Introduction to assisted reproduction

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(Benita Denny, Wellcome Photo Library).

In 1978 the birth of Louise Brown, the first baby born using IVF technologies, changed the face of medical practice worldwide and it has continued to evolve. It is estimated that more than 4 million babies have been born worldwide through IVF. In response to concerns of how rapidly the technologies were developing, Baroness Warnock was asked to chair a committee to develop the principles and regulations of IVF and embryology. In 1984 the Warnock report was published which subsequently led to the Human Fertilistation and Embryology Act of 1990, and the establishment of the Human Fertilisation and Embryology Authority (HFEA).

The impact of the HFEA, the Royal College of Obstetricians and Gynaecologists (RCOG) and National Institute for Health and Clinical Excellence (NICE) publications on the management of the infertile couple has been considerable on UK practice. The term 'assisted reproduction treatments' (ART) refers to treatments that enable a couple to conceive by means other than sexual intercourse, and include intrauterine insemination (IUI), in vitro fertilisation (IVF), intracytoplasmic sperm injection (ICSI), donor insemination and egg donation.

In this tutorial, many of the treatment choices and their suitability for any couple will be based on the RCOG and NICE publications, and the more recent published literature.

Learning objectives

When you have completed this tutorial you will be able to:

  • outline the suitability of ART for the different diagnostic categories
  • explain the principles of ART and their associated psychological stresses
  • describe the complications associated with ART and their management
  • summarise the outcomes and success of the different treatments
  • identify pregnancy-related problems following ART
  • identify fetal and neonatal complications following ART

Last updated: 14/7/2013 (tutorial was revised and updated by Dr K Jayaprakasan)

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