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The Bar Mitzvah ceremony is a rite of passage into manhood and coming of age. It is conducted when the boy reaches the age of 13 to show that the boy has become a man in the eyes of the Synagogue and are now responsible for themselves. The boy is seen as an adult after this ceremony. The boy is now entering puberty (and thus in the process of becoming fertile). This is a celebration of the start of puberty and thus fertility.
Some sedating medication is given to the woman; however, general anaesthesia is not required. The surgeon then inserts a needle into the woman's ovary via the vagina in order to remove the eggs. The liquid collected is then examined in order to ensure eggs are present. The man, who has been instructed to not have sexual intercourse before the sample must be given, then provides a semen sample. This is normally done by masturbation. The sperm is then removed from the semen and are mixed with the eggs. Fertilization can be detected after 18 hours or so. The embryos are the \n incubated for 2 to 3 days before being inserted into the woman's uterus. This is done via the cervix using a catheter. The woman must remain in the resting position for about an hour. Certain hormones are given to the woman. The pregnancy test result will be positive if implantation occurs.
Sperm is either collected through masturbation or is surgically removed from a testicle though an incision. The female must receive daily hormonal injections and be monitored for two weeks before the procedure. FSH is injected to stimulate the production of multiple eggs. If follicles develop, a human chronic gonadotropin (hCG) is injected into the female to cause the follicles to mature. These eggs are then collected about 36 hours after the follicles have matured using a laparoscopy. Under high magnification, a holding pipette is used to hold the egg in place while the single sperm cell is injected into the egg using an injection pipette (this is done to multiple eggs to ensure fertilization). The eggs are incubated overnight and then checked to determine whether fertilization has occurred or not. If the eggs have been successfully fertilized, the eggs will be left to develop for another 3 to 5 days. Two to four of these embryos are then placed into the uterus using a catheter which is inserted through the cervix. The unused embryos may be frozen for future use.
Can be done even if the man has a low sperm count
Can be used where the man has had an irreversible vasectomy
Can be used when the man has no sperm in his semen due to blocked tubes or blockages. If IVF was not successful this procedure can be tried
Immature sperm cell can be used
The hormone treatment can cause ovarian hyperstimulation syndrome
Increased chance of multiple births
There are possible birth defects (e.g. Heart and internal urinary/genital defects)
Relatively new procedure so not all side effects are known
Slight increased chance of abnormalities in offspring
Gamete Intrafallopian Transfer (GIFT)
Very similar to the IVF procedure, except the gametes are transferred into the woman's fallopian tubes. This means that fertilization occurs in the body. The embryo therefore develops inside the body naturally.
How is this technique carried out?
The woman is given hormones before the procedure to stimulate the ovaries to produce more than one egg. Some sedating medication is given to the woman; however, general anaesthesia is not required. The surgeon then inserts a needle into the woman's ovary via the vagina in order to remove the eggs. The liquid collected is then examined in order to ensure eggs are present. The man, who has been instructed to not have sexual intercourse before the sample is given, then provides a semen sample. This is normally done by masturbation. The gametes are immediately inserted in the woman's fallopian tubes. This is done via the cervix using a catheter. The woman must rest for a while after the procedure. Natural fertilization and implantation then take place. A progesterone injection is given to the woman to prepare the lining of the uterus for implantation.
Can be used if there are problems when inserting the zygote through the cervix into the uterus
Fertilization and implantation occur naturally, thus this procedure may be preferred to IVF due to religious reasons
Does not increase the chances of ovarian cancer
It is more complicated than the IVF procedure
If no pregnancy occurs, you cannot tell whether fertilization took place or not. This means you cannot tell whether the sperm was able to penetrate into the egg
You are more likely to have multiple births (can increase risk of miscarriage)
Fertility drugs can have side-effects
You have an increase chance of an ectopic pregnancy
More invasive procedure than IVF
Zygote Intrafallopian Transfer (ZIFT)
The egg is fertilized outside the woman's body and then inserted into the fallopian tube of the woman.
How is this technique carried out?
Medications are given to the woman to stimulate the maturing of the woman's follicles. The eggs are then removed while the woman is under anaesthesia. The eggs are then mixed with the woman's partner's sperm and left overnight to fertilize. Once the eggs have been fertilized, they are placed back into the woman's fallopian tubes through laparoscopy. 1 to 4 embryos are inserted and then left to implant into the uterus naturally.
Fertilization occurs outside the body. This means that id no pregnancy occurs; the doctors know that it is not due to the fact that the sperm did not fertilize the egg.
Implantation occurs naturally
Women with a history of ectopic pregnancies should avoid this procedure
A decent sperm sample is needed
Multiple pregnancies can occur
Increased risk of ectopic pregnancies
Requires two surgical procedures
Ethical issues surrounding ART:
Child is not seen as a kind gift of nature
Women undergoes medical and psychological risks
Allows single women or lesbian couples to have a child
Some believe that surrogacy is the exploitation of the woman as an incubator
I believe that one cannot simply recommend any technique to every person, as each person's circumstances are different. Firstly, the reason for infertility needs to be considered. Is it due to a blocked or damaged fallopian tube? If so, neither GIFT nor ZIFT can be carried out as the gametes/embryo needs to be inserted into the woman's fallopian tube. Another cause could be a low sperm count, in which case either GIFT or IVF would probably be most effective as a single sperm cell can be used in GIFT. IVF, however, seems to be the most popular method of ART, it is less invasive on the body, is less expensive and has a relatively high success rate with little or no complications in the resulting child's health later on in life. GIFT would be the best option for someone who is religious and does not believe in fertilization outside the body as with the GIFT procedure, fertilization and implantation occur naturally inside the body.