Assisted reproductive technology (ART)

Question 1

When is ART used?

Answer 1

Infertility, cancer and fertility preservation, same sex couple

Question 2

The term __________ is used to describe couples who have not been able to conceives after one year of natural unprotected intercourse

Answer 2

Infertile

Question 3

_____________ means that couples have a reduced ability to conceive and produce children

Answer 3

Sub-fertile

Question 4

Infertility, according to WHO, is a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after _________ months or more of regular ______________ sexual intercourse

Answer 4

12; unprotected

Question 5

What are the typical conception rates of normal fertility?

Answer 5

50% after 3 months, 85% conceive by 12 months, 992% after 2 years

Question 6

When is the highest probability of conception?

Answer 6

1 to 2 days prior to ovulation

Question 6

Likelihood of fertility ____________ to 1% after 3 years of intercourse without contraception

Answer 6

Decreases

Question 6

Ovum survives how many hours after ovulation?

Answer 6

12-24 hours

Question 6

What are the biggest factors of infertility?

Answer 6

Male and female factors

Question 6

Sperm lives for how many days in female reproductive tract?

Answer 6

3-5 days

Question 7

What are some of the identifiable female factors of infertility?

Answer 7

Ovulatory disorders, endometriosis, pelvic adhesions, tubal blockage

Question 7

Which of the following lead to male infertility?
a) Antibodies against sperm
b) Blockage of sperm delivery system
c) Deficiencies in sperm production

Answer 7

All of the above

Question 8

How many eggs are released every month?

Answer 8

One egg

Question 8

Who may benefit from IVF?

Answer 8

Women with blocked or damaged Fallopian tubes, men with low sperm count or poor sperm motility, woman with ovulation disorders or uterine fibroids, individuals with a genetic disorder, unexplained infertility

Question 8

1 in ______ couples will face a fertility issue

Answer 8

6

Question 9

How many IVF babies have been born to date?

Answer 9

More than 5 million

Question 9

Place the basic steps of IVF in order:
a) Transfer embryos back into the uterus
b) Secure the sperm
c) Collect the eggs
d) Combine the eggs and sperm together in the lab and provide the appropriate environment for fertilization and early embryo growth
e) Monitor and stimulate the development of healthy eggs in the ovaries

Answer 9

e, c, b, d, a

Question 10

Fertility ___________ are prescribed to stimulate __________ production

Answer 10

Medications; egg

Question 11

__________ test samples are taken to check hormone levels

Answer 11

Blood

Question 12

What kind of medication is administered to women undergoing IVF?

Answer 12

Oral contraceptive to prevent formation of cysts

Question 13

Eggs are retrieved through a minor surgical procedure that uses ____________ imaging to guide a hollow needle through the __________ cavity to remove the eggs

Answer 13

Ultrasound; pelvic

Question 14

How are oocytes retrieved?

Answer 14

A probe is inserted into the vagina and a needle passes through the vaginal wall to the ovary, where the eggs are aspirated and extracted

Question 15

What is the process by which the sperm and eggs are mixed together and stored in a laboratory to encourage fertilization?

Answer 15

Insemination

Question 16

In cases where there is a lower probability of fertilization due to male factor, which method is used?

Answer 16

Intracytoplasmic sperm injection (ICSI)

Question 17

How many days following the egg retrieval and fertilization are the embryos transferred into the woman's uterus?

Answer 17

Three to five days

Question 18

What are morphologically normal looking oocytes?

Answer 18

Those in germinal vesicle or with one polar body

Question 19

A sample of semen analysis for ART is assessed for which features?

Answer 19

Count, motility, progression, abnormality

Question 20

According to WHO, the normal sperm concentration is ______________/ml or more, the total motility is __________% or more, the progressive motility is __________% or more and the morphology is __________% or more normal forms

Answer 20

15 000 000, 40, 32, 4

Question 21

How is sperm prepared for insemination?

Answer 21

Sperm is washed

Question 22

True or false: Not all sperm are normal, but they are the same sizes

Answer 22

False, all sperm are normal, but with different sizes

Question 23

Globozoospermia refers to round headed sperm with no ____________

Answer 23

Acrosome

Question 24

Each egg-cumulus complex is inseminated with ______________ prepared sperm after 3-4 hours _______________ of oocytes

Answer 24

25 000, pre-incubation

Question 25

ICSI involves the injection of a single __________ into the _____________, bypassing all the oocyte coat penetration and gamete fusion steps

Answer 25

Sperm; oocyte

Question 26

Human oocyte activation for male pronuclear development achieved by vigorous suction of _____________ and sperm nuclear insertion

Answer 26

Ooplasm

Question 27

What indicates normal fertilization?

Answer 27

The presence of two pronuclei

Question 28

What is crucial at each developmental stage of embryo?

Answer 28

Culture media

Question 29

What is the device used to grow and maintain cell and embryo cultures?

Answer 29

Incubator

Question 30

The incubator with _______ CO2 and _______ O2 control interacts with the culture media used, to determine the pH within the system

Answer 30

6%, 5%

Question 31

Identify the following characteristics with their cleavage stage grading: 1. < 50% fragmentation 2. Evenly sized blastomeres 3. Variation in refractility 4. Remaining blastomeres should appear viable

Answer 31

1. Grade 3 2. Grade 1 3. Grade 2 4. Grade 4

Question 32

What do we observe on day 3 of the embryo?

Answer 32

4-8 cells

Question 33

Which day is morula observable?

Answer 33

Day 4

Question 34

When is the blastocyst formed?

Answer 34

Day 5

Question 35

Which day are morphologically good quality blastocysts chosen for transfer?

Answer 35

Day 5/6

Question 36

What is the purpose of real-time embryo monitoring device?

Answer 36

Measure the length of cell cycle, compaction, blastocoel formation and compare effects of various culture conditions

Question 37

Blastocyst hatches out of the _________ ___________

Answer 37

Zona pellucida

Question 38

When is assisted hatching used?

Answer 38

2 previous implantation failures, 37 years old or older, thickened ZP, IVM embryos, thawed oocytes/embryos

Question 39

What does IVM stand for?

Answer 39

In vitro maturation

Question 40

In which of the following circumstances would IVM be used? a) Some women are extremely sensitive to stimulation with exogenous gonadotropins b) A decreased risk of developing ovarian hyper-stimulation syndrome

Answer 40

a

Question 41

Immature oocytes can be matured in vitro after releasing from the ____________ follicles in vitro

Answer 41

Antral

Question 42

Which cells are associated with oocyte quality?

Answer 42

Cumulus cells

Question 43

Embryo development makes its transition from ___________________ zygote after fertilization of the oocyte to a blastocyst

Answer 43

Single-celled

Question 44

What happens to the embryos that were not used?

Answer 44

They are frozen via slow freezing or vitrification (fast freezing)

Question 45

How does vitrification work?

Answer 45

Embryo washed with buffer, soaked in equilibration solution for 3-5 minutes then soaked in vitrification solution for 30 seconds

Question 46

What is the process of thawing?

Answer 46

1.0 M of sucrose for 1 minute, 0.5 M of sucrose for 2 minutes, 0.25 M of sucrose for 3 minutes, then washed twice for 5 minutes with buffer

Question 47

What does a pregnancy test search for?

Answer 47

Levels of hCG

Question 48

When is a fetal heart beat detected after embryo transfer?

Answer 48

4-5 weeks