Jumat, 30 November 2007

The Process of Egg Donor

Egg donation is the process of a young woman giving her eggs to an infertile couple that desires to have children. This donation is part of third party reproduction, in which a pregnancy is the goal by in vitro fertilization.

An egg donor may be motivated by a number of reasons to donate her eggs. Some egg donors may feel that by donating they provide a benefit for another couple. Others may be helping an infertile couple that they know or decide to donate from another infertility experience. Some donors are attracted to the monetary compensation.

Women that are infertile may need an egg donor for any number of reasons. Infertile couples may need an egg donor because the female partner cannot have biological children due to her eggs being unfertile. Another problem which may cause couples to seek out an egg donor would be a genetic disorder that the couple does not wish to pass on to their child. Or the female partner may simply be past her child-bearing years and is unable to conceive because of menopause or age-related factors.

Couples can recruit a donor that they know or use an anonymous donor. Couples can also choose an egg donor through a database with pictures, personality information, and a family medical history about the donor. All egg donors are extensively screened for a healthy medical history, and even recruited for potential characteristics such as a high IQ, college education, musical or athletic ability, and beauty. Some donors can gain higher monetary compensation for their services due to their exceptional abilities, some clinics even givie exceptional donors the ability to choose their price (up to $15,000) for their time and effort (particularly for ethnic donors that are in high demand). Higher monetary compensation is very common in states such as California, Arizona, and east coast states where Ivy League schools are present.

Once the egg donor is accepted into the program (after doctor tests and a psychological exam), she undergoes the in vitro fertilization stimulation therapy. The IVF stimulation involves daily injections of fertility drugs to boost the production of the donor’s eggs. After several weeks of injections and doctor appointments, the final step for the donor is the egg retrieval procedure. The procedure involves retrieval through a needle inserted through the vaginal while the donor is sedated. After egg retrieval, the ova are fertilized by the sperm of the male partner in the laboratory, and after several days, the resulting embryo(s) is placed in the uterus of the female recipient. During this time, the donor and the recipient have been prepared for the embryo transfer. The female recipient will hopefully conceive and carry that baby to term. The recipients will raise the child as their own.

Since the inception of IVF treatments, egg donor recipients often have a 50% chance of success. Personal factors may affect the treatment, but success has been known by women of all ages and conditions. The oldest woman to give birth by egg donation was 66 years old. With advanced technology, fertility services can help many infertile couples conceive through an egg donor.

By Genevieve Bordeaux

Senin, 26 November 2007

Make a Test-Tube Baby

IVF is the scientific approach to getting pregnant. Originally termed "test-tube" babies by the Press, embryos are fertilized in the lab, removed from a human body. One attempt at pregnancy through IVF is termed a cycle, and can be divided into 5 general phases.

1. Preparation

You're body is manipulated with drugs. Doctors prescribe a medication such as Lupron to shut down your ovaries for two weeks.

2. Stimulation

Following the Lupron series you will receive a set of up to 14 shots of another medication, such as pergonal, to hyperstimulate egg production. At the conclusion of these shots you will be given a final medication to boost maturity of your eggs.

3. Harvesting

Once the eggs have reached maturity you are heavily sedated and between 5-15 eggs are suctioned from your ovaries via ultrasound guided vaginal retrieval.

4. Fertilization

Egg and sperm meet each other for the first time in the lab. Approximately 100,000 motile sperm are introduced to each egg. Fertilization is documented and the growing embryos are carefully observed in vitro for up to 6 days. The growing trend is to observe growth longer, past the 6-8 cell stage, and blastocyst or advanced stage embryo transfer is not uncommon. There are several benefits to a blastocyst transfer, you might wish to ask your Reproductive team about them.

5. Embryo Transfer

Mom comes back in the picture as 3 or 4 growing embryos are transferred back into your uterus in a procedure that resembles a PAP smear. With any luck a new baby begins growing. On average it takes 3 IVF cycles to establish a pregnancy.

This is a very brief draft of a typical IVF cycle, and it can be an expensive, invasive procedure. But for couples who are having trouble conceiving, IVF is a well-established, proven method to overcoming infertility. There are a million people out there who walking proof it works.

By Daniel Todd

Sabtu, 17 November 2007

Bayi Tabung dari Sudut Pandang Hukum Perdata Indonesia

Latar Belakang Munculnya Inseminasi Buatan (Bayi Tabung)

Pelayanan terhadap bayi tabung dalam dunia kedokteran dikenal dengan istilah fertilisasi-in-vitro yang memiliki pengertian sebagai berikut : Fertilisasi-in-vitro adalah pembuahan sel telur oleh sel sperma di dalam tabung petri yang dilakukan oleh petugas medis. Inseminasi buatan pada manusia sebagai suatu teknologi reproduksi berupa teknik menempatkan sperma di dalam vagina wanita, pertama kali berhasil dipraktekkan pada tahun 1970. Awal berkembangnya inseminasi buatan bermula dari ditemukannya teknik pengawetan sperma. Sperma bisa bertahan hidup lama bila dibungkus dalam gliserol yang dibenamkan dalam cairan nitrogen pada temperatur -321 derajat Fahrenheit.

