In Vitro Fertilization: Difference between revisions

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==Introduction==
#REDIRECT [[Assisted_Reproductive_Technology]]
[[File:IVF-Louise Brown.jpg|thumb|Louise Brown, the first IVF baby as an adult.]]
__NOTOC__
In vitro fertilization covers the aided fertilization process, in contrast with in vivo fertilization which is the normal uterine occuring fertilization process. The first successful IVF was carried out in the UK in 1978 by Edwards RG, et al.<ref name="PMID6775685"><pubmed>6775685</pubmed></ref>, receiver of the 2010 Nobel Prize in Medicine. The now many different reproductive options are know as Assisted Reproductive Technologies (ART) and this technique continues to grow worldwide with development of new medical technologies.


The Latin, ''In vitro'' = "in glass" meaning in essence a test tube as apposed to ''in vivo'' (in life or a living body). Note that even in vivo fertilization can also now be assisted through some fertility drug treatments. Both processes have the same biological outcome, fusion of male and female gametes to form a diploid zygote.
In Australia, the first successful IVF occurred in 1980.<ref name="PMID7353686"><pubmed>7353686</pubmed></ref> and during 2005 1,596 IVF babies were born. In the same year in Australia and New Zealand 51,017 treatment cycles were reported, an increase of 13.7% of ART treatment cycles from 2004. In all countries using Assisted Reproductive Technologies (ART), pregnancy rates vary for the different methods of treatment and also between individual IVF or GIFT units. In Australia best clinical pregnancy rate (per 100 oocyte retrieval cycles) by most successful 25% of all clinics increased from 24.9% (1998) to 34.4% (2001) (NPSU data - ART 2002 report)
{{Template:Fertilization Links}} | [http://embryology.med.unsw.edu.au/Notes/week1_5b.htm original page]
==Some Recent Findings==
[[File:Intracytoplasmic_sperm_insemination.jpg|thumb|Intracytoplasmic sperm insemination]]
{|
|-bgcolor="F5FAFF"
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* '''The Nobel Prize in Physiology or Medicine 2010 was awarded to Robert G. Edwards "for the development of in vitro fertilization".''' <ref name="PMID6775685" /> [http://nobelprize.org/nobel_prizes/medicine/laureates/2010/ Nobel Prize 2010]
* '''Assisted Reproductive Technologies (ART) With Baboons'''<ref><pubmed>20631291</pubmed></ref> A Nonhuman Primate Model for ART and Reproductive Sciences "The first ART baboons produced by ICSI, a pair of male twins, were delivered naturally at 165 days postgestation. Genetic testing of these twins confirmed their ART parental origins and demonstrated that they are unrelated fraternal twins not identicals."
* '''Trends in delivery and neonatal outcome after in vitro fertilization in Sweden: data for 25 years.'''<ref><pubmed>20139431</pubmed></ref> "The decrease in unwanted outcomes can, to a large extent, be explained by the reduced rate of multiple births but was seen also among singletons. Other explanations can be sought in changes in the characteristics of patients undergoing IVF."
* '''Human serum albumin and serum substitute supplement for IVF culture.'''<ref><pubmed>19147504</pubmed></ref>
|}
==18 Ways to Make a Baby==
[[File:USA_assisted_reproductive_technology_1996.jpg|right|400px]]
# Natural sex
# Artificial insemination - of mother with father's sperm
# Artificial insemination - of mother with donor sperm
# Artificial insemination - with egg and sperm donors, using surrogate mother
# In vitro fertilization (IVF) - using egg and sperm of parents
#  IVF - with Intra-Cytoplasmic Sperm Injection (ICSI)
#  IVF - with frozen embryos
#  IVF - with Preimplantation Genetic Diagnosis (PGD)
#  IVF - with egg donor
#  IVF - with sperm donor
#  IVF - with egg and sperm donor
#  IVF - with surrogate using parents' egg and sperm
#  IVF - with surrogate and egg donor
#  IVF - with surrogate and sperm donor
#  IVF - with surrogate using her egg, sperm from baby's father
# IVF - with surrogate using egg and sperm donors*
# Cytoplasmic transfer**
# Nuclear transfer and cloning
==First IVF Baby==
Louise Brown was born at 1147 BST on 25 July, 1978, in Oldham, United Kingdom.
