In vitro fertilization IVF

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In vitro fertilization (IVF)

• DP Biology -- March 2009

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IVF

• Fertilization of egg with sperm outside the body
• reimplantation of embryo in uterus.
• In vitro In the glass
• vs.
• In vivo In life

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Why Used

• To treat a variety of fertility problems,
  including
• Blocked fallopian tubes
• Polycystic ovaries
• Low sperm count / poor sperm motility
• IVF is a last resort treatment for
  infertility.
• To screen out embryos
• with genetic disorders

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Overview of Process

• Collection of eggs
• Weeks 1-3 Hormones are given to stop release LH
  and FSH, thus stopping womens natural cycle

5
Overview of Process

• Collection of eggs
• Weeks 1-3 Hormones are given to stop release LH
  and FSH, thus stopping womens natural cycle
• Week 4 Large doses of LH and FSH injected into
  woman to stimulate ovaries into producing many
  follicles

6
Overview of Process

• Collection of eggs
• Weeks 1-3 Hormones are given to stop release LH
  and FSH, thus stopping womens natural cycle
• Week 4 Large doses of LH and FSH injected into
  woman to stimulate ovaries into producing many
  follicles
• Week 5 Hormone HCG inject to cause follicles to
  mature

7
Overview of Process

• Collection of eggs
• Weeks 1-3 Hormones are given to stop release LH
  and FSH, thus stopping womens natural cycle
• Week 4 Large doses of LH and FSH injected into
  woman to stimulate ovaries into producing many
  follicles
• Week 5 Hormone HCG inject to cause follicles to
  mature
• Week 5 Mature eggs are aspirated using a
  micropipet guided by a transvaginal ultrasound

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Overview of Process

• Collection of eggs

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Overview of Process

• Collection and processing of sperm
• Semen is collected in a sample bottle

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Overview of Process

• Collection and processing of sperm
• Semen is collected in a sample bottle
• Convential IVF - Healthiest sperm selected based
  upon motility. Sperm are injected below a dense
  liquid those that swim to the top are removed.

11
Overview of Process

• Collection and processing of sperm
• Semen is collected in a sample bottle
• Convential IVF - Healthiest sperm selected based
  upon motility. Sperm are injected below a dense
  liquid those that swim to the top are removed.
• Injection of sperm into egg
• - used for cases where
• sperm are malformed
• or have limited mobility

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Overview of Process

• Fertilization (convential procedure)
• Sperm egg mixed in a petri dish
• Fertilization is confirmed 12-24 hours later

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Overview of Process

• Fertilization (convential procedure)
• Sperm egg mixed in a petri dish
• Fertilization is confirmed 12-24 hours later
• Embryo selection transfer
• 2 days after fertilization, healthy embryos are
  selected
• Embryos placed on uterus lining using a catheter
  guided by ultrasound
• Most procedures recommend transfer of 1-3 embryos

14
Overview of Process

• Pregnancy Support Monitoring
• Progesterone is given for the first two weeks to
  maintain the uterine lining
• 6 weeks after fertilization, an ultrasound is
  done to monitor pregnancy

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Costs

• IVF is expensive 10,000 per treatment
• Multiple cycles may be needed

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Costs / Success

• IVF is expensive 10,000 per treatment
• Multiple cycles may be needed

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IVF Stats

• 15 of couples experience infertility problems
• 50 of couples with fertility problems will
  eventually conceive (usually with less drastic
  measures than IVF)
• 5 of couples with fertility problems will
  attempt IVF

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IVF Stats

• 30 of IVF cycles result in pregnancy
• 24 result in live birth
• (compare to 40 of natural fertilizations
  resulting in live birth)

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IVF Stats

• 30 of IVF cycles result in pregnancy
• 24 result in live birth
• (compare to 40 of natural fertilizations
  resulting in live birth)
• 11 of IVF pregnancies are multiples
• (compare to 1 in natural pregnancies)
• Slightly higher risk of birth defects associated
  with IVF

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IVF Stats

• 30 of IVF cycles result in pregnancy
• 24 result in live birth
• (compare to 40 of natural fertilizations
  resulting in live birth)
• 11 of IVF pregnancies are multiples
• (compare to 1 in natural pregnancies)
• Slightly higher risk of birth defects associated
  with IVF
• 1st IVF baby 1978
• Total IVF babies gt200,000

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Ethical Arguments for / against IVF
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IVF Around the World

• Cultural / Religious Perspectives
• Catholic church / fundamentalist Protestant --
  life begins at conception / some thought that it
  interferes with Gods will
• Orthodox Judiasm -- support if no other method of
  fertility has worked, and a waiting period has
  been respected.
• Muslim beliefs -- no donor eggs / sperm or
  surrogacy in some branches

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IVF Around the World

• Variation in regulation between nations
• No guidelines (Canada, Greece)
• Guidelines but no enforcement (US, Japan)
• Limitations on embryo transfer (Belgium - max 1)
• Limitations on embryo destruction (Italy -- all
  must be implanted, max three fertilized)
• Limitations on treating single women (Sweden,
  Denmark, some Australian states)
• Limitations on donor egg / sperm (Egypt, Saudia
  Arabia)
• Limitations on screening of embryos (UK - no
  cosmetic or gender determination)