The study of human anatomy and physiology is one of the crucial Biology Topics for medical professionals and researchers.
Amniocentesis in the Context of Infertility – Types, Causes, Symptoms, Diagnosis & Treatment
Contraception is a process to prevent pregnancy. Contraceptives are devices that prevent conception or pregnancy without in any way interfering with the reproductive health of the individuals. For contraception, various methods are used like
- Safe period
- Withdrawal method
- Uses of condom, diaphragm, cervical cap
- Use of chemical substances (aerosol foam, cream-delfenl, etc.)
- Uses of intrauterine devices (IUD)
- Oral contraceptive pills
- Surgical methods like vasectomy, tubectomy, etc.
Abortion is the method of termination of conception in females. In case of unplanned or unwanted pregnancy, usually, within 12 weeks after conception, abortion is done and this is more or less non-problematic. There are some medicines that may promote abortion. If the medicines do not work, then an expert physician may carry out the termination of pregnancy by suction or curate method. In such a method, the inner wall of the uterus is scraped.
Procedure of Abortion
1. Abortion Pill:
A medical abortion procedure is used for the first seven to nine weeks of pregnancy. It can also be referred to as RU-486 and Mifeprex. After 1-2 days of taking the pill, prostaglandin is injected. Thus uterus is contracted and abortion occurs.
2. Dialation and Curettage Technique:
A surgical abortion procedure is used to terminate a pregnancy up to 16 weeks gestation.
3. Vaccum Aspiration:
A procedure used as early as 3, weeks since the last period is considered less inva with only local anesthesia being used on the cervix.
Medical Termination of Pregnancy (MTP)
Medical Termination of Pregnancy (MTP) or abortion is the termination of pregnancy before the foetus becomes viable. MTP is comparatively safe upto 12 weeks of pregnancy. But if the doctor advises that its continuation would seriously affect the health of the mother, then termination is legally allowed upto 28 weeks of pregnancy.
Types of MTP
Medical Termination of pregnancy is of two types Spontaneous and Therapeutic.
- Spontaneous: When a woman never knows about her conceives and the abortion passes with the menses. About 1/3 rd of all pregnancies abort spontaneously within 4 weeks of conception.
- Therapeutic: When the continuation of pregnancy dangerously affects the health of the mother then doctors advise the patients (mothers) to take a legal termination from the pregnancy. It is called therapeutic MTP. The physician or gynecologist allows abortion upto 28 weeks of pregnancy.
Significance of MTP:
- It helps in getting rid of unwanted pregnancies and such pregnancies which may be harmful or even fatal either to the mother or to the foetus or both.
- MTP plays a significant role in decreasing the human population.
Disadvantages of MTP:
- Almost all the cases (not 100%) MTPs are done illegally by unqualified quacks which may be fatal.
- MTP is being misused by people who just want to kill the female child which means people use this process to abort the female foetus.
- Many social, emotional, religious, and ethical issues have been raised against the MTP.
The process by which amniotic fluid is collected from the pregnant woman and by analysis of the embryo cells in it, the structure of the embryo, its chromosomal abnormalities, metabolic defects, etc. can be known, as called Amniocentesis.
Process of Amniocentesis
It is done in the following ways:
- By ultrasonography, the correct position of the embryo in the mother’s uterus is known.
- About 30-40 ml. of amniotic fluid is collected by introducing a sterilized needle in the abdominal wall of the mother after 15-16 weeks of pregnancy.
- The fluid is centrifuged to separate the embryo cells from the liquid part.
- The watery liquid is used in the biochemical analysis (α-feto protein or AFP test).
- The embryo cells are increased in number by culture experiment.
- The dividing cells in the culture are examined under the microscope to determine the structure and number of chromosomes, genetic defects, etc.
Significance of Amniocentesis
It helps to know the following in the embryo:
- Abnormalities of chromosomes (Down’s syndrome, Klinefelter’s syndrome, etc.)
- Genetic disorder.
- Sex of the embryo.
- Inborn errors of metabolism (Alkaptonuria, Phenylketonuria, Albinism).
- Provides information about the baby’s health before birth.
- The amniotic fluid contains some stem cells which can be used in genetic engineering.
Misuse of Amniocentesis
- It is being used to kill the normal female foetus. It is legally banned for the determination of sex to avoid female foeticide.
- Amniocentesis has a small risk for women. About 1-2% of women feel spotting, cramping, or leaking of amniotic fluid after the test.