== Blastocyst Formation (in vitro) ==
The table below shows human blastocyst ''in vitro'' changes during week 1 development.<ref><pubmed>10221713</pubmed></ref>
[[File:Human blastocyst formation-in vitro.jpg]]
:'''Links:''' [[Week 1]] | [[Blastocyst]]
==Embryo Culture Milestones==
* 1949 8 cell mouse embryo -> blastocyst (in saline and egg yolk)
* 1956 8 cell mouse embryo -> blastocyst (first embryo culture medium)
* 1957 2 cell mouse embryo -> blastocyst
* 1958 8 cell mouse embryo -> blastocyst, then transferred to pregnant recipient
* 1960's development of culture requirements for mouse mebryos
* 1965 2 cell mouse embryo -> blastocyst, then transferred into pseudopregnant recipient
* 1968 zygotes from mouse -> blastocysts
* 1968,70 2 & 4 cell rabbit embryos -> blastocyst in serum supplemented medium
* 1970,71 1 & 2 cell rabbit embryos -> blastocyst in defined medium
* 1970,81 Culture of in vitro fertilized human embryo -> 16 cells -> blastula
* 1998 Cloning of adult sheep "dolly"
* 2004 Cloning of human blastocysts
Data modified from<ref><pubmed>15726768</pubmed></ref>
==Oldest IVF Mother==
There is still risk, ethical and genetic debate about very old women becoming pregnant by IVF.
* 2003 India - A 65-year old Indian woman was the oldest in the world to give birth by IVF.
* 2006 United Kingdom - A 62-year old woman has become the UK's oldest woman to give birth to a child.
* 2008 Australia - A 54-year old woman has become Australia's oldest woman pregnant by IVF (most Australian IVF clinics do not treat women over 50)
==IVF Sex Ratios==
A recent paper looked at Australian assisted reproductive technology (ART) data (2002-2006) studied the effect on human sex ratio at birth by different procedures. [http://www.ncbi.nlm.nih.gov/pubmed/20875033 PMID:20875033]
:"More males were born following in vitro fertilisation single embryo transfer (IVF SET) (53.0%) than intracytoplasmic sperm insemination (ICSI) SET (50.0%), and following blastocyst SET (54.1%) than cleavage-stage SET (49.9%). For a specific ART regimen, IVF blastocyst SET produced more males (56.1%) and ICSI cleavage-stage SET produced fewer males (48.7%). The change in the sex ratio at birth of SET babies is associated with the ART regimen. The mechanism of these effects remains unclear. Fertility clinics and patients should be aware of the bias in the sex ratio at birth when using ART procedures."
== Assisted Reproductive Technology (Australia and New Zealand) ==
{| class="prettytable"
| [[File:IVF cycles ANZ 1999-2004.jpg]]
| '''2005''' - 51,017 treatment cycles reported to ANZARD in Australia and New Zealand in 2005. Of these cycles, 91.1% were from Australian fertility centres and 8.9% from New Zealand's centres. There is an increase of 13.7% of ART treatment cycles from 2004.<ref name="ART2005">Wang YA, Dean JH & Sullivan EA. [http://www.preru.unsw.edu.au/PRERUWeb.nsf/page/art11 Assisted Reproduction Technology in Australia and New Zealand 2005] National Perinatal Statistics Unit (2007) [http://www.aihw.gov.au/publications/index.cfm/title/10469 AIHW Assisted reproduction technology series no. 11]</ref>
|-
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| &nbsp;
|}
Average age of women was 35.5 years (35.2 years in 2002). Women aged older than 40 years has increased from 14.3% in 2002 to 15.3% in 2005.
