project report on assisted reproductive technologies

7/29/2019 Project Report on Assisted Reproductive Technologies

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Delhi Public School, Noida

Biology CBSE Project

Submitted By: ChhaviSinghXii- Science


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Acknowledgements

I would like to pay my heartfelt thanks to my subject teacher

__________________________________ for guiding me throughout this tenure.

I would also like to thank my family and friends for helping me inthis project.


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Certificate

This is to certify that the Project work has been satisfactorily

completed under my guidance and supervision by Ms. Chhavi

Singh, student of XIIth Science.

T. Signature

______________


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Index

Topic Definition & Meaning Brief Discussion Examples

Detailed study of In-vitro fertilization Method

Success Rates Expansion of IVF Risks Bibliography


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Topic :Assisted

Reproductive Technologies

(Case Study)


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Definition & Meaning

Assisted reproductive technology (ART) a general term referring to methods

used to achieve pregnancyby artificial or partially artificial means. It is reproductive

technology used primarily in infertility treatments. Some forms ofARTare also used in fertile

couples forgenetic reasons.ARTis also used in couples who are discordant for certain

communicable diseases, e.g. AIDS, to reduce the risk of infection when a pregnancy is

desired. Examples ofARTinclude in vitro fertilisation, intra-cytoplasmic sperm injection

(ICSI), cryopreservation, and intrauterine insemination (IUI). There is yet no strict definition

of the term. Usage of the ART mainly belongs in the field ofreproductive endocrinology and

infertility.
http://en.wikipedia.org/wiki/Pregnancyhttp://en.wikipedia.org/wiki/Reproductive_technologyhttp://en.wikipedia.org/wiki/Reproductive_technologyhttp://en.wikipedia.org/wiki/Infertilityhttp://en.wikipedia.org/wiki/Preimplantation_genetic_diagnosishttp://en.wikipedia.org/wiki/AIDShttp://en.wikipedia.org/wiki/In_vitro_fertilisationhttp://en.wikipedia.org/wiki/Intracytoplasmic_sperm_injectionhttp://en.wikipedia.org/wiki/Cryopreservationhttp://en.wikipedia.org/wiki/Reproductive_endocrinology_and_infertilityhttp://en.wikipedia.org/wiki/Reproductive_endocrinology_and_infertilityhttp://en.wikipedia.org/wiki/Reproductive_endocrinology_and_infertilityhttp://en.wikipedia.org/wiki/Reproductive_endocrinology_and_infertilityhttp://en.wikipedia.org/wiki/Cryopreservationhttp://en.wikipedia.org/wiki/Intracytoplasmic_sperm_injectionhttp://en.wikipedia.org/wiki/In_vitro_fertilisationhttp://en.wikipedia.org/wiki/AIDShttp://en.wikipedia.org/wiki/Preimplantation_genetic_diagnosishttp://en.wikipedia.org/wiki/Infertilityhttp://en.wikipedia.org/wiki/Reproductive_technologyhttp://en.wikipedia.org/wiki/Reproductive_technologyhttp://en.wikipedia.org/wiki/Pregnancy


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Definition:

The Centres for Disease Control and Prevention (CDC)which is required as a

result of the 1992 Fertility Clinic Success Rate and Certification Act to publish the annual

ART success rates at U.S. fertility clinicsdefines ART to include "all fertility treatments in

which both eggs and sperm are handled. In general, ART procedures involve surgically

removing eggs from a woman's ovaries, combining them with sperm in the laboratory, and

returning them to the woman's body or donating them to another woman." According to

CDC, "they do not include treatments in which only sperm are handled (i.e., intrauterineor

artificialinsemination) or procedures in which a woman takes medicine only to stimulate

egg production without the intention of having eggs retrieved."
http://en.wikipedia.org/wiki/Centers_for_Disease_Control_and_Preventionhttp://en.wikipedia.org/wiki/Centers_for_Disease_Control_and_Prevention


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Brief DiscussionART has been used in the United States since 1981 to help women become pregnant, most

commonly through the transfer of fertilized human eggs into a womans uterus (in vitro

fertilization). However, deciding whether to undergo this expensive and time-consuming

treatment can be difficult.

According to CDCs 2010 ART Success Rates, 147,260* ART cycles were performed at 443

reporting clinics in the United States during 2010, resulting in 47,090 live births (deliveries of

one or more living infants) and 61,564 infants. Although the use of ART is still relatively rare

as compared to the potential demand, its use has doubled over the past decade. Today, over

1% of all infants born in the U.S. every year are conceived using ART.

*Excludes cycles in which a new treatment procedure was being evaluated.


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The National Institute of Child Health and Human Development held a

workshop on September 12-13, 2005, to summarize the risks for adverse pregnancy outcomes

after assisted reproductive technology (ART), develop an approach to counseling couples

regarding these risks, and establish a research agenda. Although the majority of ART children

are normal, there are concerns about the increased risk for adverse pregnancy outcomes.

