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1. Summarizing an IVF
IVF stands for in vitro fertilization, which is a medical procedure where an egg is fertilized by sperm outside the body, in vitro (in a laboratory dish). The fertilized egg, or embryo, is then implanted into the uterus to establish a pregnancy. It's often used as a fertility treatment for individuals or couples struggling with infertility.
2. How do you perform an internal ultrasound?
An internal ultrasound, or transvaginal ultrasound, is a medical procedure where a small device called a transducer is inserted into the vagina to create images of pelvic organs. The patient lies on an examination table, and the transducer, about the size of a tampon, is gently moved within the vagina to capture images on a monitor. It's a routine and safe procedure used for assessing reproductive health, monitoring pregnancies, and diagnosing gynecological conditions.
3. How do you do Tube test - HyCoSy?
HyCoSy, or Hysterosalpingo Contrast Sonography, is a procedure used to assess the patency of the fallopian tubes and detect any abnormalities in the uterine cavity. A contrast agent is injected into the uterus via a catheter, and ultrasound monitors its flow through the tubes, detecting blockages or issues.
4. How do you perform the egg collection procedure in IVF?
In the IVF egg collection procedure, the woman undergoes ovarian stimulation, monitored for egg development. After a trigger shot, the actual retrieval occurs about 36 hours later. Under sedation, a thin needle is guided by ultrasound to aspirate mature eggs from the ovaries through the vaginal wall. The collected eggs are then processed in the lab for fertilization. Specific details may vary, so consulting with a fertility specialist is essential for personalized information.
5. How do an egg and sperm meet?
The meeting of an egg and sperm, or fertilization, occurs in the fallopian tubes. During ovulation, the egg is released and travels down the tube. Sperm, having entered through the reproductive tract, navigate to the fallopian tubes. One sperm penetrates the egg, initiating fertilization. The resulting zygote undergoes cell division, forming an embryo that implants into the uterus, marking the start of pregnancy.
6. How do you perform ICSI?
ICSI involves the injection of a single high-quality sperm directly into a mature egg using micromanipulation tools. After this microinjection, fertilization is monitored, and successful embryos are selected for transfer into the uterus, making it a valuable technique in cases of male infertility or previous IVF failures.
7. How does cell division occur?
Cell division occurs through mitosis and meiosis. In mitosis, a cell duplicates its DNA and divides into two genetically identical daughter cells for growth and tissue repair. Meiosis involves two rounds of division, resulting in four haploid cells with half the original chromosome number, crucial for sexual reproduction in the formation of gametes (sperm and eggs).
8. How does an Embryo develop to blastocyst stage?
Embryo development begins with fertilization, progressing through cleavage to form a blastocyst. The blastocyst, with trophectoderm and inner cell mass layers, hatches and implants in the uterus, marking a crucial stage for further embryonic differentiation and potential pregnancy.
9. How do you do an Embryo Biopsy using Laser as part of pre-genetic testing?
Embryo biopsy for pre-genetic testing involves using a laser to create an opening in the outer layer of a blastocyst. A few cells from the trophectoderm are then extracted for genetic analysis. This precise technique allows for the screening of genetic abnormalities before selecting healthy embryos for transfer, typically after freezing.
10. How do you perform embryo transfer procedure?
The embryo transfer procedure involves preparing the woman's uterine lining with hormonal treatments, selecting healthy embryos for transfer, and delicately placing them into the uterus using a thin catheter. The success of the procedure, vital for assisted reproductive technology, depends on factors like embryo quality and the woman's reproductive health. After the transfer, hormonal support may be continued to enhance the chances of implantation.
11. How does an embryo implant?
After embryo transfer, the blastocyst attaches to the uterine lining, aided by enzymes for implantation. The trophectoderm then forms the placenta, establishing a connection for nutrient exchange. Successful implantation depends on factors like a receptive uterine lining, embryo quality, and synchronization with the menstrual cycle. Hormonal support may enhance chances, ensuring the initiation of a healthy pregnancy.