Since ANZARD was established in 2002 there has been a significant increase in the number of embryos transfer cycles where women received single-embryo transfers (SET). SET cycles accounted for 48.3% of embryos transfer cycles in 2005, compared to 28.4% in 2002. The increase of SET cycles resulted more singleton deliveries. The proportion of singleton deliveries was 85.9% in 2005, the highest proportion ever reported.
Babies born to women who had a single-embryo transfer had better outcomes compared to babies born to women who had a double-embryo transfer (DET). In 2005, there were '''3,681 SET babies and 5,589 DET babies.''' In SET babies, 96.1% were singletons, compared to 61.6% singletons in DET babies. SET babies had a lower proportion of preterm babies (11.7%), compared to 30.6% in DET babies. Similarly, 8.0% of SET liveborn babies were low birthweight, compared to 25.0% in DET liveborn babies.
Perinatal mortality rate is a measure of perinatal outcomes. In 2005, for all babies born following ART treatment, the perinatal mortality rate was 14.7 deaths per 1,000 births, a 23.8% decrease from 19.3 deaths per 1,000 births in 2004. The perinatal mortality rate was the lowest among singletons born following SET (7.3 deaths per 1,000 births) in 2005.<ref name="ART2005" />
'''2004''' - 41,904 IVF treatment cycles were started in Australia 92.6% (38,823) and New Zealand 7.4% (3,081). (More? NPSU [http://www.npsu.unsw.edu.au/NPSUweb.nsf/page/Assisted+Reproduction+Technology+Reports Assisted Reproduction Technology Reports])
'''In Vitro Fertilization''' - ABC News [http://www.abc.net.au/am/content/2007/s1857958.htm Baby born from frozen embryo]
"In what's thought to be a world first, a baby has been born in Melbourne using a woman's frozen egg and a donor's frozen sperm which created an embryo that was also frozen, then thawed and implanted into the mother"
"JOHN MCBAIN: Oh egg freezing is very difficult. Embryo freezing itself is very well established. We would probably have about 55 per cent of all the babies born from our program, and that's about 1,400 a year, come from frozen embryos. So, that's very well established technology. But even with these embryos, only 70 per cent of the embryos survive the freezing and thawing. With eggs, it's closer to 40 to 50 per cent, and then you have to have the number which don't fertilise following that, and then you have to have those which end up being frozen, possibly not surviving the embryo freezing stage too, and that's a reason we don't promote it."
== Assisted Reproductive Technology (USA) ==
[[File:USA_assisted_reproductive_technology_1996.jpg|right]]
* '''Centre for Disease Control (USA) 1999 Survey of Assisted Reproductive Technology''': Embryo Laboratory procedures and Practices (January 29, 1999) USA statistics including the survey document.
1996 Assisted Reproductive Technology Success Rates National Summary and Fertility Clinic Reports
* The 1996 report of pregnancy success rates is the second to be issued. The report includes a national report that uses information from 300 U.S. fertility clinics to provide an indepth national picture of ART; fertility clinic tables that provide ART success rates for each clinic that submitted and verified its1996 data; and an appendix containing a glossary of terms and lists of reporting and nonreporting clinics in the United States. (See Pie Graph)
1995 Assisted Reproductive Technology Success Rates National Summary and Fertility Clinic Report.]
* This report gives consumers and potential assisted reproductive technology (ART) users an idea of a woman's average chances of having a pregnancy and a live birth by using ART. The report includes a national summary that uses the information from all reporting fertility clinics to provide an indepth national picture of ART; fertility clinic reports that provide ART success rates for 259 clinics in the United States; and an appendix containing a glossary of terms used in the national and clinic reports.
[[File:USA_ART_live_birth_rates_1996.jpg]]
== European Society of Human Reproduction and Embryology ==
Reports annually (in the journal ''Human Reproduction'') on the European results of assisted reproductive techniques. Listed below are some statistical information gathered from reporting clinics for the current 2001 report. [http://humrep.oupjournals.org/cgi/content/abstract/20/5/1158 ESHRE Report 2001]
=== Highlights from the 2001 Report ===
* From 23 countries, 579 clinics reported 289,690 cycles
* IVF 120,946, ICSI 114,378, frozen embryo transfer (FER) 47,195 and egg donation (ED) 7,171 (4% increase since the year 2000)
* <nowiki>European data on intra-uterine inseminations (IUIs) were reported from 15 countries. A total of 67 124 cycles [IUI husband'sperm (IUI-H) 52 949 and IUI donor sperm (IUI-D) 14 185] were included. </nowiki>
* In 12 countries where all clinics reported to the register, a total of 108 910 cycles were performed in a population of 131.4 million (829 cycles/million inhabitants).