More than 30% of ART pregnancies are twins or higher-order multiple gestations (triplets or

greater) and more than one half of all ART neonates are the products of multifetal gestations,

with an attendant increase in prematurity complications. Assisted reproductive technology

singleton pregnancies also demonstrate increased rates of perinatal complications-small for

gestational age infants, preterm delivery, and perinatal mortality-as well as maternal

complications, such as preeclampsia, gestational diabetes, placenta previa, placental

abruption, and cesarean delivery. Although it is not possible to separate ART-related risks

from those secondary to the underlying reproductive pathology, the overall increased

frequency of obstetric complications, including preterm birth and small for gestational age

neonates, should be discussed with the couple. Significant gaps in knowledge were identified,

and the basic science and clinical and epidemiologic research required to address these gaps

is outlined.


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Examples

Artificial Insemination

Cloning

Embryonic splitting or cleavage

Cryopreservation of sperms, oocytes or embryos

Embryo transfer

Fertility medication

Hormone treatment

In-vitro fertilization Intra-cytoplasmic sperm injection

Pre-implantation genetic diagnosis


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Artificial Insemination

Artificial insemination (AI) is the deliberate introduction of semen into a female for the

purpose offertilisation, by means other than ejaculation directly into the vagina oroviduct.

Artificial insemination is a fertility treatment for humans, and is a common practice in the

breeding ofdairy cattle and pigs. Artificial insemination may employ assisted reproductive

technology, donated sperm, and/oranimal husbandry techniques.

In HumansArtificial insemination is a means for a woman to conceive when she does not have a male

partner, when she does not want a male partner, or when a male partner's sexual inhibition or

physical limitation impedes his ability to impregnate her by sexual intercourse. Women who

have issues with the cervix such as cervical scarring, cervical blockage from endometriosis,or thick cervical mucus also benefit from AI since the sperm must pass through the cervix to

result in fertilization.
http://en.wikipedia.org/wiki/Inseminationhttp://en.wikipedia.org/wiki/Fertilisationhttp://en.wikipedia.org/wiki/Vaginahttp://en.wikipedia.org/wiki/Oviducthttp://en.wikipedia.org/wiki/Fertility_treatmenthttp://en.wikipedia.org/wiki/Dairy_cattlehttp://en.wikipedia.org/wiki/Pighttp://en.wikipedia.org/wiki/Assisted_reproductive_technologyhttp://en.wikipedia.org/wiki/Assisted_reproductive_technologyhttp://en.wikipedia.org/wiki/Sperm_donationhttp://en.wikipedia.org/wiki/Animal_husbandryhttp://en.wikipedia.org/wiki/Fertilisationhttp://en.wikipedia.org/wiki/Sexual_inhibitionhttp://en.wikipedia.org/wiki/Sexual_inhibitionhttp://en.wikipedia.org/wiki/Fertilisationhttp://en.wikipedia.org/wiki/Animal_husbandryhttp://en.wikipedia.org/wiki/Sperm_donationhttp://en.wikipedia.org/wiki/Assisted_reproductive_technologyhttp://en.wikipedia.org/wiki/Assisted_reproductive_technologyhttp://en.wikipedia.org/wiki/Pighttp://en.wikipedia.org/wiki/Dairy_cattlehttp://en.wikipedia.org/wiki/Fertility_treatmenthttp://en.wikipedia.org/wiki/Oviducthttp://en.wikipedia.org/wiki/Vaginahttp://en.wikipedia.org/wiki/Fertilisationhttp://en.wikipedia.org/wiki/Insemination


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Cloning

Human cloning is the creation of a genetically identical copy of a human. It does not refer

to monozygotic multiple births or the reproduction of humans/animals cells ortissue. The

ethics of cloning is an extremely controversial issue. The term is generally used to refer to

artificial human cloning; human clones in the form of identical twins are commonplace, withtheir cloning occurring during the natural process of reproduction.

There are two commonly discussed types of human cloning: therapeutic

cloningand reproductive cloning. Therapeutic cloning involves cloning cells from an adult

for use in medicine and transplants, and is an active area of research. Reproductive cloning

would involve making cloned humans, for couples wanting to have a child, but cannot

naturally.
http://en.wikipedia.org/wiki/Monozygotichttp://en.wikipedia.org/wiki/Multiple_birthhttp://en.wikipedia.org/wiki/Cell_(biology)http://en.wikipedia.org/wiki/Tissue_(biology)http://en.wikipedia.org/wiki/Twinshttp://en.wikipedia.org/wiki/Twinshttp://en.wikipedia.org/wiki/Tissue_(biology)http://en.wikipedia.org/wiki/Cell_(biology)http://en.wikipedia.org/wiki/Multiple_birthhttp://en.wikipedia.org/wiki/Monozygotic


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Embryonic splitting or

cleavage

In embryology,cleavage is the division ofcells in the early embryo. The zygotes of many

species undergo rapid cell cycles with no significant growth, producing a cluster of cells the

same size as the original zygote. The different cells derived from cleavage are called

blastomeres and form a compact mass called the morula. Cleavage ends with the formation of

the blastula.

Depending mostly on the amount ofyolkin the egg, the cleavage can be holoblastic (total or

entire cleavage) ormeroblastic (partial cleavage). The pole of the egg with the highest

concentration of yolk is referred to as the vegetal pole while the opposite is referred to as

the animal pole.

