A detailed explanation about the protocol behind the use of IVF Test tube babies

1. Presented By,
Sonia John
II M.Sc.Zoology

2. INTRODUCTION
 Assisted reproductive technology(ART)- Manipulation of
reproduction in humans and animals
 Used primarily in infertility treatments ,hence ART a.k.a
FERTILITY TREATMENT
 Includes:
1. IVF
2. ZIFT,GIFT
3. IUI,ICSI etc

3. In-Vitro Fertlization(IVF)
 Process by which egg is fertilized outside the body in-vitro
 Fertilization of the oocytes in the laboratory conditions.
 This is in contrast with the natural fertilization,which occurs in
the uterus
 Reasonably successful as it results in 70-80% of fertilized eggs
 Through IVF technology,a large number of offsprings can be
produced from a single individual

4. When it is Done
 For infertility treatments:
 Female infertility caused due to problems n the
fallopian tubes
 Male infertility caused due to low sperm quality

5.  The first successful birth of a "test tube baby", Louise Brown,
occurred in 1978.
 Robert G. Edwards , the physiologist who developed the
treatment, was awarded the Nobel Prize in Physiology or
Medicine
 Subhash Mukhopadhyay ,was a physician from Kolkata, India, who
created the world's second and India's first child using in-vitro
fertilisation, Durga
 Kamala Rathnam- South India’s 1st test tube baby

7. With IVF, women who are past
menopause can still become pregnant.
Adriana Iliescu held the record as
the oldest woman to give birth
using IVF and donated egg,
when she gave birth in 2004
at the age of 66.

8. PROTOCOL OF IVF
 Following are the stages involved in IVF
1. Ovarian stimulation
2. Egg retrieval
3. Sperm collection
4. Fertilization in the laboratory
5. Embryo culture
6. Embryo transfer

9. 1. Ovarian Stimulation
 Both the male and female partner made to undergo fitness tests
and check-ups
 Injectable medications are provided to the female partner daily
for an average of 10 – 12 days to stimulate the woman’s ovaries to
produce multiple eggs.
 The ovarian response to the medications are monitored with the
help of ultrasound and blood work and medication dosing is
adjusted accordingly.

10. 2.Egg Retrieval
 When the eggs are mature and ready, the woman undergoes an
ultrasound guided egg retrieval procedure under light sedation.
 The eggs are retrieved from the patient using a transvaginal
technique called transvaginal oocyte retrieval involving an
ultrasound-guided needle piercing the vaginal wall to reach the
ovaries. Through this needle follicles can be aspirated, and the
follicular fluid is passed to an embryologist to identify ova.
 Usually takes between 20 to 40 minutes;10-30 eggs retrieved

11. 3.Sperm Collection
 In the meantime, semen is prepared for fertilisation by removing
inactive cells and seminal fluid in a process called sperm
washing.
 If semen is being provided by a sperm donor, it will usually have
been prepared for treatment before being frozen and
quarantined, and it will be thawed ready for use.

12. 4.Co-incubation and Fertilization
in the Laboratory
 After the eggs and sperm have been analyzed and prepared, the
eggs are then inseminated.
 The sperm and the egg are incubated together in a culture
media in order for the actual fertilisation to take place.
 The duration of this co-incubation should be about 1 to 4 hours
to have higher pregnancy rates

13. 5.Embryo Culture
 After fertilization, the embryos are allowed to grow in special
media for 3 – 5 days until they have reached optimal growth.
 The main durations of embryo culture are until cleavage
stage (day two to four after co-incubation) or the blastocyst stage
(day five or six after co-incubation).
 Embryo culture until the blastocyst stage confers a significant
increase in live birth rate per embryo transfer.

14. 6.Embryo Transfer
 Laboratories have developed grading methods to judge oocyte
and embryo quality.
 1-3 embryos are then transferred into the uterus 3-5 days after
egg retrieval.
 Under ultrasound guidance, a thin long catheter containing the
embryos is passed through the cervix into the uterus where the
embryos are placed. After embryo transfer, 3-5 days of pelvic rest
is recommended. A pregnancy test is scheduled 12 days later.

16. Risks
1. Multiple pregnancy – up to 30%, mostly twins.
2. Ovarian hyperstimulation syndrome (OHSS) – ovarian
enlargement with multiple cysts in association
3. Ovarian torsion –twisting of ovaries, may require surgery.
4. Increased rate of abortion
5. Premature delivery, low birth weight baby etc

17. References
 Rastogi.S.C. Biotechnology:Principles and
Applications. Narosa Publishing House
 Satyanarayana.U.Biotechnology.Books and Allied
(P)Ltd
 www.americanpregancy.com
 http://en.wikipedia.org/InVitroFertilization
 www.emedicinehealth.com
 www.webmd.com