What are the main clinical techniques available for the manipulation of human reproduction? Briefly describe the risks and benefits of each approach.

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What are the main clinical techniques available for the manipulation of human reproduction? Briefly describe the risks and benefits of each approach.

Fertility refers to the ability of a couple to conceive through sexual activity. Infertility is therefore defined as the inability of a couple to conceive after a year of regular sexual intercourse without the use of contraception. It is said that approximately 80% of healthy fertile women are able to conceive during this time ().

Causes

Causes of infertility involve both female and male factors. In rough terms, about one-third of infertility cases can be attributed to male factors, and about one-third to factors that affect women.  For the remaining one-third of infertile couples, infertility is caused by a combination of problems in both partners or, in about 20 percent of cases, is just unexplained (www.timelinescience.org). 

Probably the most common cause of infertility in women is a malfunctioning of the complex hormonal interactions, which control the menstrual cycle. The monthly cycle is controlled by the pituitary gland, which is governed by another gland, the hypothalamus. A failure to ovulate is normally caused by the woman’s body failing to make enough of the pituitary hormones, or releasing them at the wrong time. The result can be an inadequate production of the female hormones and consequently a disruption of normal ovulation.

Other factors may include abnormalities with the reproductive organs such as damaged fallopian tubes, cervical environment or ovarian cysts (Jones 1991).

Male factors include inadequate or abnormal sperm production and delivery, anatomical problems, previous testicular injuries, hormonal imbalances, antibodies against sperm, or the presence of a varicose vein around the scrotal sac - all of which may affect sperm quality and quantity ().

 Studies from various European countries show 15-20% of couples experience infertility some time in their reproductive life, so it is a very common problem (Jones 1991). Exploring ways to treat infertility has been going on for many centuries. However, it was not until there was an understanding of how the human reproductive system worked that significant advances were made into the treatment of infertility.

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Treatments        

In the last 50 years it has become increasingly more possible to treat at least some forms of infertility. Hormonal imbalances concerned with female ovulation can be corrected with “fertility drugs”. Some women do not make enough FSH to stimulate the release of follicles from the ovary. Synthetic FSH hormone can be used to replace natural FSH, therefore bringing about ovulation and hopefully pregnancy (Jones 1991). Surgery may be needed if there is a physical blockage in either the male or female, which causes a barrier to sperm movement.

Artificial Insemination

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