Pada mulanya program pelayanan ini bertujuan untuk menolong pasangan suami istri yang tidak mungkin memiliki keturunan secara alamiah disebabkan tuba falopii istrinya mengalami kerusakan yang permanen. Namun kemudian mulai ada perkembangan dimana kemudian program ini diterapkan pula pada pasutri yang memiliki penyakit atau kelainan lainnya yang menyebabkan tidak dimungkinkan untuk memperoleh keturunan.

Otto Soemarwoto dalam bukunya “Indonesia Dalam Kancah Isu Lingkungan Global”, dengan tambahan dan keterangan dari Drs. Muhammad Djumhana, S.H., menyatakan bahwa bayi tabung pada satu pihak merupakan hikmah. Ia dapat membantu pasangan suami istri yang subur tetapi karena suatu gangguan pada organ reproduksi, mereka tidak dapat mempunyai anak. Dalam kasus ini, sel telur istri dan sperma suami dipertemukan di luar tubuh dan zigot yang terjadi ditanam dalam kandungan istri. Dalam hal ini kiranya tidak ada pendapat pro dan kontra terhadap bayi yang lahir karena merupakan keturunan genetik suami dan istri.

Akan tetapi seiring perkembangannya, mulai timbul persoalan dimana semula program ini dapat diterima oleh semua pihak karena tujuannya yang “mulia” menjadi pertentangan. Banyak pihak yang kontra dan pihak yang pro. Pihak yang pro dengan program ini sebagian besar berasal dari dunia kedokteran dan mereka yang kontra berasal dari kalangan alim ulama. Tulisan ini tidak akan membahas mengenai pro kontra yang ada tetapi akan membahas mengenai aspek hukum perdata yang menekankan pada status hukum dari si anak dan segala akibat yang mengikutinya.

Proses Inseminasi Buatan (Bayi Tabung)

Dalam melakukan fertilisasi-in-virto transfer embrio dilakukan dalam tujuh tingkatan dasar yang dilakukan oleh petugas medis, yaitu :
1. Istri diberi obat pemicu ovulasi yang berfungsi untuk merangsang indung telur mengeluarkan sel telur yang diberikan setiap hari sejak permulaan haid dan baru dihentikan setelah sel-sel telurnya matang.
2. Pematangan sel-sel telur sipantau setiap hari melalui pemeriksaan darah Istri dan pemeriksaan ultrasonografi.
3. Pengambilan sel telur dilakukan dengan penusukan jarum (pungsi) melalui vagina dengan tuntunan ultrasonografi.
4. Setelah dikeluarkan beberapa sel telur, kemudian sel telur tersebut dibuahi dengan sel sperma suaminya yang telah diproses sebelumnya dan dipilih yang terbaik.
5. Sel telur dan sperma yang sudah dipertemukan di dalam tabung petri kemudian dibiakkan di dalam lemari pengeram. Pemantauan dilakukan 18-20 jam kemudian dan keesokan harinya diharapkan sudah terjadi pembuahan sel
6. Embrio yang berada dalam tingkat pembelahan sel ini. Kemudian diimplantasikan ke dalam rahim istri. Pada periode ini tinggal menunggu terjadinya kehamilan.
7. Jika dalam waktu 14 hari setelah embrio diimplantasikan tidak terjadi menstruasi, dilakukan pemeriksaan air kemih untuk kehamilan, dan seminggu kemudian dipastikan dengan pemeriksaan ultrasonografi.

Permasalahan Hukum Perdata yang Timbul Dalam Inseminasi Buatan (Bayi Tabung)

Inseminasi buatan menjadi permasalahan hukum dan etis moral bila sperma/sel telur datang dari pasangan keluarga yang sah dalam hubungan pernikahan. Hal ini pun dapat menjadi masalah bila yang menjadi bahan pembuahan tersebut diambil dari orang yang telah meninggal dunia. Permasalahan yang timbul antara lain adalah :
1. Bagaimanakah status keperdataan dari bayi yang dilahirkan melalui proses inseminasi buatan?
2. Bagaimanakah hubungan perdata bayi tersebut dengan orang tua biologisnya? Apakah ia mempunyai hak mewaris?
3. Bagaimanakah hubungan perdata bayi tersebut dengan surogate mother-nya (dalam kasus terjadi penyewaan rahim) dan orang tua biologisnya? Darimanakah ia memiliki hak mewaris?

