Lect 8: In vitro Fertilization Flashcards Preview

Unit 7 - Repro & Renal Physiology > Lect 8: In vitro Fertilization > Flashcards

Flashcards in Lect 8: In vitro Fertilization Deck (28)
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What is Infertility?

the inability to conceive within 12 months without contraception


Common causes of male infertility

low sperm count
problems with quality of sperm
motility issues
genetic mutation of sperm


Common causes of female infertility

failure to ovulate regularly or at all
low supply of egg-producing follicles
blocked or damaged Fallopian tubes
uterine problems (fibroids, polyps)


Ovarian Reserve

peaks in early fetal life (5-7 millon gametes at 20 wks of birth)
by the time you reach puberty you are down to 400,000
fertility can begin to decline by age 27
significant decline seen at age 35 and >
by age 45 spontaneous pregnancy are rare


Treatment of Infertility

1. ovulation induction
2. reproductive tract surgery (for damaged tubes)
3. intrauterine insemination (IUI)
4. assisted reproduction (IVF, GIFT)


Intrauterine insemination (IUI)

Two techniques: to concentrate sperm
swim up specimen
column technique



don't take Ibuprofin can retard ovulation


What is the purpose of Down regulation of the Hypothalamic-Pituitary-ovarian axis (HPO)

during the menstrual cycle the brain knows when th one follicle is matured and is ready to extrude it. However, they want more than one egg so they give meds to bypass this axis


What is the Long protocol?

given GnRH agonists


What is the short protocol?

given GnRH antagonists


Controlled ovarian hyperstimulation?

to get as many eggs


What are some examples of apecialized ancillary IVF procedures?

Assisted embryo hatching
Intra Cytoplasmic Sperm Injection (ICSI)
Preimplantation Genetic Diagnosis
Oocyte and Embryo Cryopreservation
Oocyte and Embryo Donation
Gestational Carriers (Surrogacy)


Mullerian agenesis

the Mullerian ducts are two tubes that fuse together to form the fallopian tubes, uterus and upper vagina. They have ovaries and can produce eggs that can be transferred to a surrogate


H-P-O Axis

arcuate nucleus produces GnRH which secrete it in pulses. Starts during puberty at night. This gets released and stimulates the gonadotrophins (FSH, LH). LH stimulates Theca cells to produce androgens and FSH will stimulates the granulosa cells to upregulate aromatase which converts androgens (testosterone to beta-estradiol). Need both cells types. They feedback on the brain to have --/+ impact


H-P-O down regulation & suppression

GnRH agonists you get a flare effect but overtime it gets desensitized where there is activity to stop the production of LH & FSH
==>long protocol


H-P-O down regulation & suppression

GnRH antagonist are competitive inhibitors of the receptor causing immediate block of FSH & LH
==>short protocol


GnRH Analogs

can make antagonist or agonist


hCG Trigger

bombarding the ovaries with lots of FSH to produce as many eggs as possible. Need hCG because it binds to the same receptor as LH does. LH surge causes ovulation. hCG mimics LH surge inducing ovulation. Then you retrieve this egg. hCG is also produced by the embryo as well. hCG has a longer half life due to sailic acid (a sugar molecule)


Oocyte insemination (2)

1. standard oocyte insemination
2. ICSI- direct injection of the sperm into the oocyte allowing them to combine and divide


Oocyte insemination - blastocyst

After the cell divides you transfer anywhere between the 4-8 cell stage. Blastocyst is a day 5 embryo. Day 6 it implants. Problem is that if you are Day 3 and the embryo is moving along nicely yo may not get to blastocyst stage and have no embryo. It depends on the amount of eggs that the person has to work with



directly injecting the sperm into the egg
==>2PN stage (two pronuclei stage one from mom and one from dad)


Embryo Transfer

directly injecting the egg the egg into the uterus under ultrasound


Options for Excess Embryos

freeze embryos
donate for research/stem cells
embryo adoption


Limiting Factor

is the age of the egg, not the mother


PGD- preimplanatation genetic

to see if you have any genetic disorders


Three parent Embryos

using mitochondrial nucleus adding to an normal cell. Transplant that nucleus to another cell than fertilizing that egg with a sperm


Artifcial Gametes

using stem cells to become sperm and eggs and combine then to make an individual