Cleavage differs from other forms ofcell division in that it increases the number of cellswithout increasing the mass. This means that with each successive subdivision, the ratio of

nuclear to cytoplasmic material increases.
http://en.wikipedia.org/wiki/Embryologyhttp://en.wikipedia.org/wiki/Cell_(biology)http://en.wikipedia.org/wiki/Embryohttp://en.wikipedia.org/wiki/Zygotehttp://en.wikipedia.org/wiki/Cell_cyclehttp://en.wikipedia.org/wiki/Blastomerehttp://en.wikipedia.org/wiki/Morulahttp://en.wikipedia.org/wiki/Blastulahttp://en.wikipedia.org/wiki/Yolkhttp://en.wikipedia.org/wiki/Vegetal_polehttp://en.wikipedia.org/wiki/Animal_polehttp://en.wikipedia.org/wiki/Cell_divisionhttp://en.wikipedia.org/wiki/Cell_divisionhttp://en.wikipedia.org/wiki/Animal_polehttp://en.wikipedia.org/wiki/Vegetal_polehttp://en.wikipedia.org/wiki/Yolkhttp://en.wikipedia.org/wiki/Blastulahttp://en.wikipedia.org/wiki/Morulahttp://en.wikipedia.org/wiki/Blastomerehttp://en.wikipedia.org/wiki/Cell_cyclehttp://en.wikipedia.org/wiki/Zygotehttp://en.wikipedia.org/wiki/Embryohttp://en.wikipedia.org/wiki/Cell_(biology)http://en.wikipedia.org/wiki/Embryology


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Cryopreservation of sperms, oocytes or

embryos

Cryopreservation is a process where sperms, oocytes and embryos are preserved by cooling

to sub-zero temperatures, typically 77 K (= 196 C, the boiling point ofliquid nitrogen). At

these cold temperatures, any biological activity, including the biochemical reactions that

would cause cell death, is effectively stopped. However, ifcryoprotectant solutions are not

used, the cellsbeing preserved are likely to be damaged due to freezing during the cooling or

thawing process.
http://en.wikipedia.org/wiki/Temperaturehttp://en.wikipedia.org/wiki/Liquid_nitrogenhttp://en.wikipedia.org/wiki/Cell_deathhttp://en.wikipedia.org/wiki/Cryoprotectanthttp://en.wikipedia.org/wiki/Cell_(biology)http://en.wikipedia.org/wiki/Freezinghttp://en.wikipedia.org/wiki/Freezinghttp://en.wikipedia.org/wiki/Cell_(biology)http://en.wikipedia.org/wiki/Cryoprotectanthttp://en.wikipedia.org/wiki/Cell_deathhttp://en.wikipedia.org/wiki/Liquid_nitrogenhttp://en.wikipedia.org/wiki/Temperature


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Embryo Transfer

Embryo transfer refers to a step in the process of assisted reproduction in which embryos

are placed into the uterus of a female with the intent to establish a pregnancy. This technique

(which is often used in connection with in vitro fertilization (IVF)), may be used in humans

or in animals, in which situations the goals may vary.
http://en.wikipedia.org/wiki/Embryohttp://en.wikipedia.org/wiki/Uterushttp://en.wikipedia.org/wiki/Pregnancyhttp://en.wikipedia.org/wiki/In_vitro_fertilisationhttp://en.wikipedia.org/wiki/In_vitro_fertilisationhttp://en.wikipedia.org/wiki/Pregnancyhttp://en.wikipedia.org/wiki/Uterushttp://en.wikipedia.org/wiki/Embryo


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Fertility Medication

Fertility medication are drugs which enhance reproductive fertility. For women, fertility

medication is used to stimulate follicle development of the ovary. There are currently very

few fertility medication options available for men.
http://en.wikipedia.org/wiki/Fertilityhttp://en.wikipedia.org/wiki/Ovarian_folliclehttp://en.wikipedia.org/wiki/Ovaryhttp://en.wikipedia.org/wiki/Ovaryhttp://en.wikipedia.org/wiki/Ovarian_folliclehttp://en.wikipedia.org/wiki/Fertility


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Hormone Treatment

Hormone treatment orhormonal therapy is the use ofhormones in medical

treatment. Treatment with hormone antagonists may also referred to as hormonal therapy.
http://en.wikipedia.org/wiki/Hormoneshttp://en.wikipedia.org/wiki/Hormone_antagonisthttp://en.wikipedia.org/wiki/Hormone_antagonisthttp://en.wikipedia.org/wiki/Hormones


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In-vitro fertilization

In vitro fertilization (IVF) is the technique of letting fertilization of the male and female

gametes (sperm and egg) occur outside the female body.

Techniques usually used in in vitro fertilization include:

Transvaginal ovum retrieval (OCR) is the process whereby a small needle is inserted

through the back of the vagina and guided via ultrasound into the ovarian follicles to

collect the fluid that contains the eggs. Embryo transferis the step in the process whereby one or several embryos are placed into

the uterus of the female with the intent to establish a pregnancy
http://en.wikipedia.org/wiki/Fertilizationhttp://en.wikipedia.org/wiki/Gameteshttp://en.wikipedia.org/wiki/Transvaginal_ovum_retrievalhttp://en.wikipedia.org/wiki/Embryo_transferhttp://en.wikipedia.org/wiki/Embryo_transferhttp://en.wikipedia.org/wiki/Transvaginal_ovum_retrievalhttp://en.wikipedia.org/wiki/Gameteshttp://en.wikipedia.org/wiki/Fertilization


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Intra-cytoplasmic sperm

injection

Intracytoplasmic sperm injection (ICSI) is a procedure in which a single sperm is injected

directly into an egg.

