ʻO ka PMA (medically assisted procreation) a i ʻole AMP (medically assisted procreation) e pili ana i nā ʻenehana a pau i hoʻohana ʻia no ka hana hou ʻana i loko o ka ʻāpana o nā kaʻina kūlohelohe o ka fertilization a me ka ulu ʻana o ka embryonic mua. Hiki iā lākou ke uku no ka infertility i hoʻokumu ʻia i ka lāʻau lapaʻau a i ʻole e pale i ka lawe ʻana i kekahi mau maʻi koʻikoʻi.

ʻO ka hana mua i ke kaʻina hana hoʻohua i kōkua ʻia, ʻo ia ka hoʻokō ʻana i kahi loiloi infertility i mea e ʻike ai i ke kumu kūpono o ka infertility i nā kāne a / a i ʻole wahine.

Ma ka pae ʻelua, ʻo ka Hühner test (a i ʻole post-coital test) ka hoʻokolokolo kumu. Loaʻa ia i ka lawe ʻana i ka mucus cervical 6 a 12 mau hola ma hope o ka moe ʻana i ka manawa o ka ovulation a me ka nānā ʻana iā ia e hōʻoia i kona maikaʻi.

I loko o nā wahine, aia ka loiloi kumu:

• kahi pā wela e nānā i ka lōʻihi a me ka maʻamau o ka pōʻaiapuni a me ka hele ʻana o ka ovulation
• he hōʻike hoʻokolohua lapaʻau e ʻike ai i nā mea ʻino o ka ʻāpana genital
• he loiloi hormonal e ka ho'āʻo koko e nānā i ka maikaʻi o ka ovulation
• nā hoʻokolohua kiʻi lāʻau no ka nānā ʻana i nā ʻano ʻokoʻa (uterus, tubes, ovaries). ʻO ke kani kani ka hōʻike mua-laina, akā hiki ke hoʻohui ʻia e nā ʻenehana ʻē aʻe (MRI, laparoscopy, hysteroscopy, hysterosalpingography, hysterosonography) no ka ʻimi ʻana i ka nui.
• he hoʻokolohua lapaʻau e ʻike ai i ka hele ʻana o ka varicocele, cysts, nodules a me nā mea ʻino ʻē aʻe ma nā ala like ʻole.
• ka nānā 'ana i ka hua manu: he spermogram (ka nānā 'ana i ka helu, ka ne'e a me ke 'ano o ka sperm), kahi mo'omeheu sperm (huli no ka ma'i) a me ka ho'ā'o 'ana i ka sperm migration a me ke ola.

Hiki ke hana ʻia nā hoʻokolohua ʻē aʻe e like me ka karyotype a i ʻole biopsy endometrial i kekahi mau kūlana.

I loko o nā kāne, aia ka loiloi infertility:

 Ma muli o nā hopena, hiki ke kuhikuhi ʻia nā hoʻokolohua ʻē aʻe: nā hōʻike hormone, ultrasound, karyotype, genetic examinations. 

Ma muli o ke kumu o ka ʻike ʻole ʻia, e hāʻawi ʻia nā ʻano hana hana hou i kōkua ʻia i nā kāne:

• ka hoʻoulu ʻana i ka ovarian maʻalahi e hoʻoulu i ka maikaʻi o ka ovulation
• ʻO ka hoʻokomo ʻana me ka sperm o ka hoa (COI) pili i ka hoʻokomo ʻana i ka sperm i hoʻomākaukau mua ʻia i loko o ka lua o ka ʻōpū i ka lā o ka ovulation. Hoʻomaka pinepine ia e ka hoʻoulu ʻana i ka ovarian i mea e loaʻa ai nā oocytes maikaʻi. Hāʻawi ʻia ia i nā hihia o ka infertility i wehewehe ʻole ʻia, ka hiki ʻole o ka hoʻoulu ʻana o ka ovarian, ka pilikia viral, ka wahine cervicalo-ovulatory infertility a i ʻole ka male male ʻole.
• in vitro fertilization (IVF) ʻo ia ka hana hou ʻana i ke kaʻina hana fertilization i loko o kahi paipu hoʻāʻo. Ma hope o ka hoʻoulu ʻana o ka hormonal a me ka hoʻomaka ʻana o ka ovulation, ua puncture ʻia kekahi mau follicles. Hoʻomākaukau ʻia nā oocytes a me nā spermatozoa i loko o ka hale hana a hoʻomoʻi ʻia i loko o kahi kīʻaha moʻomeheu. Inā kūleʻa, hoʻoili ʻia hoʻokahi a ʻelua embryo i ka ʻōpū. Hāʻawi ʻia ʻo IVF i nā hihia o ka infertility unexplained, insemination insemination, mixed infertility, makua makua kahiko, ālai ʻia nā uterine tubes, sperm abnormalities.
• ʻO ICSI (intracytoplasmic injection) kahi ʻano like ʻole o IVF. Hoʻokomo ʻia ka fertilization ma laila: wehe ʻia ka lei o nā cell e puni ana i ka oocyte i mea e hoʻokomo pono ai i kahi sperm i koho mua ʻia i loko o ka cytoplasm o ka hua. Hoʻokomo ʻia nā oocytes micro-injected i loko o kahi kīʻaha moʻomeheu. Hāʻawi ʻia kēia ʻenehana i nā hihia o ka male infertility koʻikoʻi.

