**4. Oocyte donation**

 Oocyte donation is one of the necessary arms of ART. It is usually recommended for women with poor ovarian reserve possibly due to primary and secondary ovarian failure. It can be due to surgical causes, damage following chemotherapy or radiotherapy, with certain genetic disorders associated with gonadal dysgenesis like Turner syndrome or patient with a known genetic disorder. It is reported that oocyte donation is one of the most successful techniques resulting in pregnancy, particularly in perimenopausal women.

 One of the earlier concerns was how to *incorporate psychosocial care* into the infertility treatment protocol. This incorporation of psychosocial care is to provide the best possible care to the infertile patient. After incorporating the psychosocial care into the treatment protocol, the patient's preferences and needs are evaluated. The patient wishes to have good interaction with the staff; wishes continuity of care from the same doctor, get information that could be easily understood by the patient and to have a long standing interaction with clinic and the healthcare personnel.

 Singleton pregnancies, preterm delivery and perinatal mortality as well as maternal complications, such as preeclampsia, gestational diabetes, placenta previa, placental abruption and cesarean delivery are some of the reported outcomes of ART. The following figure (**Figure 1**) explains the possible factors that may influence pregnancy outcome following ART.

 *Cryopreservation of oocytes and embryos involves* appreciating the multiple contexts in which oocyte and embryo cryopreservation may be applied. It will enable one to understand the relative impact of cryopreservation on oocytes and embryo quality. It will allow the reader to have a grasp of the concept of selection/attrition

#### **Figure 1.**

*The factors that affect embryo/quality which determines the outcome of assisted reproductive methods.* 

#### *Infertility, Assisted Methods of Reproduction and Hormonal Assays DOI: http://dx.doi.org/10.5772/intechopen.83748*

as it applies to the efficiency of assisted methods of reproduction (ART). It will allow to gain insights into relative balance of advantages and disadvantages associated with oocyte and embryo cryopreservation in different clinical conditions.

Apart from discussions on the nature of infertility and the assisted methods of reproduction, there are widespread discussions regarding the ethical aspects related to infertile patients and ART.

 *Sperm banks have become* one of the accessory health centers of assisted reproductive technology. In simple terms, they collect viable healthy semen samples from responsible sperm donors and preserve them according to stipulated international standards. They become the dispensing center of semen to those needy couples or couples referred to them by the physician who treat these patients. Different countries have different rules and regulations depending upon the religion and sociocultural background. Taking one aspect of a complex issue of sperm donation like keeping the anonymity of sperm donor, many countries have different opinions or regulations. Some nations want anonymous sperm donors and in some countries it is suggested that names of sperm donors be made known. In India, sperm donation is common and yet it is a social taboo, rather a social paradox—one does not want to be seen in such clinics; yet many who are desperate to have a child in the family visit these banks. In countries like India, it is said, in desperation, the recipient's father in law (husband's father or brother) comes forward to donate semen samples. What will be the sociological implications to the child born out of such donation will be an ethical issue of great concern. It is said that sperm banks are facilitators receiving semen samples from the donors and giving the samples to the needy. This sounds very pragmatic and unethical. The name sperm bank itself like gene banks dehumanizes human life and dignity. Artificial insemination ("give life and give hope" sounds like "donate blood and save lives") may give hope to desperate parents to have children. Yet, there is lot of difference between saving lives and giving life. Giving life carries social responsibility, which needs to take into account the child's rights.