This procedure is most commonly used to overcome male infertilityproblems, although it

may also be used where eggs cannot easily be penetrated by sperm, and occasionally in

addition tosperm donation.

It can be used in teratozoospermia, because once the egg is fertilized, abnormal sperm

morphology does not appear to influence blastocyst development or blastocyst

morphology.[3]Even with severe teratozoospermia, microscopy can still detect the few sperm

cells that have a "normal" morphology, allowing for optimal success rate.
http://en.wikipedia.org/wiki/Spermatozoonhttp://en.wikipedia.org/wiki/Ovumhttp://en.wikipedia.org/wiki/Infertilityhttp://en.wikipedia.org/wiki/Sperm_donationhttp://en.wikipedia.org/wiki/Teratozoospermiahttp://en.wikipedia.org/wiki/Blastocysthttp://en.wikipedia.org/wiki/Intracytoplasmic_sperm_injection#cite_note-French_et_al_2010-2http://en.wikipedia.org/wiki/Intracytoplasmic_sperm_injection#cite_note-French_et_al_2010-2http://en.wikipedia.org/wiki/Intracytoplasmic_sperm_injection#cite_note-French_et_al_2010-2http://en.wikipedia.org/wiki/Intracytoplasmic_sperm_injection#cite_note-French_et_al_2010-2http://en.wikipedia.org/wiki/Blastocysthttp://en.wikipedia.org/wiki/Teratozoospermiahttp://en.wikipedia.org/wiki/Sperm_donationhttp://en.wikipedia.org/wiki/Infertilityhttp://en.wikipedia.org/wiki/Ovumhttp://en.wikipedia.org/wiki/Spermatozoon


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pre-implantation genetic

diagnosis

In medicine and (clinical) genetics pre-implantation genetic diagnosis (PGD or PIGD) (also

known as embryo screening) refers to procedures that are performed on embryosprior

toimplantation, sometimes even on oocytesprior to fertilization. PGD is considered another

way to prenatal diagnosis. When used to screen for a specific genetic disease, its main

advantage is that it avoids selective pregnancy termination as the method makes it highly

likely that the baby will be free of the disease under consideration. PGD thus is an adjunct

to assisted reproductive technology, and requires in vitro fertilization (IVF) to

obtain oocytes orembryos for evaluation.
http://en.wikipedia.org/wiki/Medicinehttp://en.wikipedia.org/wiki/Geneticshttp://en.wikipedia.org/wiki/Embryohttp://en.wikipedia.org/wiki/Implantation_(human_embryo)http://en.wikipedia.org/wiki/Oocytehttp://en.wikipedia.org/wiki/Fertilisationhttp://en.wikipedia.org/wiki/Prenatal_diagnosishttp://en.wikipedia.org/wiki/Genetic_diseasehttp://en.wikipedia.org/wiki/Abortionhttp://en.wikipedia.org/wiki/Assisted_reproductive_technologyhttp://en.wikipedia.org/wiki/In_vitro_fertilisationhttp://en.wikipedia.org/wiki/Oocyteshttp://en.wikipedia.org/wiki/Embryohttp://en.wikipedia.org/wiki/Embryohttp://en.wikipedia.org/wiki/Oocyteshttp://en.wikipedia.org/wiki/In_vitro_fertilisationhttp://en.wikipedia.org/wiki/Assisted_reproductive_technologyhttp://en.wikipedia.org/wiki/Abortionhttp://en.wikipedia.org/wiki/Genetic_diseasehttp://en.wikipedia.org/wiki/Prenatal_diagnosishttp://en.wikipedia.org/wiki/Fertilisationhttp://en.wikipedia.org/wiki/Oocytehttp://en.wikipedia.org/wiki/Implantation_(human_embryo)http://en.wikipedia.org/wiki/Embryohttp://en.wikipedia.org/wiki/Geneticshttp://en.wikipedia.org/wiki/Medicine


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Detailed study of In-vitrofertilization

In vitro fertilisation (IVF) is a process by which an egg is fertilisedby sperm outside the

body: in vitro. IVF is a major treatment forinfertility when other methods ofassisted

reproductive technology have failed. The process involves monitoring a woman's ovulatory

process, removing ovum or ova(egg or eggs) from the woman's ovaries and

letting sperm fertilize them in a fluid medium in a laboratory. When a woman's natural cycle

is monitored to collect a naturally selected ovum (egg) for fertilisation, it is known as natural

cycle IVF. The fertilised egg (zygote) is then transferred to the patient'suterus with the

intention of establishing a successful pregnancy. The first successful birth of a "test tube

baby", Louise Brown, occurred in 1978. Louise Brown was born as a result of natural cycle

