In Vitro Fertilization

a.k.a
TEST TUBE BABIES or
ART (Assisted Reproductive Technology)

What is In Vitro Fertilization?

In vitro fertilization (IVF) is the joining of a woman s egg and a man s sperm in a laboratory dish. In Vitro means outside the body fertilization means the sperm has attached to and entered the egg

IVF has been successfully used since 1978. It is most often tried when other less expensive fertility techniques have failed. When the IVF procedure is successful, the process is combined with a procedure known as embryo transfer, which is used to physically place the embryo in the uterus.

Significance of IVF
Main reason: Infertility -the state of being unable to produce offspring.

In a WOMAN

The inability to conceive.

In a MAN

The inability to impregnate.

Probable causes of INFERTILITY blocked fallopian Delayed marriages and late Damaged or
childbearing Sexually transmitted diseases Diet Lack of exercise Previous contraceptive use leading to sterility Sterility from previous abortion Advanced age of the woman (advanced maternal age) tubes (can be caused by pelvic inflammatory disease or prior reproductive surgery) Endometriosis (the presence of endometrium elsewhere than in the lining of the uterus) Male factor infertility, including falling sperm count (medicines, alcohols, etc) and blockage

5 basic steps of In Vitro Fertilization

Step 1: Stimulation, Super ovulation, Ovulation induction
Medicines, commonly called fertility drugs, are given to the woman to boost her egg production. These are prescribed to control the timing of the egg ripening and to increase the chance of collecting multiple eggs during one of the woman's cycles. Normally, a woman produces one egg per month. Fertility drugs tell the ovaries to produce several eggs. During this step, the woman will have regular transvaginal ultrasounds to examine the ovaries and blood tests to check hormone levels.

Clomid- generic name for clomephene citrate

Follistim fertility drug

5 basic steps of In Vitro Fertilization

Step 2: Egg retrieval
Follicular Aspiration

A minor surgery, called follicular aspiration, is done to remove the eggs from the woman s body. The surgery is normally done as an outpatient procedure in the doctor s office. The woman will be given medicines so she does not feel pain during the procedure. Using ultrasound images as a guide, the health care provider inserts a thin needle through the vagina and into the ovary and sacs (follicles) containing the eggs. The needle is connected to a suction device, which pulls the eggs and fluid out of each follicle, one at a time. The procedure is repeated for the other ovary. The woman may have some cramping after the surgery, but it usually goes away within a day but a feeling of fullness or pressure may last for several weeks following the procedure. In rare cases, a pelvic laparoscopy may be needed to remove the eggs.

Laparoscopic view of a normal pelvis (looking down from belly button area) Uterus in midline, fallopian tubes and ovaries (white structures) to the sides Black surgical probe at top left

5 basic steps of In Vitro Fertilization

Step 3: Insemination and Fertilization
The man s sperm (which is usually obtained through ejaculation) is placed together with the best quality eggs and stored in an environmentally controlled chamber. The mixing of the sperm and egg is called insemination. The sperm usually enters (fertilizes) an egg a few hours after insemination. If the doctor thinks the chance of fertilization is low, the laboratory staff may directly inject a single sperm into the egg. This is called intracytoplasmic sperm injection (ICSI).

Insemination

FERTILIZATION

5 basic steps of In Vitro Fertilization

Step 4: Embryo Culture
When the fertilized egg divides, it becomes an embryo. Laboratory staff will regularly check the embryo to make sure it is growing properly. Within about 5 days, a normal embryo has several cells that are actively dividing. Couples who have a high risk of passing a genetic (hereditary) disorder to a child may consider pre-implantation genetic diagnosis (PGD). This PGD is done about 3 -4 days after fertilization wherein laboratory scientists remove a single cell from each embryo and screen the material for specific genetic disorders. According to the American Society for Reproductive Medicine, PGD can help parents decide which embryos to implant, which decreases the chance of passing a disorder onto a child. The technique is controversial and not offered at all centers.

Pre- implantation Genetic Diagnosis

5 basic steps of In Vitro Fertilization

Step 5: Embryo transfer
Embryos are placed into the woman s womb 3 - 5 days after egg retrieval and fertilization. The procedure is done in the doctor s office while the woman is awake. The doctor inserts a thin tube (catheter) containing the embryos into the woman s vagina, through the cervix, and up into the womb. If an embryo sticks to (implants) in the lining of the womb and grows, pregnancy results. This process is often guided by ultrasound. The procedure is usually painless, but some women experience mild cramping. These steps are followed by rest and watching for early pregnancy symptoms. A blood test and potentially an ultrasound will be used to determine if implantation and pregnancy has occurred. *More than one embryo may be placed into the womb at the same time, which can lead to twins, triplets, or more. The exact number of embryos transferred is a complex issue that depends on many factors, especially the woman s age. Unused embryos may be frozen and implanted or donated at a later date.*

TRIPLETS

What are the risks associated with IVF

IVF requires a significant physical, emotional, financial, and time commitment. Stress and depression are common among couples dealing with infertility.

