One may live, and one may thrive.
One can have a million trials.
One may conquer the world and thrones.
One can seek peace or gold.
And down the road, one may seek,
Reliving the childhood that has been lost,
Crawling the steps to a newer road,
But for some, this may be a distant thought.
The agony, the pain, and the cries at night,
Killing the hope and desires in life.
It’s not just a wish; it’s not a desire.
Some can pour their heart and soul.
Yet remains their stories unfold.
Recent reports from the World Health Organization (WHO) state that one out of six adults, 17.5% of the adult population, suffer from infertility globally. Women suffering from infertility, and the inability to bear a child by conventional means are becoming a common problem today. It goes the same for the male to have progeny of their own. The magnitude of this problem reflects the increasing need for better accessible and affordable treatment options and related facilities. The burden of financial costs and the unavailability of proper treatment remains a fact in many regions, and low-economy countries. Mostly these treatments are paid for by personal pockets, causing financial strain and hardship. The emotional trauma associated with infertility diseases is too personal to measure in words.
Not having a child can be a choice today but not necessarily the only option couples have in case of infertility. Infertility is becoming more and more common nowadays. With the rising problem, we have an increasing number of solutions. Some of them are very creative yet effective.
Intrauterine Insemination
When sperm are sluggish to move, have poor quality, or are insufficient, IUI (Intrauterine Insemination) can be a potent problem solver for couples. It can also be beneficial in situations where biological females have antibodies against the sperm or have thin, acidic, or thick cervical mucus, preventing sperm from reaching the eggs. In these cases, even when sperm manages to enter the cervix, the internal atmosphere kills the sperm before fertilization occurs. IUI can also be employed while using donor sperm. Carefully prepared (washed) sperm is introduced into the uterus using a thin, flexible catheter during the IUI technique. To improve your chances of fertilization, your doctor may advise taking fertility medications. It is only to aid the overall chances of getting pregnant.
In-vitro fertilization
IVF (In-vitro fertilization) has become very popular nowadays. It is the most common assisted method of reproduction. Fertility reduces with age. Older females may have blocked or severely damaged fallopian tubes due to scarring from endometriosis and frequently use IVF as a therapy for female infertility. This method can be employed if the sperm quality is low. IVF may also be useful for couples who have undiagnosed infertility. The eggs from the body are removed and fertilized in a lab using sperm during a multi-step process. The fertilized embryo is placed inside the uterus. A common problem with this method is that multiple pregnancies are possible, and the process is long and frustrating for couples who might need to undergo this procedure multiple times.
Genetic testing of embryos, like preimplantation genetic diagnosis (PGD) and preimplantation genetic screening (PGS), are performed to ensure that embryos are free of genetic abnormalities when implanted in the woman’s uterus. PGD detects genes linked to specific diseases in case of family disease history or parents acting as carriers for Huntington’s disease, Marfan syndrome, hemophilia, Duchenne muscular dystrophy, an abnormal chromosome number, cystic fibrosis, etc. PGS is generally associated with the study of the number of chromosomes in an embryo. The number of chromosomes should be 23 pairs, and in case of abnormal chromosome number (which is possible in case of a woman age-associated risk, 35 years or more), the embryo can fail to implant in the uterus, and miscarriage may occur. It is also used to diagnose diseases like Down syndrome.
Gamete intrafallopian transfer
IVF and gamete intrafallopian transfer (GIFT) have many similarities, yet they differ with a slight difference in the process. There are many myths and beliefs associated with bearing a child and reproduction in a conventional society. Although IVF might be one of the best assisted fertility methods, it might pose some threats to the beliefs of people who do not wish for a child (zygote) to grow outside the human body. This process is indeed a gift for those individuals who wish to bear a child but cannot. Eggs are gathered, combined with sperm in a petri dish, and then put right into the fallopian tube, where fertilization can take place using a technique called GIFT. In cases where the biological female has at least one functional fallopian tube or the biological male has a low sperm count or sperm with poor motility, the couple may choose for GIFT. Couples with unexplained infertility and those who disagree with IVF (or fertilization that occurs outside of the human body) morally or religiously can also use it as an option.
Zygote intrafallopian transfer
There is another method zygote intrafallopian transfer (ZIFT) which is very similar to that of IVF. Since sperm and eggs are fertilized outside, ZIFT is comparable to IVF. The embryo is placed inside the uterus rather than the fallopian tube. ZIFT is often employed when a couple experiences unexplained fertility issues, like when the male has a low sperm count or when the woman has at least one tube open, or when there are ovulation issues.