* '''IVF'''- clinical pregnancy rate per aspiration and per transfer was 25.1 and 29.0%, respectively.
* '''ICSI'''- clinical pregnancy rate per aspiration and per transfer was 26.2 and 28.3% (similar to the results from 2000).
* '''IUI-H'''- clinical pregnancy rate was 12.8% in women less than 40 and 9.7% in women 40 years of age.
* After IVF and ICSI, the distribution of transfer of one, two, three and 4 embryos was 12.0, 51.7, 30.8 and 5.5%, respectively.
* Distribution of singleton, twin and triplet deliveries for IVF and ICSI combined was 74.5, 24.0 and 1.5%, respectively.
* Range of triplet deliveries after IVF and ICSI differed from 0.0 to 8.2% between countries.
* After IUI-H in women less than 40 years of age, 10.2% were twin and 1.1% were triplet gestations.
== Human Fertilisation and Embryology Authority UK (HFEA) ==
The UK '''Human Fertilisation and Embryology Authority''' (HFEA) was established in August 1991 following the passing of the Human Fertilisation and Embryology Act 1990 (HFE Act).
The HFEA's principal &nbsp;tasks are to:
* License and monitor clinics that carry out in vitro fertilisation (IVF) and donor insemination
* License and monitor research centres undertaking human embryo research
* Regulate the storage of gametes and embryos
HFEA also provide a downloadable patient booklet: [http://www.hfea.gov.uk/ForPatients/YourGuidetoInfertility Your Guide to Infertility] and website information on [http://www.hfea.gov.uk/ForPatients/PatientsGuidetoDI Patients' Guide to Donor Insemination (DI)]
:'''Links:''' [http://www.hfea.gov.uk/Home Human Fertilisation and Embryology Authority, UK)]
== Sweden ==
Sweden had its first child born after in vitro fertilisation 20 years ago. A recent paper in BMJ looks at the change in multiple birthrates since a change in the early 1990s, to reduce the number of embryos transferred in the clinic from three to two.
"The rate of multiple births after in vitro fertilisation increased to a maximum of 29% in 1991 but fell to 18.5% by 2001, resulting in a 70% reduction of preterm births"
[http://bmj.bmjjournals.com/cgi/rapidpdf/bmj.38443.595046.E0v1?ecoll Temporal trends in multiple births after in vitro fertilisation in Sweden, 1982-2001: a register study] Bengt Kallen, Orvar Finnstrom, Karl Gosta Nygren, Petra Otterblad Olausson
==Ovarian Stimulation==
A variety of drug based techniques are used to stimulate maternal oocyte development, called ovarian stimulation, for any in vitro fertilization procedure. The recommended for technique will vary for some procedures and also from clinic to clinic and between countries.
'''An example of ovarian stimulation''' (based on PMID20953827)
* Gonadotrophin releasing hormone agonist (GnRHa) triptorelin acetate (0.1 mg/day) treatment started on the 22nd day of the preceding menstrual cycle.
* Human menopausal gonadotrophin (HMG) and/or follicular stimulating hormone (FSH) was carried out daily 12 to 15 days later.
** Dosage may vary dependent upon patient response and can be monitored by hourmone levels (oestradiol) and transvaginal ultrasound (follicular size).
* The resulting ovulatory wave generates large follicles (greater than 18 mm in diameter).
* Human chorionic gonadotrophin (HCG) is then administered (36 to 38 h later)
* Clinical transvaginal puncture is used to collect from these follicles cumulus-oocyte complexes.
* Oocytes are then isolated from these cumulus-oocyte complexes.
