Assisted Conception Flashcards
(34 cards)
What is assisted conception (assisted reproductive technology)?
A procedure where gametes are manipulated or removed and returned as oocyte or embryo.
What are the main types of assisted conception?
IVF+ET, GIFT, ZIFT, TET, ICSI, sperm aspiration, assisted hatching, PGD, oocyte donation.
What is the most common ART technique?
IVF + embryo transfer (≈99% of ART cycles).
List three indications for ART.
Infertility, male/female factor infertility, unexplained infertility, communicable disease discordance.
What are the steps involved in IVF?
Pituitary suppression → Ovarian stimulation → Ovulation trigger → Egg retrieval → Sperm preparation → Insemination → Fertilisation → Embryo culture → Embryo transfer → Luteal support.
Who was the first IVF baby and when was she born?
Louise Brown, born July 25, 1978.
When and by whom was the first IVF performed in Nigeria?
1989 by Prof. O.F. Giwa-Osagie and Prof. O.A. Ashiru.
What is the goal of IVF?
To bring selected sperm as close as possible to the oocyte for fertilisation.
What are the types of IVF?
Natural-cycle IVF, conventional IVF, ICSI.
What drugs are used for pituitary suppression?
COCPs, GnRH agonists (e.g., Buserelin), GnRH antagonists (e.g., Cetorelix).
What is the aim of GnRH analogue therapy?
To suppress endogenous FSH and prevent premature LH surge.
What are the differences between GnRH agonists and antagonists?
Agonist: delayed onset, initial flare; Antagonist: rapid onset, no flare.
What is the advantage of the long GnRH agonist protocol?
Complete downregulation, better control, good follicle cohort, fewer cancellations.
What is a disadvantage of the long agonist protocol?
Risk of over-suppression, higher cost, OHSS, cycle cancellation.
What medications are used for ovarian stimulation?
hMG, FSH (urinary or recombinant), Clomiphene, Letrozole, hCG.
When is hCG administered in relation to egg retrieval?
34–36 hours before egg retrieval.
What are risks of ovarian stimulation?
OHSS, multiple pregnancies, wastage of eggs/embryos.
What is the standard route for egg retrieval?
Transvaginal ultrasound-guided aspiration.
How is sperm prepared before insemination?
Swim-up or gradient centrifugation to isolate motile sperm.
How is fertilisation assessed?
By presence of 2 pronuclei and 2 polar bodies ~18 hours post-insemination.
When is embryo transfer usually performed?
Day 2–3 (48–72 hours); blastocyst transfer at Day 5 (120 hrs).
What is used for luteal phase support?
hCG, vaginal or oral progesterone, intramuscular progesterone.
What is the average success rate of IVF?
25–35% (up to 40%), influenced by maternal age and number of embryos transferred.
List risks and complications associated with IVF.
OHSS, bleeding, infection, ectopic pregnancy, multiple births, emotional/financial stress.
