318 Chapter 16
in vitro fertilization
Fertilization that occurs
when oocytes and sperm
are placed in a prepared
laboratory dish.
options for Coping with infertility
effects, including the fertilization of several eggs at once.
The result is a high-risk pregnancy that can result in babies
with neurological and other problems.
assisted reproductive technologies include
artificial insemination and ivF
Artificial insemination was one of the first methods of
assisted reproductive technology, or ART. In this approach,
semen is placed into a woman’s vagina or uterus, usually by
syringe, around the time she is ovulating. This procedure
may be chosen when a woman’s partner has a low sperm
count, because his sperm can be con centrated prior to the
procedure. In artificial insemination by donor (AID), a sperm
bank provides sperm from an anonymous donor. AID pro-
duces about 20,000 babies in the United States every year.
In vitro fertilization (IVF) is literally fertilization “in
glass.” If a couple’s sperm and oocytes are normal, they can
be used. Otherwise, variations of the technol ogy are avail-
able that use sperm, oocytes, or both, from donors (Figure
16.14B). Sperm and oocytes are placed in a glass laboratory
dish in a solution that simulates the fluid in oviducts. If fer-
tilization takes place, about 12 hours later zygotes (fertilized
eggs in the first stage of development) are transferred to a
chemical solution that will support further development.
Two to four days later, one or more embryos are trans-
ferred to the woman’s uterus. An embryo implants in about
20 percent of cases. In vitro fertilization often produces more
embryos than can be used in a given procedure. The fate of
unused embryos (which are stored frozen) has prompted
ethical debates, such as whether such embryos should be
used as a source of embryonic stem cells (Chapter 4).
n In the United States, about one in every seven couples is
unable to conceive a child after a year of trying.
n Link to Hormones from the hypothalamus and pituitary 15.3
About 20 percent of the time it’s not possible to determine
the cause of infertility. In general, infertility is best viewed
as a “couples problem” that results when one or more of the
conditions for fertilization isn’t met in one or both partners
(Figure 16.14A).
Fertility drugs stimulate ovulation
In about one-third of cases, infertility is traced to poor-
quality oocytes or to irregular or absent ovulation. These
situations are most common in women over the age of 37. A
couple’s first resort may be fertility drugs, in the hope that
one or more ovarian follicles will produce a healthy oocyte.
One commonly used drug, clomi-
phene, stimulates the pituitary gland
to release FSH. As noted in Section
15.3, this hormone triggers ovula-
tion. A drug called human menopausal
gonadotropin (hMG) is basically a
highly purified form of FSH. Injected
directly into the bloodstream, it stimulates ovulation in 70 to
90 percent of women who receive it.
Although fertility drugs have been used with great
success since the 1970s, they can cause undesirable side
F i g u r e 16.14 ART may allow a couple to overcome infertility. A Major causes
of infertility in females (above) and males (below). B Doctor inserting a human
sperm into an egg during in vitro fertilization. He is viewing the cell through a
microscope. The procedure is magnified on a monitor. The egg, held in place
by the tip of a pipette, is being pierced by a micromanipulator (the shadowy
line on the right). (© Cengage Learning)
16.8
Oviduct blockage
Uterine problems
Damaged or
absent ovaries 30–50%
40%
Hormone-
related
ovulation
problems
Cervical problems
≤10%
Unknown
Semen disorders
Testicular failure
Other
Obstruction
Undescended
testes
Varicocele
37%
6%
6%
7%
9%
10%
25%
© Heidi Specht, West Virginia University
A
B
Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).