:'''Links:''' [[Menstrual Cycle]] | [[Ovary Development]] | [[Oocyte Development]] | [[Endocrine_-_Pituitary_Development|Pituitary]]
==Gamete Banking==
Women undergoing clinical procedures of chemotherapy and/or radiotherapy (ionizing radiation) can have induced premature ovarian failure. Therefore a growing reproductive option has been the collecting of  oocytes or ovarian tissue before commencing these procedures and storing ("banking") by cryopreservation for later use. One major issue is coordination of the two procedures, as most cancer therapies commence immediately, and most reproductive procedures require substantial preparation time. Currently the cryopreservation techniques required for ovarian tissue preservation are also improving all the time.
Chemotherapy (alkylating agents) - busulfan, carboplatin, chlorambucil, cisplatin, cyclophosphamide, dacarbazine, ifosfamide, thiotepa
==References==
<references/>
===Reviews===
===Articles===
<pubmed>20124287</pubmed>
===Search Pubmed===
July 2010 "in vitro fertilization" All (29785) Review (3172) Free Full Text (6189)
'''Search Pubmed Now:''' [http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=search&term=in%20vitro%20fertilization in vitro fertilization] | [http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=search&term=assisted%20reproduction%20technology assisted reproduction technology]
== External Links ==
{{Template:External Links}}
* '''Australia''' [http://www.npsu.unsw.edu.au/art8high.htm Assisted reproductive technology in Australia and New Zealand 2002 Report - Highlights] Has links to the full report online. | [http://www.npsu.unsw.edu.au/ (Australian) National Perinatal Statistics Unit] | (Australian) National Perinatal Statistics Unit [http://www.npsu.unsw.edu.au/NPSUweb.nsf/page/Assisted+Reproduction+Technology+Reports Assisted Reproduction Technology Reports] | [http://www.nor.com.au/community/aisg/ The Australian Infertility Support Group]
* '''USA''' [http://www.cdc.gov/ART/ CDC - Assisted Reproductive Technology]
* '''UK''' | [http://www.hfea.gov.uk/Home Human Fertilisation and Embryology Authority (UK)] | [http://www.hfea.gov.uk/ForPatients/YourGuidetoInfertility Your Guide to Infertility] | [http://www.hfea.gov.uk/ForPatients/PatientsGuidetoDI Patients' Guide to Donor Insemination (DI)] | [http://www.hfea.gov.uk/ForPatients/PatientsFAQs Patients FAQs] | [http://www.hfea.gov.uk/ForPatients/PatientsGuidetoIVFClinics Patients Guide to IVF Clinics (UK)]
* '''The Merck Manual''' | [http://www.merck.com/mmhe/sec22/ch254/ch254a.html?qt=infertility&alt=sh The Merck Manual- Infertility | ][http://www.merck.com/mmhe/sec22/ch257/ch257a.html?qt=pregnancy&alt=sh The Merck Manual- Pregnancy] | [http://www.merck.com/mmhe/search.html?qt=infertility&qp=%2Bsite%3Awww.merck.com+%2Burl%3A%2Fmmhe+-url%3Aprint%2F+-url%3Aindex%2F+-url%3Aresources%2Fpronunciations+-url%3Amultimedia%2F&charset=utf8&la=en&start=0 Search The Merck Manual "Infertility"] | [http://www.merck.com/mmhe/search.html?qt=pregnancy&qp=%2Bsite%3Awww.merck.com+%2Burl%3A%2Fmmhe+-url%3Aprint%2F+-url%3Aindex%2F+-url%3Aresources%2Fpronunciations+-url%3Amultimedia%2F&charset=utf8&la=en&start=0 Search The Merck Manual "Pregnancy"]
* '''Sydney Commercial IVF Sites''' [http://www.sivf.com.au/ Sydney IVF] | [http://www.ivf.com.au/ Citywest IVF] | [http://www.ivfsouth.com.au/ IVF South] | [http://www.nsart.com.au/ North Shore Fertility Pty Ltd]
==Terms==
* '''empty follicle syndrome''' - (EFS) Term used to describe a condition in which no oocytes are recovered/obtained after an apparently successful ovarian stimulation.