12. IVF 360 degree - prediction, research, and success explained
IVF, or in vitro fertilization, is a reproductive technology where eggs and sperm are combined outside the body, and resulting embryos are transferred into the uterus. Success rates vary based on factors like age and health, ranging from around 30% for women under 35 to about 10% for those over 40. Individual experiences may differ, and consulting with a fertility specialist offers personalized insights.
13. How do fertility hormones work? Physiology of FSH and LH Hormones?
Fertility hormones regulate reproductive processes. In females, GnRH stimulates FSH and LH release, promoting egg maturation and ovulation. After ovulation, the corpus luteum produces progesterone. In males, GnRH prompts FSH and LH release, stimulating sperm and testosterone production. Fertility treatments often involve manipulating these hormones to address reproductive issues.
A trigger injection is a medication, often containing hCG, used in fertility treatments to induce the final maturation and release of eggs from the ovaries. It's a crucial step in assisted reproductive technologies, ensuring timed and controlled ovulation for procedures like IVF.
14. How does HCG (Triger Injection) work? What is the role of Human Chorionic gonadotropin in IVF conception?
Research Work
This retrospective study aimed to evaluate factors influencing assisted reproduction outcomes in women predicted to have a reduced ovarian response (AMH between 1 and 5 pmol/L). Analyzing 85 cycles, the clinical pregnancy rate was 20.33%. A linear regression model using AMH and age yielded an equation to predict oocyte count (Oocytes = age × (-ß) + Serum AMH × α). The study suggests further evaluation of combining AMH and age to predict ovarian response, presenting a simple equation for tailored strategies in reduced responders.
Keywords: Ovarian hyperstimulation; poor responders; serum antimullerian hormone.
This systematic review aimed to identify effective treatment protocols for poor ovarian response, analyzing 61 trials with 4997 cycles and 10 management strategies. The most common strategy, using gonadotropin-releasing hormone antagonist (GnRHant), showed no significant difference compared to GnRH agonist. Luteinizing hormone supplementation had no significant impact, while growth hormone and testosterone supplementation improved clinical pregnancy and live birth rates. Aromatase inhibitors and dehydroepiandrosterone supplementation showed no effect on outcomes. The study provides valuable insights into optimizing assisted conception for poor ovarian response.
Keywords: Assisted conception; in vitro fertilization; ovarian stimulation; poor ovarian response.
The diagnosis of unexplained infertility involves excluding common causes through standard fertility investigations. These include semen analysis, ovulation assessment, and tubal patency tests, selected for their definitive correlation with pregnancy. Despite thorough evaluations, approximately 15% to 30% of infertile couples remain unexplained. A review of literature via MEDLINE from 1950 to 2013 suggests that additional investigations with high false-positive results are not recommended for routine clinical practice. Couples with unexplained infertility may find reassurance, as 50% are estimated to conceive within the following 12 months after 12 months of unsuccessful attempts, with an additional 12% conceiving in the subsequent year.
Keywords: Unexplained infertility; fertility investigations; pregnancy; reproductive health.
This systematic review explores factors influencing successful fertilization in assisted conception, focusing on sperm- and oocyte-related aspects. A literature search yielded 243 papers, and qualitative analysis was conducted due to significant heterogeneity in study design. Strategies to improve fertilization rates include optimizing laboratory conditions and procedural effects. Techniques such as assisted oocyte activation, physiological intracytoplasmic sperm injection (PICSI), and intracytoplasmic morphologically selected sperm injection (IMSI) are discussed. The review emphasizes the need for adequately powered multicenter randomized trials to assess these promising strategies before clinical application.
Keywords: Fertilization; ICSI; IMSI; IVF; PICSI; assisted oocyte activation.