Tinjauan dari Segi Hukum Perdata Terhadap Inseminasi Buatan (Bayi Tabung)

Jika benihnya berasal dari Suami Istri
· Jika benihnya berasal dari Suami Istri, dilakukan proses fertilisasi-in-vitro transfer embrio dan diimplantasikan ke dalam rahim Istri maka anak tersebut baik secara biologis ataupun yuridis mempunyai satus sebagai anak sah (keturunan genetik) dari pasangan tersebut. Akibatnya memiliki hubungan mewaris dan hubungan keperdataan lainnya.
· Jika ketika embrio diimplantasikan ke dalam rahim ibunya di saat ibunya telah bercerai dari suaminya maka jika anak itu lahir sebelum 300 hari perceraian mempunyai status sebagai anak sah dari pasangan tersebut. Namun jika dilahirkan setelah masa 300 hari, maka anak itu bukan anak sah bekas suami ibunya dan tidak memiliki hubungan keperdataan apapun dengan bekas suami ibunya. Dasar hukum ps. 255 KUHPer.
· Jika embrio diimplantasikan ke dalam rahim wanita lain yang bersuami, maka secara yuridis status anak itu adalah anak sah dari pasangan penghamil, bukan pasangan yang mempunyai benih. Dasar hukum ps. 42 UU No. 1/1974 dan ps. 250 KUHPer. Dalam hal ini Suami dari Istri penghamil dapat menyangkal anak tersebut sebagai anak sah-nya melalui tes golongan darah atau dengan jalan tes DNA. (Biasanya dilakukan perjanjian antara kedua pasangan tersebut dan perjanjian semacam itu dinilai sah secara perdata barat, sesuai dengan ps. 1320 dan 1338 KUHPer.)

Jika salah satu benihnya berasal dari donor

· Jika Suami mandul dan Istrinya subur, maka dapat dilakukan fertilisasi-in-vitro transfer embrio dengan persetujuan pasangan tersebut. Sel telur Istri akan dibuahi dengan Sperma dari donor di dalam tabung petri dan setelah terjadi pembuahan diimplantasikan ke dalam rahim Istri. Anak yang dilahirkan memiliki status anak sah dan memiliki hubungan mewaris dan hubungan keperdataan lainnya sepanjang si Suami tidak menyangkalnya dengan melakukan tes golongan darah atau tes DNA. Dasar hukum ps. 250 KUHPer.
· Jika embrio diimplantasikan ke dalam rahim wanita lain yang bersuami maka anak yang dilahirkan merupakan anak sah dari pasangan penghamil tersebut. Dasar hukum ps. 42 UU No. 1/1974 dan ps. 250 KUHPer.

Jika semua benihnya dari donor

· Jika sel sperma maupun sel telurnya berasal dari orang yang tidak terikat pada perkawinan, tapi embrio diimplantasikan ke dalam rahim seorang wanita yang terikat dalam perkawinan maka anak yang lahir mempunyai status anak sah dari pasangan Suami Istri tersebut karena dilahirkan oleh seorang perempuan yang terikat dalam perkawinan yang sah.
· Jika diimplantasikan ke dalam rahim seorang gadis maka anak tersebut memiliki status sebagai anak luar kawin karena gadis tersebut tidak terikat perkawinan secara sah dan pada hakekatnya anak tersebut bukan pula anaknya secara biologis kecuali sel telur berasal darinya. Jika sel telur berasal darinya maka anak tersebut sah secara yuridis dan biologis sebagai anaknya.

Dari tinjauan yuridis menurut hukum perdata barat di Indonesia terhadap kemungkinan yang terjadi dalam program fertilisasi-in-vitro transfer embrio ditemukan beberapa kaidah hukum yang sudah tidak relevan dan tidak dapat meng-cover kebutuhan yang ada serta sudah tidak sesuai lagi dengan perkembangan yang ada khususnya mengenai status sahnya anak yang lahir dan pemusnahan kelebihan embrio yang diimplantasikan ke dalam rahim ibunya. Secara khusus, permasalahan mengenai inseminasi buatan dengan bahan inseminasi berasal dari orang yang sudah meninggal dunia, hingga saat ini belum ada penyelesaiannya di Indonesia. Perlu segera dibentuk peraturan perundang-undangan yang secara khusus mengatur penerapan teknologi fertilisasi-in-vitro transfer embrio ini pada manusia mengenai hal-hal apakah yang dapat dibenarkan dan hal-hal apakah yang dilarang.

Kasus Inseminasi Buatan di Amerika Serikat
Mary Beth Whitehead sebagai ibu pengganti (surrogate mother) yang berprofesi sebagai pekerja kehamilan dari pasangan William dan Elizabeth Stern pada akhir tugasnya memutuskan untuk mempertahankan anak yang dilahirkannya itu. Timbul sengketa diantara mereka yang kemudian oleh Pengadilan New Jersey, ditetapkan bahwa anak itu diserahkan dalam perlindungan ayah biologisnya, sementara Mrs. Mary Beth Whitehead (ibu pengganti) diberi hak untuk mengunjungi anak tersebut.