IVF. Robert G. Edwards, the physiologist who developed the treatment, was awarded

the Nobel Prize in Physiology or Medicine in 2010.
http://en.wikipedia.org/wiki/Ovumhttp://en.wikipedia.org/wiki/Fertilisationhttp://en.wikipedia.org/wiki/Spermatocytehttp://en.wikipedia.org/wiki/In_vitrohttp://en.wikipedia.org/wiki/Infertilityhttp://en.wikipedia.org/wiki/Assisted_reproductive_technologyhttp://en.wikipedia.org/wiki/Assisted_reproductive_technologyhttp://en.wikipedia.org/wiki/Ovumhttp://en.wikipedia.org/wiki/Ovaryhttp://en.wikipedia.org/wiki/Spermatozoonhttp://en.wikipedia.org/wiki/Zygotehttp://en.wikipedia.org/wiki/Uterushttp://en.wikipedia.org/wiki/Louise_Brownhttp://en.wikipedia.org/wiki/Robert_G._Edwardshttp://en.wikipedia.org/wiki/Nobel_Prize_in_Physiology_or_Medicinehttp://en.wikipedia.org/wiki/Nobel_Prize_in_Physiology_or_Medicinehttp://en.wikipedia.org/wiki/Robert_G._Edwardshttp://en.wikipedia.org/wiki/Louise_Brownhttp://en.wikipedia.org/wiki/Uterushttp://en.wikipedia.org/wiki/Zygotehttp://en.wikipedia.org/wiki/Spermatozoonhttp://en.wikipedia.org/wiki/Ovaryhttp://en.wikipedia.org/wiki/Ovumhttp://en.wikipedia.org/wiki/Assisted_reproductive_technologyhttp://en.wikipedia.org/wiki/Assisted_reproductive_technologyhttp://en.wikipedia.org/wiki/Infertilityhttp://en.wikipedia.org/wiki/In_vitrohttp://en.wikipedia.org/wiki/Spermatocytehttp://en.wikipedia.org/wiki/Fertilisationhttp://en.wikipedia.org/wiki/Ovum


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The term in vitro, from the Latin meaning in glass, is used, because early biological

experiments involving cultivation of tissues outside the living organism from which they

came, were carried out in glass containers such as beakers, test tubes, orpetri dishes. Today,

the term in vitro is used to refer to any biological procedure that is performed outside the

organism it would normally be occurring in, to distinguish it from an in vivoprocedure,

where the tissue remains inside the living organism within which it is normally found. A

colloquial term for babies conceived as the result of IVF, "test tube babies", refers to the

tube-shaped containers of glass or plastic resin, called test tubes, that are commonly used in

chemistry labs and biology labs. However, in vitro fertilisation is usually performed in the

shallower containers called Petri dishes. One IVF method, Autologous Endometrial

Coculture, is actually performed on organic material, but is still considered in vitro.

IVF may be used to overcome female infertility in the woman due to problems of

the fallopian tube, making fertilisation in vivo difficult. It may also assist in male infertility,

where there is a defect in sperm quality, and in such cases intracytoplasmic sperm

injection (ICSI) may be used, where a sperm cell is injected directly into the egg cell. This is

used when sperm have difficulty penetrating the egg, and in these cases the partner's or a

donor's sperm may be used. ICSI is also used when sperm numbers are very low. ICSI results

in success rates equal to those of IVF.

For IVF to be successful it typically requires healthy ova, sperm that can fertilise, and

a uterus that can maintain a pregnancy. Due to the costs of the procedure, IVF is generally

attempted only after less expensive options have failed.

IVF can also be used with egg donation orsurrogacy where the woman providing the egg

isn't the same who will carry the pregnancy to term. This means that IVF can be used for

females who have already gone through menopause. The donated oocyte can be fertilised in

a crucible. If the fertilisation is successful, the embryo will be transferred into the uterus,

within which it may implant.

IVF can also be combined with preimplantation genetic diagnosis (PGD) to rule out presence

ofgenetic disorders. A similar but more general test has been developed

called Preimplantation Genetic Haplotyping
http://en.wikipedia.org/wiki/In_vitrohttp://en.wikipedia.org/wiki/Latinhttp://en.wikipedia.org/wiki/Beaker_(glassware)http://en.wikipedia.org/wiki/Test_tubehttp://en.wikipedia.org/wiki/Petri_dishhttp://en.wikipedia.org/wiki/In_vivohttp://en.wikipedia.org/wiki/Petri_dishhttp://en.wikipedia.org/wiki/Autologous_Endometrial_Coculturehttp://en.wikipedia.org/wiki/Autologous_Endometrial_Coculturehttp://en.wikipedia.org/wiki/Female_infertilityhttp://en.wikipedia.org/wiki/Fallopian_tubehttp://en.wikipedia.org/wiki/Male_infertilityhttp://en.wikipedia.org/wiki/Sperm_qualityhttp://en.wikipedia.org/wiki/Intracytoplasmic_sperm_injectionhttp://en.wikipedia.org/wiki/Intracytoplasmic_sperm_injectionhttp://en.wikipedia.org/wiki/Ovumhttp://en.wikipedia.org/wiki/Uterushttp://en.wikipedia.org/wiki/Egg_donationhttp://en.wikipedia.org/wiki/Surrogacyhttp://en.wikipedia.org/wiki/Menopausehttp://en.wikipedia.org/wiki/Oocytehttp://en.wikipedia.org/wiki/Cruciblehttp://en.wikipedia.org/wiki/Preimplantation_genetic_diagnosishttp://en.wikipedia.org/wiki/Genetic_disorderhttp://en.wikipedia.org/wiki/Preimplantation_Genetic_Haplotypinghttp://en.wikipedia.org/wiki/Preimplantation_Genetic_Haplotypinghttp://en.wikipedia.org/wiki/Genetic_disorderhttp://en.wikipedia.org/wiki/Preimplantation_genetic_diagnosishttp://en.wikipedia.org/wiki/Cruciblehttp://en.wikipedia.org/wiki/Oocytehttp://en.wikipedia.org/wiki/Menopausehttp://en.wikipedia.org/wiki/Surrogacyhttp://en.wikipedia.org/wiki/Egg_donationhttp://en.wikipedia.org/wiki/Uterushttp://en.wikipedia.org/wiki/Ovumhttp://en.wikipedia.org/wiki/Intracytoplasmic_sperm_injectionhttp://en.wikipedia.org/wiki/Intracytoplasmic_sperm_injectionhttp://en.wikipedia.org/wiki/Sperm_qualityhttp://en.wikipedia.org/wiki/Male_infertilityhttp://en.wikipedia.org/wiki/Fallopian_tubehttp://en.wikipedia.org/wiki/Female_infertilityhttp://en.wikipedia.org/wiki/Autologous_Endometrial_Coculturehttp://en.wikipedia.org/wiki/Autologous_Endometrial_Coculturehttp://en.wikipedia.org/wiki/Petri_dishhttp://en.wikipedia.org/wiki/In_vivohttp://en.wikipedia.org/wiki/Petri_dishhttp://en.wikipedia.org/wiki/Test_tubehttp://en.wikipedia.org/wiki/Beaker_(glassware)http://en.wikipedia.org/wiki/Latinhttp://en.wikipedia.org/wiki/In_vitro