This retrospective cohort study aimed to compare obstetric complications in women conceiving after oocyte donation versus age-matched controls conceiving spontaneously or through autologous IVF. The study, including 45 women in each group, found a significantly higher risk of hypertensive disorders in pregnancy (pregnancy-induced hypertension and pre-eclampsia) in the oocyte donation group (33%) compared to the autologous IVF (7%) and spontaneous conception (7%) groups. Logistic regression revealed an odds ratio of 5.85 for hypertensive disorders in the oocyte donation group, emphasizing the need for managing oocyte donation as an independent risk factor and providing appropriate counseling to couples.
Keywords: Donor oocyte; Hypertensive disorder; In vitro fertilization; Intracytoplasmic sperm injection; Obstetric outcome; Pre-eclampsia.
5. Three-arm age-matched retrospective cohort study of obstetric outcomes of donor oocyte pregnancies.
This systematic review and meta-analysis, comprising 11 studies with 81,752 participants, aimed to compare pregnancy complications in women with donor oocyte (DO) IVF versus autologous oocyte IVF. The analysis revealed that DO pregnancy significantly increased the risk of hypertensive disorders (OR 3.92), small for gestational age (OR 1.81), caesarean section (OR 2.71), and preterm delivery (OR 1.34). Subgroup analysis for singleton and twin pregnancies confirmed elevated risks in both categories. Meta-regression indicated that these risks were independent of age. The study concludes that DO pregnancy is an independent risk factor for obstetric complications, emphasizing the need for careful counseling before undergoing DO-assisted conception.
Keywords: Donor oocyte pregnancy; in vitro fertilisation; pre-eclampsia; pregnancy-induced hypertension.
This article discusses the potential use of ovarian tissue cryopreservation (OTCP) as a fertility preservation option for girls with Turner's syndrome (TS), a condition associated with accelerated follicular atresia and premature ovarian failure. While donor oocyte conception has been the main fertility option, recent advances in OTCP present a promising alternative. The article highlights the variability in fertility decline in girls with TS, the success of OTCP in cancer patients, and the psychological and clinical benefits of fertility preservation. The authors argue for considering OTCP as a potential avenue for preserving biological fertility in girls with TS, emphasizing the need for ethical, clinical, and psychological considerations in this novel approach.
Keywords: IVF; Turner’s syndrome; fertility preservation; ovarian tissue cryopreservation; premature ovarian failure.
7. Time to consider ovarian tissue cryopreservation for girls with Turner's syndrome: an opinion paper.
This article discusses the potential use of ovarian tissue cryopreservation (OTCP) as a fertility preservation option for girls with Turner's syndrome (TS), a condition associated with accelerated follicular atresia and premature ovarian failure. While donor oocyte conception has been the main fertility option, recent advances in OTCP present a promising alternative. The article highlights the variability in fertility decline in girls with TS, the success of OTCP in cancer patients, and the psychological and clinical benefits of fertility preservation. The authors argue for considering OTCP as a potential avenue for preserving biological fertility in girls with TS, emphasizing the need for ethical, clinical, and psychological considerations in this novel approach.
Keywords: IVF; Turner’s syndrome; fertility preservation; ovarian tissue cryopreservation; premature ovarian failure.
This systematic review aimed to assess the accuracy of first-trimester ultrasound in diagnosing early embryonic demise. Searching MEDLINE, Embase, and the Cochrane Library, eight primary articles involving 872 women were analyzed. The study identified a lack of high-quality, prospective data for formulating accurate guidelines on the diagnosis of early pregnancy demise. Specificity estimates for certain ultrasound criteria, such as an empty gestational sac with a mean diameter of ≥25 mm and an absent yolk sac with a mean gestational sac diameter of ≥20 mm, were high, but the overall findings were limited by the small number of studies, patient variability, and the age of the included studies. The review highlights the need for a well-powered, prospective study with current ultrasound technology and a standardized reference standard for pregnancy success or loss before formulating guidelines for managing threatened miscarriage.
Keywords: First-trimester ultrasound; early embryonic demise; accuracy; threatened miscarriage.
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