Fertility tourism or reproductive tourism is a form of medical tourism, in which one travels to another country for treatment of infertility.1 The main reasons for going abroad for treatment include long waiting times related to a shortage of eggs and sperm in the patient's own country, lack of donor anonymity, over-regulation, high costs and poor experiences of treatment. In vitrofertilization and donor insemination are the major procedures for which fertility tourism is undertaken. It is estimated that 9% of couples worldwide are infertile.2 For many couples longing for a child, infertility is like a chronic illness. They invest a lot of time, energy and money to fulfill their desire of having a bundle of joy in their life. In the late 1970s, infertility treatments in the form of assisted reproductive technologies (ARTs) became commercially available in industrialized countries for the first time and soon became popular. Their growing demand spawned…
Introduction The vagina offers a unique environment for bacterial colonization. It undergoes several developmental, hormonal and microbiological changes over the course of a lifetime. At birth, it is lined by stratified squamous epithelium, which regresses as the influence of maternal estrogen wanes. In childhood, the vaginal flora contains skin commensals and bowel organisms. At menarche, the pH falls from neutral to approximately 4, and lactobacilli dominate the flora, which also includes many other organisms in lower concentrations, such as anaerobic and facultative anaerobic bacteria and Candidaspp. The hormonal environment alters every month, and the ecosystem is further disturbed by menstruation, washing, and hygiene. Sexual activity can introduce a number of new species and pathogens, as well as alter the pH. The hormonal balance undergoes further fluctuations during pregnancy and lactation. At menopause, the vaginal epithelium gradually atrophies, the pH rises, and a flora more similar to that of skin may…
Introduction Human gonadotropins play an important role in the reproductive process. Hence, their pharmacological preparations have been extensively used to stimulate follicular development in infertile women. During the 1970s, urinary hMG (derived from the urine of menopausal women) was the only gonadotropin used in infertility treatment. It contained both FSH and LH. Later, a wide range of subproducts of urinary hMG were introduced, from which most or all of the LH content had been removed.1 During the mid-1990s, modern technology was used to produce recombinant FSH (rFSH) in vitro from hamster ovarian cell cultures.2 rFSH rapidly proceeded to replace the urine-derived gonadotropins. However, these newer gonadotropins are considerably more expensive, especially since urinary gonadotropins are no longer protected by patents and can now be offered under generic pricing structures.3 Moreover, there is as yet no significant evidence that recombinant gonadotropins are superior to urinary gonadotropins in clinical pregnancy rates. At…