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Method

Theoretically, in vitro fertilisation could be performed by collecting the contents from awoman's fallopian tubes or uterus after natural ovulation, mixing it with semen, and

reinserting into the uterus. However, without additional techniques, the chances of pregnancy

would be extremely small. Such additional techniques that are routinely used in IVF

include ovarian hyper stimulation to retrieve multiple eggs, ultrasound-guided transvaginal

oocyte retrieval directly from the ovaries, egg and sperm preparation, as well as culture and

selection of resultant embryos before embryo transferback into the uterus.
http://en.wikipedia.org/wiki/Ovarian_hyperstimulationhttp://en.wikipedia.org/wiki/Transvaginal_oocyte_retrievalhttp://en.wikipedia.org/wiki/Transvaginal_oocyte_retrievalhttp://en.wikipedia.org/wiki/Embryo_transferhttp://en.wikipedia.org/wiki/Embryo_transferhttp://en.wikipedia.org/wiki/Transvaginal_oocyte_retrievalhttp://en.wikipedia.org/wiki/Transvaginal_oocyte_retrievalhttp://en.wikipedia.org/wiki/Ovarian_hyperstimulation


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Egg & Sperm Preparation

In the laboratory, the identified eggs are stripped of surrounding cells and prepared

forfertilisation. An oocyte selection may be performed prior to fertilisation to select eggs

with optimal chances of successful pregnancy. In 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.
http://en.wikipedia.org/wiki/Fertilisationhttp://en.wikipedia.org/wiki/Oocyte_selectionhttp://en.wikipedia.org/wiki/Semenhttp://en.wikipedia.org/wiki/Sperm_washinghttp://en.wikipedia.org/wiki/Sperm_donorhttp://en.wikipedia.org/wiki/Sperm_donorhttp://en.wikipedia.org/wiki/Sperm_washinghttp://en.wikipedia.org/wiki/Semenhttp://en.wikipedia.org/wiki/Oocyte_selectionhttp://en.wikipedia.org/wiki/Fertilisation


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Fertilization

The sperm and the egg are incubated together at a ratio of about 75,000:1 in the culture

media for about 18 hours. In most cases, the egg will be fertilised by that time and the

fertilised egg will show two pronuclei. In certain situations, such as low sperm count or

motility, a single sperm may be injected directly into the egg using intracytoplasmic sperm

injection (ICSI). The fertilised egg is passed to a special growth medium and left for about 48

hours until the egg consists of six to eight cells.

In gamete intrafallopian transfer, eggs are removed from the woman and placed in one of the

fallopian tubes, along with the man's sperm. This allows fertilisation to take place inside the

woman's body. Therefore, this variation is actually anin vivofertilisation, not anin

vitrofertilisation.
http://en.wikipedia.org/wiki/Culture_mediahttp://en.wikipedia.org/wiki/Culture_mediahttp://en.wikipedia.org/wiki/Pronucleihttp://en.wikipedia.org/wiki/Intracytoplasmic_sperm_injectionhttp://en.wikipedia.org/wiki/Intracytoplasmic_sperm_injectionhttp://en.wikipedia.org/wiki/Gamete_intrafallopian_transferhttp://en.wikipedia.org/wiki/In_vivohttp://en.wikipedia.org/wiki/In_vivohttp://en.wikipedia.org/wiki/In_vivohttp://en.wikipedia.org/wiki/In_vitrohttp://en.wikipedia.org/wiki/In_vitrohttp://en.wikipedia.org/wiki/In_vitrohttp://en.wikipedia.org/wiki/In_vitrohttp://en.wikipedia.org/wiki/In_vitrohttp://en.wikipedia.org/wiki/In_vitrohttp://en.wikipedia.org/wiki/In_vivohttp://en.wikipedia.org/wiki/Gamete_intrafallopian_transferhttp://en.wikipedia.org/wiki/Intracytoplasmic_sperm_injectionhttp://en.wikipedia.org/wiki/Intracytoplasmic_sperm_injectionhttp://en.wikipedia.org/wiki/Pronucleihttp://en.wikipedia.org/wiki/Culture_mediahttp://en.wikipedia.org/wiki/Culture_media


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Embryo Culture

Typically, embryos are cultured until having reached the 68 cell stage three days after

retrieval. In many Canadian, American and Australian programmes, however, embryos are

placed into an extended culture system with a transfer done at the blastocyst stage at around

five days after retrieval, especially if many good-quality embryos are still available on day 3.

