Rather than relying on nature to take its course in reproduction, representatives of BioCom can act as mediating efficiency experts. This way, reproduction better conforms to the capitalist necessity of efficiency: No useless activity occurs in the reproductive process, and less genetic material is wasted. Excess genetic material is reconfigured into a substance for commodified process, as opposed to becoming one of nonrational potential. After all, the reproductive process is practically reclassified as a purely medical process. Let BioCom demonstrate that a "better baby" (one better adapted to the imperatives of pancapitalism) can be produced through rationalized intervention. Here are some descriptions and explanations of the technologies we offer: IVF (In Vitro Fertilization) In vitro fertilization (IVF) involves fertilization outside the body in an artificial environment. This procedure was first used for infertility in humans in 1977 at Bourne Hall in Cambridge, England. To date, tens of thousands of babies have been delivered worldwide as a result of IVF treatment. Over the years, the procedures to achieve IVF pregnancy have become increasingly simpler, safer and more successful. To accomplish pregnancy as a result of IVF, several steps are involved: Stimulation of the ovary to produce several fertilizable oocytes (eggs) Retrieval of the oocytes from the ovary Fertilization of the oocytes and culture of the embryos in the IVF Laboratory Placement of the embryos into the uterus for implantation (embryo transfer or ET) What Types of Infertility Might Be Helped by IVF? Absent fallopian tubes or tubal disease that cannot be treated successfully by surgery Endometriosis that has not responded to surgical or medical treatment A male factor contributing to infertility, in which sperm counts or motility are low but there are enough active sperm to allow fertilization in the laboratory Unexplained infertility that has not responded to other treatments Infertility secondary to sperm antibodies GIFT The GIFT (Gamete Intra Fallopian Transfer) procedure is a variation of the techniques used for IVF, utilizing many of the same steps. With GIFT, after retrieving oocytes from the woman's ovaries under ultrasound guidance, the oocytes and sperm are later placed in the woman's fallopian tube to facilitate fertilization in the body. The procedure of placing the recovered eggs and sperm into the fallopian tubes requires laparoscopy (a minor surgical procedure). This differs from IVF, in which the recovered oocytes are placed in a dish in the laboratory and fertilized outside the body. GIFT is a procedure available to women who have normal fallopian tubes and, ideally, to couples for whom male factor infertility is not involved. For certain couples, GIFT may result in higher pregnancy rates than replacement of embryos into the uterus (IVF-ET). ZIFT The ZIFT (Zygote Intra Fallopian Transfer) procedure is similar to the GIFT procedure, except fertilized embryos (zygotes), not unfertilized oocytes, are placed in healthy fallopian tubes. Oocytes are retrieved in a manner similar to a regular IVF treatment, using ultrasound and sedation but no general anesthesia. The oocytes are cultured in the laboratory with sperm. The day after the retrieval, oocytes that are determined to be fertilized (but are not yet dividing) are transferred to the fallopian tubes using a laparoscope under general anesthesia. ZIFT, as opposed to GIFT, provides direct information about whether or not fertilization has been achieved. Again, for certain couples, ZIFT may result in higher pregnancy rates. ICSI Intracytoplasmic Sperm Injection is a relatively new micromanipulation technique developed to help achieve fertilization for couples with severe male factor infertility or couples who have had failure to fertilize in a previous in vitro fertilization attempt. The procedure overcomes many of the barriers to fertilization and allows couples with little hope of achieving successful pregnancy to obtain fertilized embryos. The procedure was first used at UCSF in 1994 and the first successful birth, achieved with ICSI assistance, was in February 1995. UCSF was the first San Francisco Bay Area program to achieve a pregnancy and birth with this "miracle" procedure. The technique involves very precise maneuvers to pick up a single live sperm and inject it directly into the center of a human egg. The ICSI Process The ICSI procedure requires that the woman partner undergo ovarian stimulation with fertility medications so that several mature eggs develop. These eggs are then aspirated through the vagina, using vaginal ultrasound, and incubated under precise conditions in the embryology laboratory. The semen sample is prepared by centrifuging (spinning the sperm cells through a special medium). This solution separates live sperm from debris and most of the dead sperm. The micromanipulation specialist picks up the single live sperm in a glass needle and injects it directly into the egg. Through the ICSI procedure, many couples with difficult male factor infertility problems have achieved pregnancy at UCSF. Fertilization rates of 70-80% (of all eggs injected) are currently being achieved, and pregnancy rates are comparable to those seen with IVF in couples with no male factor infertility. Worldwide, the rate of birth defects in pregnancies achieved through ICSI are no higher than those seen in the general population.