IN VITRO FERTILIZATION

INTRODUCTION Medical treatment which helps infertile couples to have baby. Used for the first time in United States in 1981. More than 4 million babies have been born. First test tube baby born in England on 25 july,1978 named Louise Brown.

IN VITRO FERTILIZATION IN HUMANS Fertilization of egg with sperms in vitro under aseptic conditions till 8-16 cell stage, then implant it in uterus of mother. Steps: Collection of oocytes Collection of sperms In vitro fertilization Implantation

Collection of oocytes From females who have normal functional ovaries but damaged fallopian tubes(tubal infertility). In non-functional ovaries, oocytes collected from donor females. Ovulation stimulated by combination of: Clomiphene hMG (human menopausal gonadotrophin) hCG (human chorionic gonadotrophin) administered to prevent the inhibition of LH by hMG.

Time of ovulation Temperature and blood pressure profile. Change in survical mucous secretions. Increase in progestrone in plasma. Increase in LH and estrogen in urine and blood. Collection of oocytes by laproscopy.

2. Collection of sperms Two types of defects Azoospermia(immotile sperm) Oligospermia(few sperm) In both cases, sperms are taken from donor male or sperm banks. Semen is collected 60-90 mins prior to fertilization, then liquified and centrifuged. Semen pellet incubated for 30-60 mins at 37°C.

3.In vitro fertilization Oocytes are incubated for 5-10 hrs for maturation. Media used for oocyte incubation and culture of zygote: Ham’s F10 media Earl’s solution Whitten’s media Whittingham’s T6 About 10,000-50,000 motile sperms are added to 100µl-1ml of culture media containing oocytes.

It is examined after 12-13 hours for detecting: Number of pro-nuclei and polar bodies Granulation Shape Fertilized oocyte contains two pro-nuclei and two polar bodies. First division occurs about 24-30 hours. If oocyte fails to divide after 30 hours it is discarded.

4. Embryo tranfer Embryos of 1-16 cells transferred to uterus. Best stage is 2-4 cells. Embryo is transferred through cervical canal with teflon catheter. Female receiving the embryo must be in correct stage of her menstrual cycle.

ADVANTAGES Helps infertile couples to have baby. DNA will be that of intended parents, if no donor egg or sperms are used. Successful pregnancy and healthy baby is born. In case of infertile male or female, sperms and egg are taken from donor male or female resp.

DISADVANTAGES Undesired multiple births i.e. delivery of more than 1 baby. Ovarian hyperstimulation syndrome. Ectopic pregnancy(outside the uterus). Success rates are much lower. Painful. Costly. Risks of infection, anaesthetic risks and haemorrhage.

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