IN VITRO FERTILISATION IVF © 2016 Paul Billiet ODWS

IVF The fertilisation of an oocyte by a sperm from a male and a female donor outside the woman Subsequent implantation of the early embryo into a receptive female’s uterus. © 2016 Paul Billiet ODWS

The method - collecting the oocytes Medication to suppress the LH surge and ovulation until the developing eggs are ready FSH injections for about 7-12 days to stimulate development of multiple eggs HCG is used 36 hours before collection to mature the oocytes and loosen them in their follicles The oocytes she produces are collected by laproscopy from mature follicles on the surface of the ovary The collected oocytes are separated from the follicular liquid. © 2016 Paul Billiet ODWS

Multiple follicles (black areas) in a stimulated ovary © 2016 Paul Billiet ODWS

The method - collecting the sperms Sperms are harvested from a male by ejaculation the sperms are washed to activate them (capacitation) Then selected for good motility. © 2016 Paul Billiet ODWS

The method - fertilisation 20 000 sperms are placed in a dish with one oocyte The culture medium is similar to that found in the fallopian tube of a woman They are left for 2 to 6 hours The zygotes are then placed in a sperm free medium. © 2016 Paul Billiet ODWS

Development of the embryo The embryos are left to develop for 3 days and the best are selected for implantation Implantation of 2 or 3 embryos in a receptive mother. © 2016 Paul Billiet ODWS

The “mother” Implantation can be in the same woman who donated the oocyte In which case the timing must be right, 7 – 10 days after ovulation Implantation could be carried out in another woman (surrogate mother) who has had hormone treatment to prepare her uterus for implantation. © 2016 Paul Billiet ODWS

Ethical Issues For IVF can permit childless couples to have their own children IVF can be used to select embryos which can survive in couples which carry genetic diseases The use of surrogate mothers could permit professional women to continue their careers. © 2016 Paul Billiet ODWS

Ethical Issues Against Not all the embryos created are used, so some will be destroyed yet they can be considered individuals The method for obtaining the oocytes from the mother are not without some risks Women are implanted with several embryos which increases the chances of multiple births. This places the mother and her babies at risk IVF could increase the chances of babies with congenital problems being born. © 2016 Paul Billiet ODWS

Risks - Congenital problems Under natural conditions For 100 oocytes exposed to sperms 84% are fertilised 69% implant in the uterus 42% develop to the end of the 1st week 37% survive to the end of the 6th week 31% survive to birth © 2016 Paul Billiet ODWS

In vivo fertilisation there is a filtering of congenital defects which occur during gamete formation IVF is 0 – 25% successful so it does not seem to be encouraging the birth of children affected with congenital problems. © 2016 Paul Billiet ODWS

It could lead to selective breeding (eugenics) It could be abused to promote particular characteristics (positive eugenics) It is already being used to eliminate undesirable characteristics (negative eugenics) such as congenital problems. © 2016 Paul Billiet ODWS

It could encourage the involvement of surrogate mothers All sorts of possible combinations are possible, sperm donors, oocyte donors, surrogate mothers. © 2016 Paul Billiet ODWS

Cells for brothers and sisters with congenital problems Stem cells can be extracted from the umbilical cords of a new born baby and transplanted into another person Several attempts are made to create the right individual. © 2016 Paul Billiet ODWS