* '''follicle stimulating hormon'''e - (FSH, gonadotropin) A glycoprotein hormone secreted by [[A#anterior pituitary|anterior pituitary]] (adenohypophysis gonadotrophs, a subgroup of basophilic cells) and acts on [[G#gametogenesis|gametogenesis]] and other systems in both males and females. In females, FSH acts on the [[O#ovary|ovary]] to stimulate [[F#follicle|follicle]] development. Negative feedback by inhibin from the developing [[F#follicle|follicle]] decreases FSH secretion. In males, acts on the testis Sertoli cells to increase androgen-binding protein (ABP) that binds androgens and has a role in spermatogenesis. FSH-defficiency in females results in infertile (block in folliculogenesis prior to [[A#antral_follicle|antral follicle]] formation) and in males does not affect fertility (have small testes but are fertile). FSH protein has a molecular weight 30 kDa and a 3-4 hour half-life in circulation. Gonadotrophins have been used clinically in humans for the treatment of infertility.
* '''human chorionic gonadotropin''' - (hCG, human chorionic gonadotrophin) Placental hormone initially secreted by cells (syncitiotrophoblasts) from the implanting [[C#conceptus|conceptus]] during week two, supporting the ovarian [[C#corpus luteum|corpus luteum]], which in turn supports the endometrial lining and therefore maintains pregnancy. Hormone can be detected in maternal blood and urine and is the basis of many pregnancy tests. Hormone also stimulates the onset of fetal gonadal steroidogenesis, high levels are [[T#teratogen|teratogenic]] to fetal gonadal tissues.
* '''human menopausal gonadotropin''' - (HMG) A clinical [[H#hormone|hormone]] preparation used in [[A#assisted reproductive technology|assisted reproductive technologies]] (ART). This hormone is collected from the urine of menopausal women and has similar biological activity to that of follicle stimulating hormone (FSH). This is used in an injectable form along with human chorionic gonadotropin (hCG) to induce [[O#ovulation|ovulation]]. Some commercial product names include Menogon or Organon.
* '''triptorelin acetate''' - A gonadotropin-releasing hormone (GnRH) agonist used clinically in an acetate or pamoate form inreproduction for  [[A#assisted reproductive technology|assisted reproductive technologies]] (ART, in vitro fertilization, IVF). This decapeptide (pGlu-His-Trp-Ser-Tyr-D-Trp-Leu-Arg-Pro-Gly-NH2) agonist stimulates the pituitary to decrease secretion of gonadotropins luteinizing hormone (LH) and follicle stimulating hormone (FSH). Also used for other clinical conditions.
* '''zona pellucida birefringence''' - (ZPB) Optical property of  the zona pellucida using polarization imaging when viewed microscopically.  Used to qualitatively predict the developmental potential of a in vitro matured metaphase-II (MII) oocytes. High birefringence has been associated with oocytes contributing to conception cycles when compared with those of nonconception cycles and higher implantation, pregnancy, and live birth rates from transferred oocytes. (More? [http://www.ncbi.nlm.nih.gov/pubmed/18284880 PMID18284880] | [http://www.ncbi.nlm.nih.gov/pubmed/20079896 PMID20079896])
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[[Category:Human Embryo]] [[Category:Week 1]] [[Category:Fertilization]] [[Category:Oocyte]] [[Category:Spermatozoa]]
[[Category:Human Embryo]] [[Category:Week 1]] [[Category:Fertilization]] [[Category:Oocyte]] [[Category:Spermatozoa]]
 
[[Category:Australia]]
[[Category:In Vitro Fertilization]] [[Category:Assisted Reproductive Technology]]
[[Category:In Vitro Fertilization]] [[Category:Assisted Reproductive Technology]][[Category:2015]]

Latest revision as of 12:07, 11 August 2015



Cite this page: Hill, M.A. (2024, March 28) Embryology In Vitro Fertilization. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/In_Vitro_Fertilization

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