In-Vitro FertilizationPresented By,

Sonia JohnII M.Sc.Zoology

INTRODUCTIONAssisted reproductive technology(ART)- Manipulation

of reproduction in humans and animals

Used primarily in infertility treatments ,hence ART a.k.a FERTILITY TREATMENT

Includes:

1. IVF

2. ZIFT,GIFT

3. IUI,ICSI etc

In-Vitro Fertlization(IVF)Process by which egg is fertilized outside the body in-vitro

Fertilization of the oocytes in the laboratory conditions.

This is in contrast with the natural fertilization,which occurs in the uterus

Reasonably successful as it results in 70-80% of fertilized eggs

Through IVF technology,a large number of offsprings can be produced from a single individual

When it is DoneFor infertility treatments:

Female infertility caused due to problems n the fallopian tubes

Male infertility caused due to low sperm quality

The first successful birth of a "test tube baby", Louise Brown, occurred in 1978.

Robert G. Edwards , the physiologist who developed the treatment, was awarded the Nobel Prize in Physiology or Medicine

Subhash Mukhopadhyay ,was a physician from Kolkata, India, who created the world's second and India's first child using in-vitro fertilisation, Durga 

Kamala Rathnam- South India’s 1st test tube baby

With IVF, women who are past 

menopause can still become pregnant. 

Adriana Iliescu held the record as

the oldest woman to give birth

using IVF and donated egg,

when she gave birth in 2004

at the age of 66.

PROTOCOL OF IVFFollowing are the stages involved in IVF

1. Ovarian stimulation

2. Egg retrieval

3. Sperm collection

4. Fertilization in the laboratory

5. Embryo culture

6. Embryo transfer

1. Ovarian StimulationBoth the male and female partner made to undergo

fitness tests and check-ups

Injectable medications are provided to the female partner daily for an average of 10 – 12 days to stimulate the woman’s ovaries to produce multiple eggs.

The ovarian response to the medications are monitored with the help of ultrasound and blood work and medication dosing is adjusted accordingly.

2.Egg RetrievalWhen the eggs are mature and ready, the woman undergoes an

ultrasound guided egg retrieval procedure under light sedation.

The eggs are retrieved from the patient using a transvaginal technique called transvaginal oocyte retrieval involving an ultrasound-guided needle piercing the vaginal wall to reach the ovaries. Through this needle follicles can be aspirated, and the follicular fluid is passed to an embryologist to identify ova.

Usually takes between 20 to 40 minutes;10-30 eggs retrieved

3.Sperm CollectionIn the meantime, semen is prepared for fertilisation

by removing inactive cells and seminal fluid in a process called sperm washing.

If semen is being provided by a sperm donor, it will usually have been prepared for treatment before being frozen and quarantined, and it will be thawed ready for use.

4.Co-incubation and Fertilizationin the LaboratoryAfter the eggs and sperm have been analyzed and

prepared, the eggs are then inseminated.

The sperm and the egg are incubated together in a culture media in order for the actual fertilisation to take place.

The duration of this co-incubation should be about 1 to 4 hours to have higher pregnancy rates 

5.Embryo Culture After fertilization, the embryos are allowed to grow in

special media for 3 – 5 days until they have reached optimal growth.

The main durations of embryo culture are until cleavage stage (day two to four after co-incubation) or the blastocyst stage (day five or six after co-incubation).  

Embryo culture until the blastocyst stage confers a significant increase in live birth rate per embryo transfer.

6.Embryo TransferLaboratories have developed grading methods to judge

oocyte and embryo quality.

1-3 embryos are then transferred into the uterus 3-5 days after egg retrieval.

Under ultrasound guidance, a thin long catheter containing the embryos is passed through the cervix into the uterus where the embryos are placed. After embryo transfer, 3-5 days of pelvic rest is recommended. A pregnancy test is scheduled 12 days later.

Risks1. Multiple pregnancy – up to 30%, mostly twins.

2. Ovarian hyperstimulation syndrome (OHSS) – ovarian enlargement with multiple cysts in association

3. Ovarian torsion –twisting of ovaries, may require surgery.

4. Increased rate of abortion

5. Premature delivery, low birth weight baby etc

ReferencesRastogi.S.C. Biotechnology:Principles and

Applications. Narosa Publishing HouseSatyanarayana.U.Biotechnology.Books and

Allied (P)Ltdwww.americanpregancy.comhttp://en.wikipedia.org/InVitroFertilizationwww.emedicinehealth.comwww.webmd.com