 Meet this beautiful couple Rahul and Priya. They have been married for years now and almost for the past two years they are trying really hard to have a baby of their own. But even after not using contraception for years, Priya fails to conceive. So they knew it was high time they go see a doctor. And when they visited they were told that there can be a number of reasons behind this infertility or behind not having a child. The reasons could be physical reasons. There can be some physical problem in both the partners. They can be congenital problem, congenital as in some problem right from the birth. And they can be problem due to some drugs they were taking for very long and they had no idea that the drug was impacting their fertility. Or sometimes the problem can be immunological. Immune system responds in such a way that conceiving is not possible. Or sometimes it can even be psychological. Well, I didn't expect the psychological problem here, but I read about it and I found that sometimes one of the partner or both the partner may have history of sexual abuse when they were young. And so that leads to one of the partner not being able to copulate well. So they can be multiple reasons. And if the problem is diagnosed to be something that medicines can cure, well and good, so the doctor will prescribe you some medications and the couple will successfully conceive in some few weeks or months. Now along with medication, the doctor will also suggest the couple some best dates in which if they copulate the chances of conceiving would be very high. And by best dates, I mean the dates of active ovulation in case of female. Now a 28 days long cycle is considered to be the standard length of a menstrual cycle. And somewhere around the 14th day, ovulation is expected. Now the doctor will ask the female partner about how long the menstrual cycle is, how long does the bleeding last. And about the dates in which she had her cycle over different months. And based on that, the doctor will predict the days of ovulation. Now why is that important? Well a female ovulate once per month and the ova remains viable only for 24 hours. So if the sperm do not reach the ova in time, there will be no fertilization and therefore no pregnancy, right? So knowing or at least predicting the days of ovulation is important. But even after all that, if a couple still fails to conceive, then the doctor suggests some tests that should be done first on the male partner and the first test that the doctor suggests is to study the sperm count. Now why is that important? Well in a normal ejaculation which is around 2.5 to 5 ml, ideally there should be around 200 to 300 million sperms in it, out of which 60% at least should have normal shape and size. And out of that 60%, at least 40% should have vigorous motility, okay? But if that is not the case, then the male partner is considered to have less sperm count. Well less sperm count can be due to high alcohol consumption, smoking, obesity, unhealthy lifestyle. Or it can also be due to some injury in the testes or some defect or damage in the passage of the sperm in the male reproductive system. So there can be a number of reasons. But no matter what the reason be, initially the doctor suggests the couple to go and exercise a healthy lifestyle at least for a few months. And if that doesn't help, only then the doctor goes ahead with something called the artificial insemination. Insemination simply means to put the semen into the female reproductive tract. So let's bring in the female reproductive part here. So these are the ovaries, this is the uterus and this tube is the fallopian tube into which the egg is released every month. Now the doctors will select a sperm sample or I should say a semen sample that has good quantity of sperm in it. And that will be injected directly into the uterus or into the fallopian tube with the help of something that looks like an injection. Now how does that help? Well, in normal sexual intercourse the sperms are released in the vagina, right? But through artificial insemination we are releasing the sperm directly into the uterus or sometimes into the fallopian tube. And that way we are reducing the distance between the egg and the sperm. So if there is a problem of less sperm mortality, this procedure will help, right? And again we are not just reducing the distance, we are also making sure that a lot of sperm reaches the egg. So the primary rationale of artificial insemination is to increase the gamut density at the site of fertilization. So there will be a lot of male gamut near the egg because we are artificially depositing it there, right? Now this wonderful technique was started long back somewhere by the end of 1700s. So this technique started with the animals first, the dairy animals or the animals that were reared for food. In that case, a very high breed of animals, if we talk about cows, a very high breed of bull is selected and the sperm of that bull is used to artificially inseminate hundreds or thousands of cows back then. And later this procedure was adopted for humans too. Now even in case of humans, let's say if the male partner is not producing enough sperm. So in such situations, they may opt for a donor, a sperm donor. Wait, when I told sperm donor, is this the image popping up in your mind? This is a poster of a very famous Bollywood movie, Vicky Donor. Well this movie was very famous because a sperm donation was considered a taboo topic and not many movies were made around it or I should say people avoided discussing such topics. But this movie did spread some awareness, but this movie also showed some wrong information here and there, maybe to make it a more spicy Bollywood drama. So one such misinformation was by the end of the movie, where it was shown that the sperm of this person was used to inseminate a lot of women and hundreds and thousands of kids were born with his genes. But in reality it is never the case because using the sperm of a single man to inseminate hundreds of women will in no way contribute to the genetic diversity, right? And also just imagine if this man in his old age is diagnosed with some viewer genetic disease, what happens then? He just can't help because he has already transferred his genes to thousands of kids by then, right? Therefore such a thing is never true, at least in case of humans. So the sperm of a single donor can be used on four to five women at max. But yes, sperm donation is a real thing and that definitely helps infertile couple to have babies. So here we learned that artificial insemination can be from the donor or from the husband. Okay, so we understood artificial insemination but what if the male partner is perfectly fine? He has great sperm count, great sperm mortality, no problem with his sperms at all but still they are not able to conceive. Well that indicates that the problem must be with the female partner. So what do we do then? Well then the female partner is asked to undergo certain tests so that her reproductive system is well understood and the doctor can find out where the problem is. But to understand the problem we should at least know the sequence of events that leads to pregnancy, right? So the first step is the release of egg by the ovaries. So the first step is releasing of the egg. Now once the eggs are successfully released into this fallopian tube then the sperm comes in, fertilizes the egg. So the second step is fertilization. And after fertilization the fertilized egg slowly moves down the fallopian tube, goes into the uterus and gets implanted, embedded into the uterine wall. So the third point is successful implantation, implantation of the embryo. Now any slight disturbance in any of these three actions can lead to infertility. So first let us understand what can go wrong with the release of egg. Now releasing of egg by the ovaries are all a hormonal play. Any slight imbalance in the body's hormone can impact the release of egg into the fallopian tube. And in situations like those a proper diagnosis of body's hormone level and consulting a doctor helps because such conditions can be cured with medications or hormone shots. But there lies a bigger problem. The problem is when the eggs are released by the ovaries properly in time into the fallopian tube but the sperms cannot reach the ova. And how does that happen you ask? Well it happens because the fallopian tubes are sometimes blocked or sometimes the tissues of the fallopian tubes are damaged to such an extent that the sperms cannot swim past them. So what happens then? Well then the doctors surgically remove the eggs from the female's body, mixes it with the sperm cells outside the body and then quickly puts it back into the female fallopian tube. The other fallopian tube which is healthy and functional which is not blocked. So that the fertilization process can take place inside the female's body. But remember for this procedure to work the female should have at least one healthy functional fallopian tube and a healthy uterus. And in this process as we have put a gamete mixture, male and female gamete mixture back into the fallopian tube this procedure is very correctly named as gamete intra-fallopian transfer. Okay with this we have learnt about two new techniques to fight infertility. First is artificial insemination and the second is gift or gamete intra-fallopian transfer. In our future video we will talk about problems related to fertilization and implantation and learn about two new techniques that will help infertile couples to have babies.