Assisted Conception Flashcards
What is the 1st step in IVF?
Multiple follicular development.
Involves 2 weeks of daily FSH injections +/- LH. With an additional drug to prevent an endogenous LH surge and premature ovulation.
What is the 2nd step in IVF?
Ovulation and egg collection.
Once an optimal number of follicles are a mature size (confirmed by scan) the Gonadotrophins are stopped.
A single injection of LH id given to stimulate final oocyte maturation.
36h later the eggs are collected by TVUSS guided aspiration.
What is the 3rd step in IVF?
Fertilisation and culture.
The eggs are incubated with sperm. The fertilised eggs are cultured until day 2-3 or 5-6 depending on the practice. Spare embryos can be frozen.
What is the 4th step in IVF?
Embryo transfer.
Two embryos are transferred into the womens uterus.
Progesterone or HcG is given until 4-8 weeks gestation .
What is IUI?
Intrauterine insemination.
Sperm are injected directly into the uterine cavity.
This can be done on a women natural cycle with testing to ensure ovulation.
Or after gonadotrophin ovulation induction.
What is ICSI?
Intracytoplasmic sperm injection
A sperm is injected directly into the oocyte cytoplasm.
Used as an adjunct in IVF when there is also male factor infertility.
What is preimplantation genetic diagnosis?
In IVF before embryo transfer 1 or 2 cells are removed for the embryo and tested using PCR for chromosomal and genetic abnormalities.
Only healthy embryos are implanted.
What are the risks of IVF?
Multiple pregnancies are common
Failure (only successful in 35% of under 35’s only 10% successful in over 40’s)
Increased risk of ectopics.
Slightly higher rates of prenatal mortality.