Negara Lain
Negara yang memberlakukan hukum islam sebagai hukum negaranya, tidak diperbolehkan dilakukannya inseminasi buatan dengan donor dan dan sewa rahim. Negara Swiss melarang pula dilakukannya inseminasi buatan dengan donor. Sedangkan Lybia dalam perubahan hukum pidananya tanggal 7 Desember 1972 melarang semua bentuk inseminasi buatan. Larangan terhadap inseminasi buatan dengan sperma suami didasarkan pada premis bahwa hal itu sama dengan usaha untuk mengubah rancangan ciptaan Tuhan.

Jumat, 16 November 2007

Some Causes of Infertility in Woman

There are many factors that will relate how a woman develops infertility. While it is prevalent among Americans, no data can truly present the actual intensity or prevalence of this condition.

Infertility is definitely not a physical disease. Unlike simpler conditions like flu or the more complex ones such as those of cancer, symptoms of infertility are not focused on the obvious signs.

In fact, a woman need not undergo a series of comprehensive tests and examinations before she can truly be diagnosed of infertility. The same goes with men only differing in one thing, male infertility is much more difficult to be spotted unless obvious presentations of erectile dysfunction are seen.

Pelvic Inflammatory Disease or PID


This is presumed to be the most common cause of infertility. This arises from internal infections that are caused by bacteria penetrating into the internal reproductive organs of a female. The typical organs affected are those surrounding the pelvic area but when aggravated, infections may also radiate into the neighboring intestines. Infertility associated with PID is definite if the portion affected is the fallopian tube, a condition that is medically termed as salpingitis.

Endometriosis

According to data gathered from medical literature, nearly 30% of all infertility cases in women is covered by this condition. This is characterized with the presence of the endometrial tissue in parts other than the uterus. This tissue is the one women discharge during menstrual cycle.

Having this condition however does not actually suggest the likelihood of being unable to conceive. But it may largely contribute to the development of the disease

Polycystic Ovarian Syndrome


This is the condition characterized by the over-production of androgens in the female's system. This occurrence will drive the lowering in the release of other hormones such as Follicle Stimulating Hormone and Luteinizing Hormone which will eventually caused the stoppage of mature egg production.

Early Menopause or Premature Ovarian Failure


This is the premature depletion of follicles in women during ages prior to her 40th years. This is characterized by long periods of irregular menstrual flow. This condition is very much comparable with true menopause since both impede a woman to produce eggs.

Idiopathic Hypogonadotropic Hypogonadism


This is rarely the case among infertile women. This is identified when there is 'no' production of LH and FSH. Thus, the impossibility of developing egg cells. There are actually no physical symptoms that will help conclude the presence of this condition. Most cases of Idiopathic Hypogonadotropic Hypogonadism fall under unknown infertility cases.

By Low Jeremy

Perokok punya Bayi Tabung Sehat?

Rokok berkaitan erat dengan kemampuan reproduksi. Salah satunya, adalah kemampuan seorang pria untuk menghasilkan sperma yang berkualitas. Berbagai penelitian membuktikan bahwa rokok bisa menurunkan kualitas sperma. Ini sangat masuk akal mengingat dalam sebatang rokok terdapat sekitar 4.000 partikel kimia yang berbahaya bagi tubuh alias beracun.
Secara sederhana dapat dijelaskan bahwa racun dalam rokok ini bisa masuk ke testis, sehingga mengganggu perkembangan sperma. Partikel tersebut masuk ke darah dan semen. "Kondisi pada sperma akibat rokok itu bisa dilihat dari jumlah spermanya yang berkurang, gerakannya menjadi lambat, dan bentuknya menjadi jelek," jelas embriologis dari Klinik Infertilitas Permata Hati RS Dr Sardjito, dr Ita Fauzia Hanoum, MCE.
Ada penelitian yang bisa membuktikan kalaupun bentuk sperma tidak bermasalah, kemudian gerakannya tidak terlalu berpengaruh, jumlahnya juga tidak terlalu turun, tetapi DNA-nya rusak. Jadi, kata dia, sekarang yang menjadi perhatian para perokok, terutama perokok berat, adalah kemungkinan tidak punya anak.
Penelitian yang mengemukakan bahwa rokok dapat mempengaruhi kualitas sel DNA sperma pria banyak membuat papa pria tersebut memilih jalur bayi tabung dalam hal memperoleh keturunan, tapi lewat proses bayi tabung-pun, DNA sel sperma yang sudah rusak akan tetap mempengaruhi proses kelahiran bayi tabung.
Kerusakan DNA itu bisa mempengaruhi banyak hal, bisa yang minor sampai ke mayor.
"Angka keguguran menjadi tinggi. Kalau ayah dan ibunya merokok, kontribusinya menjadi dua, tetapi kalau ibunya tidak merokok, angka kegugurannya karena DNA ayahnya rusak," tandasnya. Parahnya lagi, kalau si ibu tidak mengalami keguguran dan anak lahir hidup, anaknya mungkin ada kecacatan tertentu. "Apalagi bila si isteri usainya sudah lanjut, suami merokok, angka kecacatan anaknya akan semakin tinggi," jelasnya.
Di Klinik Permata Hati belum dilakukan penelitian tentang hubungan laki-laki yang ikut program bayi tabung dengan perilaku merokok, tetapi mereka selalu ditanya apakah mereka merokok atau tidak. Disarankan pula kepada para suami perokok yang ikut program bayi tabung agar tidak merokok. ''Memang ada yang mempertimbangkan hal itu, tetapi sebagian besar menganggap tidak ada pengaruhnya dan tidak peduli. Mereka tetap merokok. Padahal pendidikan mereka menengah ke atas,'' ungkap Ita. Dari hasil penelitian juga didapatkan bahwa suami perokok kemampuan untuk menghamili isterinya lebih lambat daripada suami yang tidak merokok. Kalaupun sang istri bisa hamil, masalah lain akan menanti di depan mata. Maka dari itu cara bayi tabung pun tetap tidak akan memberikan hasil yang baik jika anda tetap merokok.

