Alternative Methods of Reproduction
Some couples are infertile due to various physical abnormalities. When corrective medical procedures fail, alternative methods of reproduction are available to couples who wish to become parents.
During artificial insemination by a donor (AID), sperm are placed in the vagina by a physician. In some cases, a women is artificially inseminated by her husband's sperm. This is especially helpful if the husband has a low sperm count because the sperm can be collected over a period of time and concentrated so that the sperm count is sufficient for fertilization. Often, however, a woman is inseminated by sperm acquired from an anonymous donor. At times, a mixture of husband and donor sperm are used.
A variation of AID is intrauterine insemination (IUI).
IUI involves hormonal stimulation of the ovaries, followed by placement of the donor's sperm in the uterus, rather than in the vagina.
In the case of in vitro fertilization (IVF), hormonal stimulation of the ovaries is followed by laparoscopy, in which an aspiratory tube is used to retrieve preovulatory eggs. Alternately, a needle can be inserted through the vaginal wall and guided by the use of ultrasound to the ovaries, where it is used to retrieve eggs. This method is called transvaginal retrieval. Sperm from the male are then placed in a solution that approximates the conditions of the female genital tract. When eggs (sometimes treated to facilitate entrance of a sperm) are introduced, fertilization occurs. The resultant zygotes begin development, and after two to four days, the embryos are inserted into the uterus of the woman, who is now in the secretory phase of her menstrual cycle. If implantation is successful, normal fetal development continues to term.
Gamete intrafallopian transfer (GIFT) was devised as a means to overcome the low success rate (15-20%) of in vitro fertilization. The method is identical to in vitro fertilization except that the eggs and sperm are immediately placed in the uterine tubes after they have been brought together. This procedure is helpful to couples whose eggs and sperm never join in the uterine tubes; sometimes, the egg enters the abdominal cavity instead of the uterine tubes, and sometimes the sperm never reach the uterine tubes. GIFT has an advantage in that it is a one-step procedure for the woman: The eggs are removed and reintroduced all in the same time period. For this reason, it is less expensive-approximately $1,500 compared to $3,000 and higher for in vitro fertilization.
In some instances, women who are called surrogate mothers are paid to have babies by other individuals who contributed sperm (or eggs) to the fertilization process.
If all of these alternative methods of reproduction are considered, a baby potentially could have five parents: (1) a sperm donor, (2) an egg donor, (3) a surrogate mother, and (4) and (5) an adoptive mother and father.
