In Vitro Fertilization

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Welcome
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In Vitro Fertilization
Hariom Yadav1, Shalini Jain1 and Mukesh
Yadav2 1Animal Biochemistry Division, National
Dairy Research Institute, Karnal-132001, Haryana,
INDIA 2SOS in Chemistry, Jiwaji University,
Gwalior-474011, M.P., INDIA Corresponding
author Email yadavhariom_at_gmail.com
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Female reproductive system
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Male reproductive system
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Normal Fertilization
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IVF In vitro fertilization
In vitro in glass
Fertilization Ova Sperm
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Basic Principle of IVF
Hormonal treatment
Female
Harvest the ovum
Mature Ova
Keep to develop embryo
Mix in a test tube
Motile sperms
Collect semen
Transfer to mother
Male
Natural ejaculation
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Hormonal Treatments

• Drugs currently in use include
• clomiphene citrate (Clomidâ, Seropheneâ)
• human menopausal gonadotropin (hCG)
• gonodotropin releasing hormone (GnRH) analog
  called leuprolide (Lupronâ)
• Most of these drugs may be used alone or in a
  combination with others.

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Egg Harvest

• Ultra Sound Guided Aspiration
• Laproscopy

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Fig 1
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Oocytes with granulosa cells
"Naked" Oocyte
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8-cell embryo for transfer
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Blastocyst for transfer
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Implantation
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Fourteen Days after Initial Cell Division
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Viable Fetus
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After Birth
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Alternates of IVF

• Gamete intrafallopian transfer (GIFT) GIFT
  is similar to IVF. It is used when a woman has at
  least one normal fallopian tube. Eggs are placed
  in this tube along with a mans sperm to
  fertilize there.
• Zygote intrafallopian transfer (ZIFT) ZIFT is
  tubal embryo transfer in which a womans eggs are
  taken from her ovaries, fertilized in the
  laboratory, and put back in the fallopian tubes
  rather than the uterus.
• Assisted fertilization techniques when not enough
  sperm are available or sperm quality is not
  sufficient to fertilize include the following
• Partial zona dissection
• Subzonal sperm injection
• Intracytoplasmic sperm injection
• Embryo cryopreservation (frozen fertilized egg
  and sperm)

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ICSI Stands for intracytoplasmic sperm
injection. This process is used to inject a
single sperm into each egg before the fertilized
eggs are put back into the woman's body. The
procedure may be used if the male has a low sperm
count.
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Cryopreservation of Ova, Sperm and Embryo
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Risks
Superovulation Stimulates Egg Development
Ovarian Hyperstimulation Syndrome (OHSS)
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• There may be a failure to recover an egg
  because- follicles that contain mature eggs may
  not develop in the treatment cycle
• - ovulation has occurred before time of egg
  recovery- one or more eggs cannot be recovered-
  pre-existing pelvic scarring and/or technical
  difficulties prevent safe egg recovery
• The eggs that are recovered may not be normal
• There may be insufficient semen to attempt
  fertilization of the recovered eggs because the
  man is unable to produce a semen specimen,
  because the specimen contains an insufficient
  number of sperm to attempt fertilization, because
  the laboratory is unable to adequately process
  the specimen provided, or because the option to
  use a donor sperm as a "backup" was declined
• Fertilization of the eggs to form embryos may
  fail even when the egg(s) and sperm are normal
• The embryos may not develop normally or may not
  develop at all. Embryos that display any abnormal
  development will not be transferred
• Embryo transfer into the uterus may be
  difficult/impossible, or implantation(s) may not
  occur after transfer, or the embryo(s) may not
  grow or develop normally after implantation
• Any step in the IVF-ET process may be complicated
  by unforeseen events, such as hazardous or
  catastrophic weather, equipment failure,
  laboratory conditions, infection, human error and
  the like.

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Normal results Success rates vary widely between
clinics and between physicians performing the
procedure and implantation does not guarantee
pregnancy. Therefore, the procedure may have to
be repeated more than once to achieve pregnancy.
However, success rates have improved in recent
years, up from 20 in 1995 to 27 in
2001. Abnormal results An ectopic or
multiple pregnancy may abort spontaneously or may
require termination if the health of the mother
is at risk. The number of multiple pregnancies
has decreased in recent years as technical
advances and professional guidelines have led to
implanting of fewer embryos per attempt.
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Ethics

• Bypassing the natural method of conception.
• The creation of life in the laboratory.
• Fertilization of more embryos than will be
  needed.
• Discarding of excess embryos.
• Unnatural environment for embryos.
• Use of untested technology.
• Not affordable for many.
• Misallocation of medical resources.
• Creation of embryos, then freezing them, and
  keeping them "in limbo".
• Exposure of embryos to unnatural substances.
• Destruction of embryos in research.
• Potential to create embryos for medical
  purposes.
• Potential to select embryos (PGD).
• Potential to modify embryos.
• Facilitation of the idea that embryos are
  commodities.
• Financial rewards for IVF doctors dissuade them
  from recommending other methods to couples.
• Infertility is treated as a disease and not as a
  symptom of underlying
• medical problems.

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Separating the traditional mother-father model
Pregnancy past menopause
Religious objections
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Thank you