Bayi Tabung Lebih Pintar?

Penelitian pertama terhadap anak-anak usia delapan tahun dari hasil pembuahan melalui metode intracytoplasmic sperm injection (ICSI) atau bayi tabung menunjukkan bahwa mereka rata-rata memiliki tingkat intelegensi yang lebih baik daripada anak-anak hasil reproduksi normal. Hal tersebut menolak anggapan bahwa teknik tersebut tidak seaman metode in vitro vertilization (IVF) standar yang biasa dipakai untuk menghasilkan bayi tabung.

ICSI dilakukan dengan menyuntikkan sperma secara langsung ke dalam sel telur, berbeda dengan IVF standar yang hanya meletakkan sperma sedekat mungkin dengan sel telur, tanpa disuntikkan, agar dapat melakukan pembuahan secara alami.

Beberapa penelitian pendahuluan yang dilakukan sejak 1998 melaporkan bahwa anak-anak hasil bayi tabung/ICSI usia satu tahun terlambat berkembang dibandingkan anak-anak yang normal. Sehingga keamanan teknik tersebut sempat diragukan. Tapi, penelitian yang lebih lama terhadap anak usia lima tahun, tidak ditemukan perbedaan tingkat perkembangan yang signifikan.

Baru-baru ini, tim yang dipimpin Lize Leunens dari Free University of Brussels (VUB) di Belgia membandingkan antara tingkat intelegensi dan kemampuan motorik terhadap 151 anak hasil bayi tabung usia delapan tahun dengan 153 anak hasil pembuahan normal.

Hasilnya, tidak ada perbedaan dalam kemampuan motorik dan anak-anak ICSI memiliki nilai tes intelegensi yang lebih tinggi daripada yang normal. Leunens memaparkan hasil penelitiannya dalam pertemuan tahunan Perkumpulan Reproduksi Manusia dan Embriologi Eropa di Kopenhagen, Denmark, Selasa (21/6).

"Kami sangat gembira karena dalam jangka panjang anak-anak hasil bayi tabung tersebut tidak menderita kemunduran dalam perkembangannya," katanya.

Dalam penelitian tersebut, tidak ada perbedaan level pendidikan dari ibunya, yang diketahui mempengaruhi tingkat intelegensi seorang anak. Oleh karena itu Leunens berpendapat bahwa alasan yang dapat menerangkan adalah motivasi yang lebih besar dari ibu yang mengandung bayi ICSI. "Ibu yang mengandung bayi ICSI ini mungkin mendedikasikan dirinya secara khusus sebagai orang tua," katanya.

Selain itu, penjelasan yang masuk akal juga disampaikan menanggapi kemunduran tingkat perkembangan pada bayi ICSI yang berusia sangat muda. Beberapa penelitian menunjukkan bahwa ibu bayi ICSI lebih suka membesarkan anaknya di rumah daripada mengirimkan ke playgroup atau berinteraksi dengan orang lain, kondisi yang mungkin menyebabkan kemunduran dalam perkembangan sosial.

Tapi, penelitian ini bukanlah jawaban terakhir. Penelitian lain menunjukkan bahwa penolakan banyak orang tua untuk mengijinkan anaknya diteliti, mungkin agak menurunkan kepercayaan hasil penelitian Leunens. Faktanya, sepertiga orangtua anak-anak ICSI menolak berpartisipasi.

Tanpa mengesampingkan kemungkinan-kemungkinan yang lain, Leunens menyatakan bahwa hasil penelitian tidak berbeda dengan kondisi yang dipaparkan orang tua melalui wawancara telepon. Ia juga menekankan bahwa penelitiannnya tidak melihat masalah kesehatan yang lain.(NewScientist.com/Wah)

Tehnik Bayi Tabung: Bedah Laparoskopik

Dalam proses bayi tabung secara ICSI, GIFT atau ZIFT seringkali ada operasi bedah laparoskopik (laparoscopic surgery). Ini adalah sedikit pembahasan mengenai laparoscopic surgery tersebut.

