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The first IVF child is in his 30s. And she is one of the hundreds of thousands who were conceived outside of the mother's womb. But the spectacular achievements in obstetrics do not end there. Infertility is treated more and more effectively, future motherhood is possible, and genetic defects of the fetus are treated without waiting for delivery.
Late motherhood, diseases that make it difficult to get intopregnancy , congenital defectsfetus- in modern medicine there are many problems that keep you awake at night obstetricians. More and more married couples turn to them for help they once could not count on. In the laboratories of scientists, a lot of promising discoveries are being made, which give childless families back hope of having their own children. This is a chance they've never had before.
Infertility treatment - in vitro
When Luiza Brown, the world's first test-tube baby, was born in July 1978, it marked the beginning of a fertility revolution. For tens of thousands of couples unable to conceive a child naturally, the possibilities of artificial insemination (the so-calledin vitromethod, meaning "in glass") have opened up.
It's been 30 years and the method started in the UK Britain, after minor modifications, is still used today. Unfortunately, still with variable happiness - the best world centers achieve success, i.e. pregnancy through in vitro fertilization, in 40-50% of cases.
Since the birth of Luisa Brown, the scope of infertility treatment has significantly expanded, which affects as many as one in five couples in reproductive age. In the past, only a woman with sick fallopian tubes could be helped in this way, the current methods of insemination, artificial insemination and the so-called micromanipulation is used in all types of infertility found in both women and men.
Unlike classical in vitro fertilization - in which sperm are added to a selected egg - in micromanipulation, one sperm is introduced directly inside the cell. This method therefore enables fertilization outside the mother's body when only single sperm are present in the semen.
Artificial insemination techniques not only pave the way to motherhood for childless people. Thanksbefore it became possible what we could read about a dozen or so years ago in science fiction books: examining embryos for genetic defects, creating an organ donor embryo that could save the life of older siblings, and finally the possibility of having a child by older women after menopause.
The technology of fertilization in a test tube allows parents to postpone the decision about motherhood, thanks to the storage of reproductive cells - sperm and eggs - in special banks where they do not age like their owners.
Do doctors and scientists have not gone too far, however, overcoming biological and ethical barriers? The skeptics' resistance is quenched by the supporters of modern obstetrics with one argument: all these discoveries are a boon to people who, for various reasons, cannot have children. Why deny them this right?
Infertility treatment - straight from the freezer
Even today, many infertile couples and women after radical oncological surgeries can get pregnant thanks to safer freezing of eggs. Young cancer patients who are undergoing treatment with chemotherapy or radiotherapy can deposit their reproductive cells in an appropriate bank in advance and use them after the completion of oncological treatment.
Anyway, storing eggs in hibernation is becoming more and more fashionable among women who want to postpone motherhood until at least 40 years of age. Then the natural chances of getting pregnant are much smaller than at the age of 20 or 30, although still quite likely (reportedly the oldest mother in the world is a 67-year-old Spanish woman - in the spring of 2006 she underwent IVF in Latin America and in December 2006 She gave birth to twins).
The idea of freezing eggs is simple, but it is constantly being refined: the idea is to store eggs in liquid nitrogen in a way that does not destroy them. Traditional methods wreak considerable havoc on the inside of the egg, which makes it completely useless after defrosting and the embryo does not develop. Eggs, unfortunately, do not tolerate well … the temperature of -196˚C (in contrast to sperm, which is much more durable in this respect).
Innovative methods used in clinics treating sterile couples, where their embryos or single embryos are kept reproductive cells give a greater chance of pregnancy development. One of such methods is instant freezing of eggs in a very small amount of liquid, thanks to which their interior, unlike conventional freezing, remains resistant to the effects of low temperature. The technique is called vitrification, and though it is recognized for nowit is considered an experimental method, and it is beginning to be used on an increasing scale.
Infertility treatment: artificial uterus
Many cutting-edge experiments in obstetrics do not go beyond laboratories, however. Along with attempts to use stem cells to rebuild damaged organs - such as the heart, liver and pancreas - scientists are puzzling over the creation of an artificial uterus. If this is successful, it will be possible for women who are unsuccessfully trying to conceive a child to have a chance to survive motherhood, even if the fetus was to develop outside their body.
As early as 2002, a team of researchers from Cornell University in the UK. Britain reported that for the first time in history, it was possible to create an artificial endometrium. Similar signals also came from Japan, where work was done on a plastic uterus filled with amniotic fluid kept at body temperature.
The creation of a mechanical uterine substitute, however, has aroused controversy from the outset, comparable to human cloning plans. Will the fetal life developing outside the mother's body, where it can respond to her heartbeat, emotions, and natural movements, be unaffected by its further development after birth? The aforementioned experiments carried out in laboratories in the UK Britain and Japan had to be discontinued under the guidelines of bioethics committees.
However, although the success of such experiments, culminating in the birth of a he althy newborn baby, remains a thing of the future for the time being, many experts already point to at least a few benefits. Well, the artificial uterus will provide offspring not only to a childless woman, but also make it easier to keep the fetus alive when it is impossible under natural conditions. An artificial uterus can also minimize the discomfort of pregnancy. Although this argument makes motherhood the domain of laboratory activities, all indications are that the birth of a developing human in a laboratory, outside of the mother's organism, is only a matter of time.
Treatment of birth defects of the fetus
Several years ago, would we have believed that birth defects can be treated during pregnancy, before the baby is born? Today, various surgical procedures, such as spinal hernia operations, elimination of heart defects, decompression of hydrocephalus, are performed in several-month-old fetuses without waiting for delivery. Modern ultrasound scanners allow you to see the fetus in three dimensions - the image is so accurate that a doctor can recognize a cleft palate or assess the blood flow in the tiny brain of a baby developing inside the uterus.
Even before development takes placeembryo, many dramas can be prevented. Thanks to the dissemination of in vitro fertilization techniques, doctors are able to test the genetic material of sperm and egg cells for the presence of defective genes in them, and then implant into the uterus only such embryos that are free from these defects. This ensures that the newborn will be born he althy. The so-called Preimplantation diagnostics is currently used in a few fertility treatment clinics ( although it began to be used in the world in 1989), but with time the number of such centers and the scope of the tests offered will certainly increase. Already today, geneticists can check whether the embryos develop genetically conditioned diseases such as hemophilia, cystic fibrosis, phenylketonuria, Huntington's disease or others, related to the transmission of genes responsible for certain cancers (e.g. hereditary breast cancer).
UK In the UK, this type of preimplantation diagnostics can be used to select offspring who are to donate bone marrow for sick older siblings (Adam Nash was born in 2000, whose genetic material at the embryo stage was tested for tissue compatibility with his sister awaiting a life-saving transplant ).
And again the agitated voices of skeptics are heard: are we one step away from designing children for special tasks? Can the selection of embryos for use in the treatment of other people count on the support of ethics? Geneticists reassure: we cannot refuse to help parents who want to take care of their children from the embryo stage. Why should they find out about the transmission of defective genes only after the birth of a child - is it ethical?
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