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Assisted reproduction (ART), also known as medically assisted procreation (MAP), is a set of clinical and biological practices that enable a heterosexual couple or an unmarried woman to conceive a child. This article explores the different techniques available, the stages in the MAP process and the implications for those concerned.
There are several methods of medically assisted procreation, each adapted to specific situations. Here are some of the most commonly used:
Artificial insemination is often the initial step in a MAP programme. This method involves injecting sperm directly into the woman’s uterus during her ovulatory period. Ideal candidates for this technique are often couples with minor fertility problems or unmarried women wishing to conceive without a male partner.
Advantages: simple, non-invasive and less expensive procedure.
Disadvantages: relatively low success rate compared with other techniques.
In vitro fertilisation, commonly known as IVF, involves collecting eggs from the woman and sperm from the man and fertilising them in the laboratory. Once the embryos have been obtained, they are transferred to the woman’s uterus in the hope that they will implant and develop.
Advantages: higher success rate, possibility of genetically diagnosing the embryos before transfer.
Disadvantages: complex, costly and sometimes emotionally distressing.
Frozen embryo transfer (FET) is a complementary technique to IVF. After a first attempt at IVF, surplus embryos can be frozen for later use. They will be thawed and implanted in the uterus during a subsequent cycle.
Advantages: several attempts possible without further ovarian stimulation, reduced costs and stress.
Disadvantages: risk of embryo survival after thawing.
A PMA pathway is structured around a number of key stages that enable fertility problems to be assessed and treated, while providing personalised follow-up for candidates.
Initially, detailed medical consultations and preliminary examinations are carried out to assess fertility factors in both partners or the single woman. This may include hormone tests, sperm analyses and pelvic ultrasounds.
For techniques such as IVF or artificial insemination, ovarian stimulation is often necessary. This involves stimulating the ovaries to produce several oocytes in a single cycle. Specific drugs and hormonal injections are generally used for this.
In the case of IVF, an ovarian puncture is carried out to collect the oocytes produced. These oocytes are then brought into contact with spermatozoa for in vitro fertilisation. For artificial insemination, this stage is replaced by the direct injection of sperm into the uterus.
There are certain criteria that must be met in order to benefit from MAP. These criteria vary slightly from country to country, but are broadly similar.
Age is a determining factor for MAP. In general, women must be under 43 to be eligible. Marital status also plays a role, as the techniques can be offered to married or cohabiting heterosexual couples and to unmarried women in some countries.
Complex medical histories often require a full assessment. This may include genetic diseases, a history of cancer, or major hormonal dysfunctions.
The main reason for undergoing MAP is obviously related to various fertility problems. These can affect one or both partners and range from sperm abnormalities in men to ovulatory or tubal disorders in women.
The MAP process can be emotionally challenging. It is therefore crucial to surround yourself with the right psychological support to help you cope with the ups and downs.
Having the positive support of friends and family can often help you get through this process with greater serenity. Open dialogue between loved ones can help ventilate emotions and provide day-to-day support.
It is also possible to join specific MAP support groups where participants share their personal experiences. In addition, individual or couple therapy with a mental health professional specialising in infertility can offer significant help.
The cost of MAP varies considerably from country to country and also depends on the techniques used.
The financial factor plays an important role in the choice of method. Costs may include :
Artificial insemination: usually less expensive with a more affordable average cost.
IVF: very expensive but with a higher success rate.
Frozen embryo transfer: intermediate costs as some steps have already been taken.
There are a number of financial aid options available to support couples or women throughout the MAP process. Depending on the country, there may be different levels of public or private insurance reimbursement for MAP treatments.
The field of MAP is constantly evolving, with new technological innovations and therapeutic approaches.
Advanced technologies, such as embryo gene editing and immune compatibility testing, are making rapid progress and promise substantial improvements in both the success and safety of procedures.
New drug protocols and holistic approaches incorporating acupuncture, meditation and dietary modifications are showing positive results. Research continues to explore these avenues to offer increasingly personalised and effective solutions.
PlusBaby resources are intended to provide general information and are not a substitute for professional medical advice, diagnosis or treatment.
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