Operasi bedah laparoskopik merupakan teknik bedah yang dilakukan dengan cara membuat lubang kecil di dinding perut dan mengangkat kandung empedu dengan instrumen khusus menggunakan sistem endokamera melalui layar monitor.
Operasi ini digunakan dalam prosedur bayi tabung untuk memasukkan sel telur yang sudah dibuahi oleh sel sperma dan berkembang menjadi zigot ke dalam tuba fallopi si pasien wanita untuk kemudian agar dapat tumbuh secara alamiah menjadi bayi.

Efek bedah laparoskopik merupakan kebalikan dari efek bedah konvensional yang seringkali menimbulkan rasa nyeri pasca operasi, munculnya bekas pembedahan, masa pulih yang lambat, dan masa rawat yang panjang. Efek laparoskopik ini yaitu rasa nyeri yang minimal, masa rawat pendek, masa pulih cepat serta luka parut yang minimal.

Angka kematian pada sistem operasi bedah ini tercatat nihil, sedangkan penyulit dan konversi ke bedah konvensional kurang dari satu persen. Bedah laparoskopik sendiri merupakan teknik bedah invasif minimal yang menggunakan sistem endokamera, pneumoperitoneum dan instrumen khusus.

Pembedahan dilakukan di dalam rongga abdomen melalui layar monitor tanpa melihat dan menyentuh langsung organ yang dioperasi. Karena itu, spesialis bedah memerlukan pelatihan koordinasi mata dan tangan untuk menguasai keterampilan teknik bedah laparoskopik.

Selasa, 13 November 2007

Designing Your Baby through PDG

Imagine that you can choose what your brother or sister would look like. Imagine if you could choose your child's eye color, hair color, IQ level, and even his interests. Imagine a world where everyone is perfectly healthy and wise IQ-wise.

This seems like a scene from a science fiction movie? Well, it might be possible in the near future to the promotion of preimplantation genetic diagnosis or PGD. PGD is a procedure in which the embryo is genetically tested to be free of the disease and then implanted in the mother using invitro fertilization (IVF).

Parents can now choose to have the ultimate child who excelled in both studies and sports. We all got a glimpse of IPRs in the 1997 film Gattaca where genetic engineering and IVF enabled engineering children, including factors such as gender, intelligence, life and even eliminate several genetic and hereditary diseases.

However, the DPI does not exist only in science fiction films. In fact, the DPI continues to develop in an exciting technology with the incredible potential to increase women's opportunities and not just a healthy pregnancy, but a healthy infant as well.

The DPI has been made famous by Dr. Jeffrey Nisker, the University of Ontario. He launched the IPR, and was the first person in Canada to offer such a procedure revolutionary engineering manually embryos. Since then, he has stopped its program and closed down due to overwhelming requests from across Canada to access PGD, not to avoid serious genetic conditions for sex selection, but above all to avoid having a daughter.

It is against its concern and belief that all children should be cherished, regardless of their sex. Among the cases in which the DPI was made, when a couple needed the procedure of having a baby with the right genetic makeup to save the life of their son. Leanne and Stephen needed the procedure to save their first-born, BJ, who suffers from a rare genetic disease, Hyper IGM. BJ is missing a vital part of his immune system and survives only through blood transfusions regularly.

The child needs to be free of disease and of the same sex as BJ, only then they can be assured that the tissue can be transplanted to the newborn BJ. The procedure is long and tedious with Leanne and Stephen go through a roller coaster of emotions that the fertilized eggs are extracted and then sent for testing.

After a few rounds missing, Leanne and Stephen made a hit and the embryo was transplanted into Leanne. Soon, their baby will arrive, bringing aid and hope to his older brother and parents! The DPI has nevertheless raised some ethical concerns of society, especially with regard to its potential and who should decide how to use this revolutionary new technology.

The procedure allows parents to determine the sex of the embryo, and thus can be used to select the sex of an embryo, preferably to another within the framework of "family balancing".

The company also raised the issue of doctors and scientific "playing God", which interferes with the natural shape of the design can have a major impact on our planet in the future.

By: Michael Russell

Minggu, 11 November 2007

How Acupuncture Affect IVF

A number of reasons have been shown how acupuncture affects the outcome of in vitro fertilization, or IVF. Acupuncture has been shown to positively affect the level of the ovary and pituitary hormones while the electro-acupuncture treatment showed will lead to better and improved blood flow within the uterine arteries of women are infertile.

In conjunction with IVF therapy of acupuncture modern, as a complementary therapy, is increasingly common. Studies have shown that acupuncture helps patients respond better to medication and improving pregnancy rates and leading healthy eggs. Many women who have had problems with high levels of FSH or who have suffered a miscarriage are advised that acupuncture is the answer to their problems.