Amniocentesis is a process by which the abnormalities of the embryo chromosomes can detect in the prenatal phases. Not only that, but by this method reconstruction of embryo karyotypes is also been possible. Mapping the chromosome by amniocentesis is helpful to detect monosomies, trisomies, or other structural abnormalities of chromosomes. Along with that, amniocentesis is also performed to detect the neural tube defect in an unborn baby. This results, when the neural tube or developing spine fails to close properly. The two main NTDs (neural tube defects) are anencephaly and spina bifida. When the neural tube fails to close the base of the skull called anencephaly causes serious defects in brain development and spina bifida occurs when the neural tube fails to close along the spine. About 1-2 in every 1000 babies are affected by this disease. Which are detected and corrected by amniocentesis in prenatal life.
It is said by doctors that a late marriage after the age of 35, or conception at this age is risky for the child because there is a high chance to born a defective child. So amniocentesis should be performed for the betterment of the child’s health and life. Not only amniocentesis but also Chorionic Villus Sampling (CVS) is used for detecting parents and also chromosomal abnormalities, such as Down syndrome as well as other genetic disorders.
Ultrasonography is a non-invasive technique used for detecting the condition of foetus, by applying ultrasound (high-frequency sound) at the lower abdomen of the mother. Ultrasonography is also used to detect any abnormalities in the uterus, ovaries like stones, tumors, cysts, etc. To determine the foetal status, like the amniotic cavity, umbilical cord, and placenta; an endoscope is inserted through the abdomen, by making a small insertion and passes into the uterus.
A large number of couples are infertile. It means they are unable to produce children in spite of unprotected sexual activities. Thus the inability to conceive or produce children even after unprotected sexual cohabitation is called infertility.
Types of Infertility
Infertility is of two types, i.e., primary and secondary infertility.
Causes of Infertility
The causes of infertility may be physical, congenital, immunological, or even psychological as well as many drugs and diseases also cause infertility. Many specialized infertility clinics can help in the diagnosis of the proper problem of the couples.
Causes of Male Infertility
- Cryptorchidism – when the testes are unable to descend into the scrotum.
- Deficiency of gonadotrophin hormone.
- Low sperm count in semen.
- Intake of cytotoxic drugs for a long time.
- Defective function of the thyroid gland.
- High prostaglandin and low fructose content in the seminal fluid.
- Obstruction or blockage of the vas deferens and vasa efferentia.
- Oligospermia due to the scrotal temperature being raised in varicocele.
- Unable to erect and penetrate the penis into the female vagina cause impotency.
- Due to a coital problem failure to deposit sperm in the vagina.
- Alcoholism exerts an effect on spermatogenesis.
- Y-chromosome deletion.
- Immotile cilia.
- Lack of knowledge about the fertile period.
- If anti-sperm antibody present in semen i.e., IgG, IgM, IgA, etc.
Cure and Treatment of Male Infertility
- Injecting testosterone into the testes increases sperm production.
- Immunosuppressive drugs can reduce the antibodies against sperm, by suppressing the immune process.
Causes of Female Infertility
- Oligoovulation or deficient ovulation.
- Anovulation. No corpus Iuteum formation.
- Early miscarriage.
- Painful sexual intercourse is experienced by women.
- Decreased level of FSH and LH.
- Chronic endometritis, fibroid uterus that makes the uterus unfavourable for implantation.
- When the growth of the vagina and uterus is defective.
- When the secondary oocyte of the ovary may not pick up by the fimbriae of the fallopian tube.
- Chronic cervicitis, presence of anti-sperm antibody, and elongation of the cervix.
- Failure of fertilization and implantation.
- Increased sperm phagocytosis by macrophages.
- Lack of knowledge about the fertile period etc.
Cure/Treatment of Female Infertility
Specialized health care units or infertility clinics could help in the diagnosis and proper treatment of many types of disorders or problems that cause infertility. The use of vitamins C, E, B12, and folic acid improves oligospermia in males. Production of gonadotrophin and stimulation of secretion of testosterone is increased by intaking clomiphene citrate of 25-50 mg daily. Surgery may be required for the correction of obstructive vasa efferentia and vas deferens. Advice to avoid intake of alcohol and tight and warm undergarments.
In the case of females, it is advised to take clomiphene citrate to induce ovulation. Surgery may be required for the correction of ovarian cysts, uterine defects and blockage of the fallopian tubes etc. Several antibiotics are referred by doctors for infections. The blockage in the female uterus, which prevent sperm and ovum attachments may be cleared by surgery. Success chances are 30% of these cases.