Assisted reproductive technology (ART) Flashcards
When is ART used?
Infertility, cancer and fertility preservation, same sex couple
The term __________ is used to describe couples who have not been able to conceives after one year of natural unprotected intercourse
Infertile
_____________ means that couples have a reduced ability to conceive and produce children
Sub-fertile
Infertility, according to WHO, is a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after _________ months or more of regular ______________ sexual intercourse
12; unprotected
What are the typical conception rates of normal fertility?
50% after 3 months, 85% conceive by 12 months, 992% after 2 years
When is the highest probability of conception?
1 to 2 days prior to ovulation
Likelihood of fertility ____________ to 1% after 3 years of intercourse without contraception
Decreases
Ovum survives how many hours after ovulation?
12-24 hours
What are the biggest factors of infertility?
Male and female factors
Sperm lives for how many days in female reproductive tract?
3-5 days
What are some of the identifiable female factors of infertility?
Ovulatory disorders, endometriosis, pelvic adhesions, tubal blockage
Which of the following lead to male infertility?
a) Antibodies against sperm
b) Blockage of sperm delivery system
c) Deficiencies in sperm production
All of the above
How many eggs are released every month?
One egg
Who may benefit from IVF?
Women with blocked or damaged Fallopian tubes, men with low sperm count or poor sperm motility, woman with ovulation disorders or uterine fibroids, individuals with a genetic disorder, unexplained infertility
1 in ______ couples will face a fertility issue
6
How many IVF babies have been born to date?
More than 5 million
Place the basic steps of IVF in order:
a) Transfer embryos back into the uterus
b) Secure the sperm
c) Collect the eggs
d) Combine the eggs and sperm together in the lab and provide the appropriate environment for fertilization and early embryo growth
e) Monitor and stimulate the development of healthy eggs in the ovaries
e, c, b, d, a
Fertility ___________ are prescribed to stimulate __________ production
Medications; egg
__________ test samples are taken to check hormone levels
Blood
What kind of medication is administered to women undergoing IVF?
Oral contraceptive to prevent formation of cysts
Eggs are retrieved through a minor surgical procedure that uses ____________ imaging to guide a hollow needle through the __________ cavity to remove the eggs
Ultrasound; pelvic
How are oocytes retrieved?
A probe is inserted into the vagina and a needle passes through the vaginal wall to the ovary, where the eggs are aspirated and extracted
What is the process by which the sperm and eggs are mixed together and stored in a laboratory to encourage fertilization?
Insemination
In cases where there is a lower probability of fertilization due to male factor, which method is used?
Intracytoplasmic sperm injection (ICSI)
How many days following the egg retrieval and fertilization are the embryos transferred into the woman’s uterus?
Three to five days
What are morphologically normal looking oocytes?
Those in germinal vesicle or with one polar body
A sample of semen analysis for ART is assessed for which features?
Count, motility, progression, abnormality
According to WHO, the normal sperm concentration is ______________/ml or more, the total motility is __________% or more, the progressive motility is __________% or more and the morphology is __________% or more normal forms
15 000 000, 40, 32, 4
How is sperm prepared for insemination?
Sperm is washed
True or false: Not all sperm are normal, but they are the same sizes
False, all sperm are normal, but with different sizes
Globozoospermia refers to round headed sperm with no ____________
Acrosome
Each egg-cumulus complex is inseminated with ______________ prepared sperm after 3-4 hours _______________ of oocytes
25 000, pre-incubation
ICSI involves the injection of a single __________ into the _____________, bypassing all the oocyte coat penetration and gamete fusion steps
Sperm; oocyte
Human oocyte activation for male pronuclear development achieved by vigorous suction of _____________ and sperm nuclear insertion
Ooplasm
What indicates normal fertilization?
The presence of two pronuclei
What is crucial at each developmental stage of embryo?
Culture media
What is the device used to grow and maintain cell and embryo cultures?
Incubator
The incubator with _______ CO2 and _______ O2 control interacts with the culture media used, to determine the pH within the system
6%, 5%
Identify the following characteristics with their cleavage stage grading:
1. < 50% fragmentation
2. Evenly sized blastomeres
3. Variation in refractility
4. Remaining blastomeres should appear viable
- Grade 3
- Grade 1
- Grade 2
- Grade 4
What do we observe on day 3 of the embryo?
4-8 cells
Which day is morula observable?
Day 4
When is the blastocyst formed?
Day 5
Which day are morphologically good quality blastocysts chosen for transfer?
Day 5/6
What is the purpose of real-time embryo monitoring device?
Measure the length of cell cycle, compaction, blastocoel formation and compare effects of various culture conditions
Blastocyst hatches out of the _________ ___________
Zona pellucida
When is assisted hatching used?
2 previous implantation failures, 37 years old or older, thickened ZP, IVM embryos, thawed oocytes/embryos
What does IVM stand for?
In vitro maturation
In which of the following circumstances would IVM be used?
a) Some women are extremely sensitive to stimulation with exogenous gonadotropins
b) A decreased risk of developing ovarian hyper-stimulation syndrome
a
Immature oocytes can be matured in vitro after releasing from the ____________ follicles in vitro
Antral
Which cells are associated with oocyte quality?
Cumulus cells
Embryo development makes its transition from ___________________ zygote after fertilization of the oocyte to a blastocyst
Single-celled
What happens to the embryos that were not used?
They are frozen via slow freezing or vitrification (fast freezing)
How does vitrification work?
Embryo washed with buffer, soaked in equilibration solution for 3-5 minutes then soaked in vitrification solution for 30 seconds
What is the process of thawing?
1.0 M of sucrose for 1 minute, 0.5 M of sucrose for 2 minutes, 0.25 M of sucrose for 3 minutes, then washed twice for 5 minutes with buffer
What does a pregnancy test search for?
Levels of hCG
When is a fetal heart beat detected after embryo transfer?
4-5 weeks