The pregnancy rate higher couples experiencing difficulty in conceiving through traditional methods are turning to other techniques to help them have a child and one of the most widely used reproductive therapies currently used is in vitro fertilization. IVF is the process of harvesting eggs from a woman, then fertilization with sperm in a laboratory.

Some studies have shown that pregnancy rates increase by as much as 40 per cent for women undergoing acupuncture treatment in addition to IVF. Acupuncture makes the uterus more receptive to the implantation, which is one of the main reasons attributed to the higher rates of success.

On a side note, for women who decide to combine acupuncture with IVF, it seems that it is preferable to undergo acupuncture treatment, in the afternoon, before transferring embryos, as well as in in the afternoon or the day after the transfer.

Many women find IVF be a source of stress and anxiety-ridden experience. These factors often result in undermining the success of IVF. However, on a positive note, a 2002 German study reported that 34 out of 80 women who have been the subject of an IVF and were also receiving acupuncture got pregnant-a success rate of 42.5 for cent. For non - this may not be very rational, but anything when compared to women undergoing IVF treatment as (no acupuncture), the pregnancy rate for those using the 'acupuncture is much higher.

Jumat, 09 November 2007

4 Factors Affecting Pregnancy After Tubal Reversal Surgery

There are many factors which will need to be taken into consideration by a woman after tubal reversal surgery has been carried and she is looking to conceive. Certainly for some women once the procedure has been carried out they find they become pregnant quite quickly afterwards, but for others it will take some time. There are a number of different factors a woman will need to consider in relation to her pregnancy after tubal reversal actually being successful.

Probably the first thing to consider when considering getting pregnant whether having had your tubes tied or not has to do with age. Even if a woman has not undergone a tubal ligation, the older she is the more likely it will be that she will have a problem conceiving. This is just a fact of life, though you will have heard of some women getting pregnant at what some would consider an advanced age. It just boils down to the younger you are when having your tubal reversal surgery, the higher the probability of getting pregnant after tubal reversal is done.

A twenty-something woman will find her chances of conceiving after tubal reversal is about 77%. As you get older the probability drops as we stated before. A female that is between thirty-five and thirty-nine finds the probability falls to 62%. For a woman over forty, the conception rate falls even further to 34%.

The next factor that plays a part in getting pregnant after a tubal ligation reversal procedure is how long the fallopian tubes were left from the original tube tying procedure. The more the doctor has to work with the better the chances are. Some will find they conceive quickly but others will take five years or more. The condition of the fallopian tubes, the length they were left and thus what the doctor has left to reconnect, and how well they are reconnected all play a part in how soon you can get pregnant and what your chances of getting pregnant are.

How long since the tubal ligation surgery was carried out? - Unfortunately the longer a woman waits in order to get her tubal ligation procedure reversed will greatly reduce her chances of being able to conceive easily. This is because the longer they wait the more damage will have been caused to their fallopian tubes, which in turn reduces the chances of the operation actually being successful.

Is Tubal Reversal a better option than IVF? - In a number of studies that have been carried out over the years relating to this matter, many women have found that having tubal reversal surgery rather than under going IVF (in vitro fertilization) treatment has been more successful.

One such study from the Chapel Hill Reversal Center, where they keep excellent track of their patients, it was discovered that the women who had the tubal reversal done, instead of the IVF treatments, conceived more easily. In addition, the number of actual babies born after they became pregnant, was higher for the tubal reversal surgery than for those who underwent IVF. Even better is that the reversal surgery is done generally on an outpatient basis with only about an hour in surgery thus lowering the cost of this treatment versus the IVF treatment which can take many tries.

All these items above need to be considered when you are making your decision concerning tubal ligation reversal. Keep it all in mind when you are looking at pregnancy after tubal reversal as any of the factors, or indeed all of the factors, could have an impact on your ability to conceive and have the child you are dreaming of. However, the factors affect you, this could still be your best bet.

Copyright 2007 Sandra Wilson
Technorati Profile

Selasa, 06 November 2007

Tehnik Bayi Tabung: Sperma Kosong

Pada proses bayi tabung, bagaimana jika ada sperma yang kosong? kosong disini maksudnya
Pada kasus cairan air mani tanpa sperma (azoospermia), mungkin akibat penyumbatan atau gangguan saluran sperma, kini bisa dilakukan pengambilan sperma dengan teknik operasi langsung pada saluran air mani atau testis. Tekniknya ada dua, MESA (Microsurgical Sperm Aspiration) dan TESE (Testicular Sperm Extraction). Pada MESA, sperma diambil dari tempat sperma dimatangkan dan disimpan (epididimis). Sedangkan pada TESE, sperma langsung diambil dari testis yang merupakan pabrik sperma. Setelah sperma diambil, dipilih yang paling baik. Selanjutnya, dilakukan langkah-langkah menurut prosedur ICSI. Teknik ini juga sudah diterapkan di RSAB Harapan Kita sejak 1996 dan telah berhasil melahirkan dua anak.