Intracytoplasmic sperm injection
A micromanipulation method used in IVF is intracytoplasmic sperm injection (ICSI). With ICSI, healthy sperm injected into the cytoplasm of an egg uses a small glass needle rather than letting it fertilize the egg naturally on a dish. Male infertility can be treated with this method because it does not require the problems associated with the sperm slow mobility and penetration.
Womb Transplantation
The absence of a uterus and absolute uterine-factor infertility (AUFI) did not have any treatment till now, but now such women have their chance. Soon, we will have our first successful pregnancy after uterus transplantation. All the women who are at child-bearing age but have not conceived due to lack of a uterus and the presence of a non-functional uterus will be able to give birth. This technique is not only limited to clinical trials, but Baylor University Medical Centre, United States, offers such treatment. With time many more centers, hospitals, and countries will surely follow. It is indeed a new scientific world we are entering! It is a relatively new procedure and there are still some risks associated with it. Further research and case-based studies can reveal the real potential and problems associated with this procedure and if it is medically safe in a long run.
Creating sperm in Petri dishes
We had heard of sperm banks. Right? What about creating sperm in a laboratory? You heard me right! Chinese are growing sperm in Petri dishes. These sperms lack tails. They are injected to enter the female body. This experiment has been successful in mice already. Humans are not far, or should I say, another revolution in biological and developmental science is just spreading its course and, on its way, to bringing revolution!It is still in the early stages of development, and it is not yet clear if it is a safe and effective way to treat male infertility.
Eggs and Sperm Banks
Although this method was introduced in 2014, it is gaining more and more popularity nowadays. People are busy and have plans, some cannot afford to conceive at present, and some have some personal and non-personal issues. But what does the future hold? Age is a factor that causes a significant effect on the quality of egg and sperm and the chances of pregnancy. Egg and sperm banks are the answer for those couples or individuals who want to save for their future without worries.
Three-parent baby
A baby generally has two parents. We have achieved a way to fertilize two different women's eggs from one sperm. The creation of a three-parent infant aims to give mothers a chance to have a child without passing on metabolic illnesses brought on by damaged mitochondria, the organelles that supply energy to cells is one of the inspirations behind the evolution of this method. The third parent is a healthy unrelated donor. The donor is used to replace the damaged mitochondria of a potential mother. This discovery can change the medical science as we know it, but ethically, it may raise many questions. The concept of the three-parent baby might not be comprehended by all. Although, science believes in possibilities and takes the risk accordingly.
Asexual Reproduction
Parenthesis is unproven in humans. It is only limited to a theory, but many scientists wonder about it. Does it have merit, or is it just some bogus concept that is difficult to say? But to ease the curiosity, let us look at the most non-scientific (or a little scientific) and unproven explanation of this scientific concept. Modern Cell Theory says that a cell cannot exist without an earlier cell, just as a species cannot exist without an earlier species. In an existing species, a given cell and species have specific 2N chromosome numbers unaffected by external forces like chemicals or the environment. As a result, Eve evolved/originated from the first, already-existing person (Adam). It is suggested in the Adam's Creation Theory for Human Evolution (AC-Theory for Human Evolution) that the first human Adam (hermaphrodite) was created by nature as a pre-existing human species, the second human Eve (hermaphrodite) evolved/originated using natural cloning/natural budding asexually, for the first time in the world from pre-existing human species (Adam) to maintain the pair level of human. I know there is a lot of theology and belief concern over this topic, but it does give us something to think about. How the first human was created is still a mystery. This mystery opens many possibilities. It should be noted that it is a theoretical concept, and there is no scientific evidence to support it.
Nutritional Therapies
Nutrition is essential for healthy living. But does it have any effect on reproduction and fertility issues? Male infertility or subfertility can be treated effectively with nutritional therapy as an alternative. Unlike other cutting-edge invasive treatments, they are affordable, and the method is simple. The chances of spontaneous conception can be improved by a slight increase in sperm quality. Even under extreme circumstances, nutritional therapy, especially L-carnitine alone or in combination with micronutrients, greatly improved sperm parameters and pregnancy rates. These inexpensive options, in my opinion, may be helpful for those without access to or unwilling to undertake more intrusive and expensive reproductive procedures.
