What is assisted reproduction?
Assisted reproduction is one of the medical wonders of the modern global world. This rapidly developing medical specialty in recent decades allows married couples with different types and severity of somatic problems to have heirs.
How does it all start?
The first data on artificial insemination in humans date back to 1790. John Hunter, dubbed the “founder of medical surgery,” administered the insemination of a patient with severe hypospadias, advising him to collect the semen secreted during coitus in a heated syringe and apply it to the woman’s vagina. In the mid-1800s, J. Marion Sims discovered the postcoital test and performed 55 inseminations. . In 1899 In Russia, the first practical methods for artificial insemination of a man were developed and described by Ilya Ivanovich Ivanov, who, although studying artificial insemination in domestic animals, dogs, rabbits and birds, was the first to develop the method used today in human medicine. For many years, partner insemination has been used only in cases of physical and psychological sexual dysfunction, such as retrograde ejaculation, vaginismus, hypospadias and impotence.Along with the progressive development of the methods, donor inseminations began to be introduced, which quickly became routine procedures for the treatment of infertility in men with azoospermia and severe oligoasthenozoospermia. 1953 was the first successful pregnancy from insemination with frozen semen. A new era in assisted reproduction is beginning. Along with the development of science, the discovery of new techniques for sperm processing and the improvement of the success of procedures, ways are being sought to treat infertility in women without functioning fallopian tubes. In order to fertilize the ovum from the sperm in vivo or by insemination, at least one of the fallopian tubes must be permeable. In the past, many women with tubal infertility have resorted to reparative surgery to restore tubal function. Unfortunately, these operations are often unsuccessful. This necessitates the development of a method that allows fertilization of the egg outside the woman’s body.
In the late 1970s, Leslie Brown, a patient with nine years of primary infertility, turned to Patrick Steptoe and Robert Edwards at Oldham General Hospital in England. At that time, fertilization of eggs outside the human body, a process known as in vitro fertilization (IVF), was considered completely experimental, leading only to abortions and a failed ectopic pregnancy. Without the use of ovarian stimulant drugs, Leslie Brown underwent a laparoscopic puncture, obtained an egg, which was fertilized in a laboratory and later transferred back to the uterus. The transfer of the embryo became the first live birth of an IVF child – Louise Brown, born in July 1978. This incredible success gives hope to thousands of childless couples around the world. Each passing year and each performed procedure contribute to the improvement of technology and the achievement of more pregnancies. Since then, a number of advances in clinical medicine and basic science have enabled more and more couples with reproductive problems to have children. Controlled ovarian hyperstimulation is introduced to increase the number of eggs obtained. February 1984 the first baby is born from a donor egg, and a month later – the first baby from a frozen embryo. In 1992 the introduction of ICSI – intracytoplasmic injection of sperm directly into the egg, represents a huge technological advancement in ART. This allows for the treatment of couples with severe male factor. In 1997 the first babies were born from frozen eggs.
The gradual introduction of new techniques – TESA, PESE, ovarian freezing, IMSI, TimeLapse, PGD inevitably increase the success of procedures. The continuing search for new methods for the treatment of infertility and the preservation of the fertility potential of certain groups of patients make assisted reproduction one of the most interesting areas of medicine. To date, more than 6 million babies worldwide have been conceived and born through assisted reproductive technologies.
|1.||Intrauterine insemination||390 BGN|
|2.||Follicular puncture under ultrasound control||450 BGN|
|3.||IVF procedure stimulated cycle||1740 BGN|
|4.||IVF procedure spontaneous cycle||610 BGN|
|5.||ICSI procedure stimulated cycle||2280 BGN|
|6.||ICSI procedure spontaneous cycle||810 BGN|
|7.||IVM Invitro Maturation||1970 BGN|
|8.||IMSI (injection of eggs with morphologically selected sperm) stimulated cycle||2730 BGN|
|9.||IMSI (injection of eggs with morphologically selected sperm) spontaneous cycle||1060 BGN|
|10.||Assisted hatching with laser||220 BGN|
|11.||Cultivation to blastocyst||430 BGN|
|13.||Preparation and synchronization of a cycle in a donor program||920 BGN|
|14.||Testicular biopsy||690 BGN|
|15.||Fee for one vial of donor sperm, incl. processing, freezing, storage and costs of mandatory donor tests, according to Ordinance № 28||150 – 327 BGN|
|1.||Chromosome analysis||220 BGN|
|2.||Predisposition to thrombosis – a comprehensive study||116.50 BGN|