Assisted Reproductive TechnologyByM.VharshiniB.Sc. Biomedical sciences

Assisted Reproductive Technologies:

• Assisted reproductive technology (ART) is the technology used to achieve pregnancy in procedures such as fertility medication, artificial insemination, in vitro fertilization and surrogacy.

• Fertility therapies where eggs and sperm are manipulated• Involve surgically removing eggs from women and

combining them with sperm in the laboratory

Why ART?

Infertility: Extremely Prevalent

• Definition: Infertility refers to the biological inability of an individual to contribute to conception, or to a female who cannot carry a pregnancy to full term.

• 7-26% of couples worldwide (90 million women).

Causes of Infertility

• Delayed marriage and child-bearing• Sexually transmitted diseases• Hormonal contraception• Abortion• Obesity• Environmental Pollution

In vitro fertilization

Definition:IVF (in vitro fertilization) is a method in which egg cells are fertilized by sperm cells outside the mother’s womb (in vitro). The resulting embryos are then transferred back into the uterus.

STEPS IN IVF

• Follicle suppression• Controlled ovarian hyper stimulation• Aspiration of eggs from follicles• Fertilization, incubation and selection of

embryos• Embryo transfer• Pregnancy test

IVF LAB: FOLLICULAR FLUID

HIGH QUALITY EGG

LOW QUALITY EGG

EMBRYOLOGIST MANIPULATING OVA AND SPERM

HIGH QUALITY THREE DAY OLD EMBRYO

INTRA-CYTOPLASMIC SPERM INJECTION

Intracytoplasmic sperm injection (ICSI) involves the direct injection of sperm into eggs obtained from invitro fertilization (IVF).

How Is ICSI Performed?•  The mature egg is held with a specialized

pipette.•  A very delicate, sharp, and hollow needle is

used to immobilize and pick up a single sperm.

•  The needle is then carefully inserted through the shell of the egg and into the cytoplasm of the egg.

•  The sperm is injected into the cytoplasm, and the needle is carefully removed.

•  The eggs are checked the following day for evidence of normal fertilization.

INTRAUTERINE INSEMINATION: IUI

• Intrauterine insemination (IUI) is a fertility treatment that involves placing sperm inside a woman’s uterus to facilitate fertilization.

• The goal of IUI is to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilization.

• It is a less invasive and less expensive option compared to in vitro fertilization.

Intrauterine insemination (IUI)

• Before IUI, ovulation stimulating medications may be used.• The IUI procedure will then be performed around the time of

ovulation, typically about 24-36 hours after the surge in LH hormone that indicates ovulation will occur soon.

• A semen sample will be washed by the lab to separate the semen from the seminal fluid.

• A catheter will then be used to insert the sperm directly into the uterus.

• This process maximizes the number of sperm cells that are placed in the uterus, thus increasing the possibility of conception.

Process of IUI

GAMETE INTRAFALLOPIAN TUBE TRANSFER (GIFT)

• GIFT is an assisted reproductive procedure which involves removing a woman’s eggs, mixing them with sperm, and immediately placing them into a fallopian tube.

• One of the main differences between this procedure and IVF and ZIFT procedures is that in GIFT the fertilization process takes place inside the fallopian tube rather than in a laboratory.

How is GIFT performed?• Patients must first have an x-ray to determine the presence of at

least one healthy fallopian tube. The doctor will also use a laparoscope to ensure that there is not any scar tissue on the outside of the fallopian tube.

• Using a laparoscope, eggs are then retrieved from the ovaries.• The male provides a sperm sample the same day that the eggs

are retrieved.• The eggs are then mixed with the sperm in a catheter.• The egg and sperm mixture is inserted into the fallopian tubes with

a catheter.• The woman is then provided with medication to build up the

uterine lining to support implantation of a fertilized egg.

ZYGOTE INTRAFALLOPIAN TRANSFER: ZIFT

• ZIFT is an assisted reproductive procedure similar to in vitro fertilization and embryo transfer, the difference being that the fertilized embryo is transferred into the fallopian tube instead of the uterus.

• Because the fertilized egg is transferred directly into the tubes, the procedure is also referred to as tubal embryo transfer (TET).

How Is ZIFT Performed?• A woman’s ovaries are stimulated with medications to

increase the probability of producing multiple eggs.• Eggs are then collected through an aspiration procedure.• Those eggs are fertilized in a laboratory in a procedure

identical to IVF, with the exception of the time frame. During the ZIFT procedure, fertilized eggs are transferred within 24 hours, versus 3-5 days as used in a regular IVF cycle.

• The fertilized eggs are then transferred through a laparoscopic procedure where a catheter is placed deep in the fallopian tube and the fertilized eggs injected.

• The final step is to watch for early pregnancy symptoms.

SURROGACY

• Surrogacy is the practice by which a woman (called a surrogate mother) becomes pregnant and gives birth to a baby in order to give it to someone who cannot have children.

• In gestational surrogacy, an egg is removed from the intended mother or an anonymous donor and fertilized with the sperm of the intended father or anonymous donor. The fertilized egg, or embryo, is then transferred to a surrogate who carries the baby to term.

• In traditional surrogacy, the surrogate is impregnated naturally or artificially, but the resulting child is genetically related to the surrogate.

• Intended parents may seek a surrogacy arrangement when either pregnancy is medically impossible, pregnancy risks present an unacceptable danger to the mother's health.

Reference• http://www.babycenter.com/0_fertility-treatme

nt-assisted-reproductive-technologies-art_4093.bc

• http://americanpregnancy.org/infertility/gamete-intrafallopian-transfer/

• https://www.surrogacyuk.org/about_surrogacy

THANK YOU