Blastocyst stage transfers have been shown to result in higher pregnancy rates.[9]In Europe,

transfers after 2 days are common.

Culture of embryos can either be performed in an artificial culture medium or inan autologous endometrial coculture (on top of a layer of cells from the woman's own uterine

lining). With artificial culture medium, there can either be the same culture medium

throughout the period, or asequential system can be used, in which the embryo is

sequentially placed in different media. For example, when culturing to the blastocyst stage,

one medium may be used for culture to day 3, and a second medium is used for culture

thereafter. Single or sequential medium are equally effective for the culture of human

embryos to the blastocyst stage. Artificial embryo culture media basically contain glucose,

pyruvate, and energy-providing components, but the addition of amino acids, nucleotides,

vitamins, and cholesterol improve the performance of embryonic growth and

development. Methods to permit dynamic embryo culture with fluid flow and embryo

movement are also available. A new method in development uses the uterus as an incubator

and the naturally occurring intrauterine fluids as culture medium by encapsulating the

embryos in permeable intrauterine vessel.
http://en.wikipedia.org/wiki/Blastocysthttp://en.wikipedia.org/wiki/In_vitro_fertilization#cite_note-8http://en.wikipedia.org/wiki/In_vitro_fertilization#cite_note-8http://en.wikipedia.org/wiki/In_vitro_fertilization#cite_note-8http://en.wikipedia.org/wiki/Autologous_endometrial_coculturehttp://en.wikipedia.org/wiki/Autologous_endometrial_coculturehttp://en.wikipedia.org/wiki/In_vitro_fertilization#cite_note-8http://en.wikipedia.org/wiki/Blastocyst


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Embryo Selection & transfer

Laboratories have developed grading methods to judge oocyte and embryo quality. In order

to optimise pregnancy rates, there is significant evidence that a morphological scoring system

is the best strategy for the selection of embryos. However, presence of soluble HLA-G might

be considered as a second parameter if a choice has to be made between embryos of

morphologically equal quality. Also, two-pronuclear zygotes (2PN) transitioning through

1PN or 3PN states tend to develop into poorer-quality embryos than those that constantly

remain 2PN.

Embryos are failed by the embryologist based on the amount of cells, evenness of growth

and degree of fragmentation. The number to be transferred depends on the number available,

the age of the woman and other health and diagnostic factors. In countries such as Canada,

the UK, Australia and New Zealand, a maximum of two embryos are transferred except in

unusual circumstances. In the UK and according to HFEA regulations, a woman over 40 may

have up to three embryos transferred, whereas in the USA, younger women may have many

embryos transferred based on individual fertility diagnosis. Most clinics and country

regulatory bodies seek to minimise the risk of pregnancies carrying multiples, as it is not

uncommon for more implantations to take than desired. The embryos judged to be the "best"

are transferred to the patient's uterus through a thin, plastic catheter, which goes through

hervagina and cervix. Several embryos may be passed into the uterus to improve chances

ofimplantation and pregnancy.
http://en.wikipedia.org/wiki/Embryohttp://en.wikipedia.org/wiki/Pregnancy_ratehttp://en.wikipedia.org/wiki/HLA-Ghttp://en.wikipedia.org/wiki/Two-pronuclear_zygotehttp://en.wikipedia.org/wiki/HFEAhttp://en.wikipedia.org/wiki/Catheterhttp://en.wikipedia.org/wiki/Vaginahttp://en.wikipedia.org/wiki/Implantation_(human_embryo)http://en.wikipedia.org/wiki/Implantation_(human_embryo)http://en.wikipedia.org/wiki/Vaginahttp://en.wikipedia.org/wiki/Catheterhttp://en.wikipedia.org/wiki/HFEAhttp://en.wikipedia.org/wiki/Two-pronuclear_zygotehttp://en.wikipedia.org/wiki/HLA-Ghttp://en.wikipedia.org/wiki/Pregnancy_ratehttp://en.wikipedia.org/wiki/Embryo


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Success Rates

IVF success rates are the percentage of all IVF procedures which result in a favorable

outcome. Depending on the type of calculation used, this outcome may represent the number

of confirmed pregnancies, called the pregnancy rate or number of live births, called the live

birth rate.

Due to advancement in reproductive technology, the IVF success rates are substantially better

today than they were just a few years ago. The most current data available in the United

States a 2009 summary complied by the Society for Reproductive Medicine which reports the

average national IVF success rates per age group using non-donor eggs.
http://en.wikipedia.org/wiki/Pregnancy_ratehttp://en.wikipedia.org/wiki/Live_birth_ratehttp://en.wikipedia.org/wiki/Live_birth_ratehttp://en.wikipedia.org/wiki/Live_birth_ratehttp://en.wikipedia.org/wiki/Live_birth_ratehttp://en.wikipedia.org/wiki/Pregnancy_rate


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Expansions of IVF

In zygote intrafallopian transfer(ZIFT), egg cells are removed from the woman's ovaries and

fertilized in the laboratory; the resulting zygote is then placed into the fallopian tube. The

following are techniques generally requires methods of in vitro fertilisation. In vitro

fertilization, however, usually does not require these techniques.