Hiki ke hana ʻia kēia mau ʻenehana like ʻole me ka hāʻawi ʻana i nā gametes.

• Hiki ke hāʻawi ʻia ka hāʻawi ʻana i ka sperm i ka wā o ka male ʻole o ke kāne i ka pōʻaiapili o ka insemination artificial me ka hāʻawi sperm (IAD), IVF a i ʻole ICSI.
• Hiki ke hāʻawi ʻia ka hāʻawi oocyte i ka wā o ka hāʻule ʻole ʻana o ka ovarian, kahi ʻino i ka maikaʻi a i ʻole ka nui o nā oocytes a i ʻole ka pilikia o ka lawe ʻana i ka maʻi. Pono ia i ka IVF.
• ʻO ka loaʻa ʻana o ka embryo ʻo ia ka hoʻoili ʻana i hoʻokahi a ʻoi aʻe paha nā embryo hau mai kahi kāne ʻaʻohe papahana makua, akā makemake lākou e hāʻawi i kā lākou embryo. Hiki ke noʻonoʻo ʻia kēia haʻawina inā loaʻa i ka lua ʻole a i ʻole ka pilikia pālua o ka hoʻoili ʻia ʻana o ka genetic anomaly.

Ma Palani, hoʻoponopono ʻia ka hana hou ʻana e ke kānāwai bioethics n ° 2011-814 o Iulai 7, 2011 (1). Ke waiho nei ia i nā loina nui.

• Mālama ʻia ʻo AMP no nā kāne a me ka wahine, o ka makahiki hānau keiki, male a i ʻole hiki ke hōʻoia i ko lāua noho pū ʻana no ʻelua mau makahiki.
• He inoa ʻole a manuahi ka hāʻawi gamete
• ʻAʻole pāpā ʻia ka hoʻohana ʻana i ka "makuahine pani" a i ʻole ka hāʻawi pālua gamete.

Mālama ka 'Inikua Ola i ka hana hou i kōkua ʻia ma lalo o kekahi mau kūlana:

• 
  pono ka wahine ma lalo o 43 makahiki;
• kaupalena ʻia ka uhi ʻana i 4 IVF a me 6 inseminations. I ka hānau ʻana o kahi keiki, hoʻihoʻi ʻia kēia counter i ka ʻole.

Ma Quebec, hoʻomalu ʻia ka hana hou ʻana e ke Federal Law on Procreation of 20042 e waiho ana i kēia mau loina.

• Hiki i nā kāne hānau ʻole, ka poʻe hoʻokahi, ka wahine, ke kāne kāne a i ʻole ka poʻe trans ke pōmaikaʻi mai ka hoʻohua i kōkua ʻia
• He manuahi a ʻike ʻole ʻia ka hāʻawi gamete
• ʻAʻole ʻike ʻia ka surrogacy e ke code civil. ʻO ka mea hānau keiki e lilo i makuahine o ke keiki a pono nā mea noi e hele i kahi kaʻina hana e lilo i mau mākua kānāwai.

ʻO ka Quebec Assisted Procreation Program, i hoʻomaka ʻia ma ʻAukake 2010, ua hoʻololi ʻia mai ka hoʻopaʻa ʻia ʻana, i ka makahiki 2015, o ke kānāwai olakino i kapa ʻia ʻo Law 20. Hoʻopau kēia kānāwai i ka loaʻa manuahi ʻana i ka polokalamu hoʻohua i kōkua ʻia a hoʻololi iā ia. me kahi ʻōnaehana ʻauhau ʻohana haʻahaʻa. Mālama ʻia ke komo manuahi i kēia manawa ke hoʻopilikia ʻia ka ulu ʻana (no ka laʻana ma hope o ka chemotherapy) a no ka inseminations artificial.