Seperti di negara lain, sejak 1992 Indonesia sudah melakukan simpan beku embrio. Perangsangan indung telur wanita pada prosedur bayi tabung memungkinkan terbentuknya banyak embrio. Tidak mungkin semua embrio ditransfer ke dalam rahim pada saat bersamaan. Embrio yang untuk sementara tidak digunakan dapat disimpan dengan cara kriopreservasi, yang selanjutnya disimpan dalam tabung berisi cairan nitrogen pada suhu 196oC di bawah nol derajat. Kapasitas tabung sekitar 100 embrio.

Simpan beku embrio ini menghemat biaya karena pasangan tidak perlu lagi mengulang proses pengerjaan dari awal lagi bila embrio berikutnya perlu ditanamkan kembali. Tidak seperti di Barat, embrio ataupun sperma yang tersimpan beku di Indonesia hanya diperuntukkan bagi pasutri yang bersangkutan.

Salah satu contoh keberhasilan teknik penyimpanan embrio bisa ditemukan di Belgia. Baru-baru ini lahir seorang bayi laki-laki sehat hasil penanaman embrio yang sudah dibekukan selama 7,5 tahun dari pasangan lain (anonim). Bayi yang dibantu kelahirannya oleh dr. Michael Vermesh ini beratnya 4 kg. Daya tahan embrio yang dibekukan bisa puluhan tahun dan tetap bisa menjadi bayi sehat.

Teknologi reproduksi in vitro ternyata sangat membantu pasangan yang mengalami gangguan reproduksi. Mengupayakan pasutri agar bisa mempunyai anak sungguh merupakan perbuatan mulia dan membahagiakan, sekalipun pembuahannya dilakukan di laboratorium. Seperti halnya Louise Brown, mungkin banyak anak yang dilahirkan melalui teknik ini ikut bersyukur bahwa kedua orang tuanya mengikuti program itu.

Minggu, 04 November 2007

Avoid The Common Traps And Increase Your Chance Of Success

IVF Clinics – Avoid the common traps and increase your chance of getting pregnant!
There are so many fertility clinics licensed to practice assisted reproductive technologies and help couples achieve their dream of a baby. With plenty to choose from it is apparent they are not all created equal and the playing field is by no means level. Pregnancy success rates can range from 10% to 60%, which means that the fertility clinic you choose is one of the most important factors to maximizing your chances of conceiving. AND the decision is all down to you!

The world of infertility is daunting. Initially you find out that the prospect that having children may not be as straightforward as you originally thought. Then having digested this shocking news, you have to find the best ways to help you get pregnant. Finding the right team of people to do this is the key to your success. It is so easy to make simple mistakes and these mistakes could cost you the difference of being pregnant or not! I fell into some of these traps because I was naïve and placed my future in the hands of the professionals and when it failed, I took that matter into my own hands and became an expert of fertility clinics that could best help us.

While it is true that most of us carefully scrutinize items of great importance like a future house or car purchase, when the stakes are much higher, we tend to throw all caution and logic to one side. This is the case with fertility. When it comes to someone providing you with the slightest glimmer of hope of becoming a parent, inevitably you will take a blind leap of faith. IVF treatment is an addictive process simply because of your hunger for success – that little baby! This is why choosing the right clinic from the beginning is one of the most important decisions you will make. If you get it right, you will be on your way to enjoying parenthood. If you get it wrong, you have one hell of a roller coaster ride ahead of you!

Common traps to avoid


Location

Some people choose the nearest clinic to their home. This understandable as throughout the fertility treatment you will need to go back and forth, sometimes several times a day. But it is a mistake to choose a clinic solely on this basis. There are other important factors, which must come into the equation. If the ideal clinic for you, after all your research has been completed is a clinic 200 miles away, investigate the possibility of staying with friends, or a local hotel for a few weeks.

Hearsay and recommendation
Choosing a clinic solely on the fact that you heard a doctor there was ‘ good’ or you know someone who went there and has had success is also wrong. Sure, it provides a good place to start but again your research must go beyond this to identify what the clinic can do for you. Every couple’s circumstances is different and what works for one couple, may not work for another. Bear this in mind when researching the types of treatments available at each clinic.

Referral from Doctor or Gynaecologist

After completing your initial investigative tests, your doctor will undoubtedly have a conversation with you about what happens next. So far you have invested all your trust in your doctor and naturally respect his/her choice of clinic. Often, a doctors referral will be based on hearsay or anecdotal information. Certainly research your doctors recommendation but if the clinic does not suit you and your partner, do not feel pressured into it.

Cost
It is our nature to seek out a good deal. When it comes to fertility treatment there is no such thing as a good deal. The cost of treatment bears no relation to the clinics’ success rate. What does pay off is the time you invest in researching and asking the right questions.

Repeat treatment
You may already have completed one cycle of treatment at a chosen clinic and wish to try again. Do not feel under pressure to use the same clinic for your next attempt. If it has not worked the first time, there may be a valid reason for it.

By Marina Nicholas