Assisted zona hatching (AZH) is performed shortly before the embryo is transferred to the uterus.

A small opening is made in the outer layer surrounding the egg in order to help the embryo hatch

out and aid in the implantation process of the growing embryo.

Intracytoplasmic sperm injection (ICSI) is beneficial in the case of male factor infertility

where sperm counts are very low or failed fertilization occurred with previous IVF

attempt(s). The ICSI procedure involves a single sperm carefully injected into the center

of an egg using a microneedle. This method is also sometimes employed when donor

sperm is used.

Autologous endometrial coculture is a possible treatment for patients who have failed previous

IVF attempts or who have poor embryo quality. The patient's fertilized eggs are placed on top of a

layer of cells from the patient's own uterine lining, creating a more natural environment for

embryo development.

Cytoplasmic transferis the technique in which the contents of a fertile egg from a donor are

injected into the infertile egg of the patient along with the sperm.

Egg donors are resources for women with no eggs due to surgery, chemotherapy, or genetic

causes; or with poor egg quality, previously unsuccessful IVF cycles oradvanced maternal age.

In the egg donor process, eggs are retrieved from a donor's ovaries, fertilized in the laboratory

with the sperm from the recipient's partner, and the resulting healthy embryos are returned to the

recipient's uterus.

Sperm donation may provide the source for the sperm used in IVF procedures where the male

partner produces no sperm or has an inheritable disease, or where the woman being treated has no

male partner.
http://en.wikipedia.org/wiki/Zygote_intrafallopian_transferhttp://en.wikipedia.org/wiki/Assisted_zona_hatchinghttp://en.wikipedia.org/wiki/Intracytoplasmic_sperm_injectionhttp://en.wikipedia.org/wiki/Autologous_endometrial_coculturehttp://en.wikipedia.org/wiki/Cytoplasmic_transferhttp://en.wikipedia.org/wiki/Egg_donorhttp://en.wikipedia.org/wiki/Advanced_maternal_agehttp://en.wikipedia.org/wiki/Sperm_donationhttp://en.wikipedia.org/wiki/Sperm_donationhttp://en.wikipedia.org/wiki/Advanced_maternal_agehttp://en.wikipedia.org/wiki/Egg_donorhttp://en.wikipedia.org/wiki/Cytoplasmic_transferhttp://en.wikipedia.org/wiki/Autologous_endometrial_coculturehttp://en.wikipedia.org/wiki/Intracytoplasmic_sperm_injectionhttp://en.wikipedia.org/wiki/Assisted_zona_hatchinghttp://en.wikipedia.org/wiki/Zygote_intrafallopian_transfer


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A gestational carrieris an option when a patient's medical condition prevents a safe

pregnancy, when a patient has ovaries but no uterus due to congenital absence or

previous surgical removal, and where a patient has no ovaries and is also unable to carry

a pregnancy to full term.

Preimplantation genetic diagnosis (PGD) involves the use of genetic screening

mechanisms such as Fluorescent In Situ Hybridization (FISH) or Comparative Genomic

Hybridization (CGH) to help identify genetically abnormal embryos and improve healthy

outcomes.

Embryo splitting can be used for twinning to increase the number of available embryos.
http://en.wikipedia.org/wiki/Gestational_carrierhttp://en.wikipedia.org/wiki/Preimplantation_genetic_diagnosishttp://en.wikipedia.org/wiki/Embryo_splitting_(disambiguation)http://en.wikipedia.org/wiki/Embryo_splitting_(disambiguation)http://en.wikipedia.org/wiki/Preimplantation_genetic_diagnosishttp://en.wikipedia.org/wiki/Gestational_carrier


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Risks

The risk of birth defects in infants born following assisted reproductive technology (ART)

treatment is a controversial question. Most publications examining the prevalence of birth

defects in ICSI and IVF infants compared to spontaneously conceived infants have serious

methodological limitations; despite this, most researchers have concluded that there is no

increased risk. METHODS: We carried out a systematic review to identify all papers

published by March 2003 with data relating to the prevalence of birth defects in infantsconceived following IVF and/or ICSI compared with spontaneously conceived infants.

Independent expert reviewers used criteria defined a priori to determine whether studies were

suitable for inclusion in a meta-analysis. Fixed effects meta-analysis was performed for all

studies and reviewer-selected studies. RESULTS: Twenty-five studies were identified for

review. Two-thirds of these showed a 25% or greater increased risk of birth defects in ART

infants. The results of meta-analyses of the seven reviewer-selected studies and of all 25

studies suggest a statistically significant 3040% increased risk of birth defects associated

with ART.

CONCLUSIONS: Pooled results from all suitable published studies suggest that children

born following ART are at increased risk of birth defects compared with spontaneous

conceptions. This information should be made available to couples seeking ART treatment.


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Bibliography

www.google.com

www.wikipedia.com

Various magazines and newspapers
http://www.google.com/http://www.wikipedia.com/http://www.wikipedia.com/http://www.google.com/

project report on assisted reproductive technologies

Documents