus (IUI, intra-uterine insemination).

ART needs highly precise handling by specialists and costly instruments, so it is available in very few centres and to few people; emotional, religious and social factors also hold it back. The law also permits legal adoption, which gives orphaned and destitute children a home.