Assisted reproduction: IVF and ICSI

Question 1

What is IVF

Answer 1

In vitro fertilization
Been successfully used since 1978

Question 2

What are the main steps of IVF

Answer 2

stimulation
egg retrieval
insemination and fertilization
embryo transfer

Question 3

What is involved in the stimulation step

Answer 3

Super ovulation

Ovaries stimulated by hormones like FSH and LH to produce eggs

During this time, the woman will have transvaginal ultrasounds to examine ovaries

Question 4

What is involved in egg retrieval

Answer 4

Invasive surgery-follicular aspiration (suck liquid and follicle with oocyte)

Needle inserted into mature follicles- connected to suction device

Question 5

What is involved in insemination and fertilization

Answer 5

Sperm placed with eggs and put in incubator

The mixing of sperm and egg is called insemination

Question 6

What is involved in embryo transfer

Answer 6

After several days , embryos ready to be transferred into uterus by flexible cannula

In most cases, 4-10 cell stage embryos are transferred. In some special cases,
the incubation in vitro is longer, and blastocysts are transferred.

Question 7

What can be done if fertilization is so low even IVF will not work
eg sperm cant penetrate egg due to defect

Answer 7

Intracytoplasmic sperm injection

ICSI- directly inject sperm into egg

Question 8

In what cases is ICSI recommended

Answer 8

• Male very low sperm count
• poor morphology/motility of sperm
• several unsuccessful in vitro attempts
• the male partner has had a vasectomy and sperm must be collected from the testicles or epididymis
• the male partner has had problems obtaining an erection and ejaculating. This includes men with spinal cord
  injuries, diabetes and other disorders.

Question 9

How are the oocytes cultivated

Answer 9

• Petri dishes 37’C (mimick body temp)
• liquid parafin prevents evaporation of the drop
• pH indicator shows change in colour, when it turns red put straight into incubator (they have to be manipulated fast)

Question 10

Why do you need to know the position of the polar body when doing ICSI

Answer 10

When we inject sperm, you CANNOT destroy spindle so you have to inject away from the polar body

Question 11

What type of nuclei does zygote have

Answer 11

HAPLOID (24 hrs after mixing of gametes)

Zygote is never diplod as the 2 pronuclei never fuse

Question 12

Where does sperm capacitation occur

Answer 12

In vagina of female

Breaks down cholesterol layer of sperm head

ATP generating system starts working so sperm becomes hyperactive- flagellum starts to move

sperm become functionally mature in women