Risks of egg retrieval include reactions to anesthesia, bleeding, infection, and damage to structures surrounding the ovaries, including the bowel and bladder. Swollen ovary due to infection In rare cases, fertility drugs may cause ovarian hyperstimulation syndrome (OHSS). This condition causes a build up of fluid in the abdomen and chest. Symptoms include abdominal pain, bloating, rapid weight gain (10 pounds within 3-5 days), decreased urination despite drinking plenty of fluids, nausea, vomiting, and shortness of breath. Mild cases can be treated with bed rest. More severe cases require draining of the fluid with a needle.

IVF is very costly. Some, but not all, states have laws that say health insurance companies must offer some type of coverage. But, many insurance plans do not cover infertility treatment. Fees for a single IVF cycle -- including costs for medicines, surgery, anesthesia, ultrasounds, blood tests, processing the eggs and sperm, embryo storage, and embryo transfer -- can quickly add up. The exact total of a single IVF cycle varies with each individual, but may cost more than $12,000 - $17,000.

A woman taking fertility medicines may have bloating, abdominal pain, mood swings, headaches, and other side effects. Many IVF medicines must be given by injection, often several times a day. Repeated injections can cause bruising. There is a risk of multiple pregnancies when more than one embryo is placed into the womb. Carrying more than one baby at a time increases the risk of premature birth and low birth weight. (However, even a single baby born after IVF is at higher risk for prematurity and low birth weight.) It is unclear whether IVF increases the risk of birth defects.

Variations of In Vitro Fertilization

Two procedures related to IVF:
a. Gamete intrafallopian transfer (GIFT) GIFT is similar to IVF, but the gametes (egg and sperm) are transferred to the fallopian tubes rather than the uterus, and fertilization takes place in the tubes rather than in the laboratory. GIFT also involves a laparoscopic surgical procedure to transfer the sperm and egg into the tubes. GIFT accounts for approximately 2% of assisted reproductive technology (ART) procedures in the United States. b. Zygote intrafallopian transfer (ZIFT) ZIFT differs from GIFT in that the fertilization process still takes place in the laboratory versus the fallopian tubes. It is similar to GIFT in that the fertilized egg is transferred into fallopian tubes, and it involves a laparoscopic surgical procedure. ZIFT accounts for less than 1.5% of assisted reproductive technology (ART) procedures in the United States.

SUCCESS of In Vitro Fertilization

According to the Society of Assisted Reproductive Technologies (SART), the approximate chance of giving birth to a live baby after IVF is as follows: 41-43% for women under age 35 33-36% for women age 35 - 37 23-27% for women ages 38 - 40 13-18% for women over age 41

First

Louise, 27, and her husband of two years, security officer, Test-Tube Wesley Mullinder, had Brown Baby - Louise their own child, who was conceived On July 25, 1978, Louise Joy Brown, the world's first successful "testtube" baby was born in Great Britain. Though the technology that made naturally. They named medicine her conception possible was heralded as a triumph intheir and science, it also little boy consider the possibilities of future ill-use. caused many to Cameron .
Lesley and John Brown were a young couple from Bristol who had been unable to conceive for nine years. Lesley Brown had blocked Fallopian tubes. Having gone from doctor to doctor for help to no avail, she was referred to Dr. Patrick Steptoe in 1976. On November 10, 1977, Lesley Brown underwent the very experimental in vitro ("in glass") fertilization procedure.

The Moral Issues

1. Obtain sperm from the man

Obtaining sperm by masturbation may be morally objectionable 2. In the laboratory place eggs and sperm together to allow for fertilization, to create embryos
Embryos are created in the laboratory (the test tube) thus human fertilization occurs apart from sexual intercourse and outside the human body. The unitive-procreative dimension of the conjugal act is lost.

3. The destruction of embryos

Many embryos created. Healthy ones kept but defective embryos are destroyed. Healthy embryos can be transferred to woman or they can be frozen for use at later date. Sometimes they are experimented on.
The human being is to be respected and treated as a person from the moment of conception Pope John Paul II

4. The problem of frozen embryos

In USA there are >400,000 frozen embryonic persons, a kind of hell of ice . In thawing them 50 % will die. Worldwide there are up to 1 million frozen embryos
Regarding what to do with the frozen embryos, remains a question.

5. Transferring many embryos into uterus of woman

Many embryos implanted in mother s womb (usually 2-4) to increase chance of pregnancy. Should too large a number of embryos start to grow, the excess embryos are usually aborted (called pregnancy reduction ).

1. Separation of the unitive-procreative dimension of the conjugal act The inseparable connection: union and procreation The Church's teaching on marriage and human procreation affirms the inseparable connection, willed by God and unable to be broken by man on his own initiative, between the two meanings of the conjugal act: the unitive meaning and the procreative meaning. By safeguarding both these essential aspects, the unitive and the procreative, the conjugal act preserves in its fullness the sense of true mutual love and its ordination toward man's exalted vocation to parenthood see Humanae Vitae 12

2. Massive destruction of human life

Currently the number of embryos sacrificed, even in the most technically advanced centers of artificial fertilization, hovers above 80%.
(Footnote 27, Dignitas Personae)

3. The child must be a gift not a product

The child has the right to be the fruit of the specific act of the conjugal love of his parents .
CCC 2378

You formed my inmost being; you knit me in my Myca Galat mother's womb. Jernet Sabado Fearfully and Gillien wonderfully Elijah Pasabing made!
Psalm 139

GJ