B8-065 Assisted Reproductive Treatments Flashcards
if FSH is greater than […], recommend donor eggs or embryos
40
(probably WHO 3)
E2 is given to patients to thicken their endometrial lining, but can slow […] growth
follicular
E2 concentration peaks in the […] phase
late follicular
used as an LH analog
has a longer half life and less expensive
hCG
the oocyte is released about […] hours after onset of LH surge
34-36
following ovulation, the oocyte is arrested in what state of meiosis?
metaphase II
when does the placenta take over progesterone production?
8-10 weeks gestation
if a pregnant patient comes in with a ruptured luteal cyst and they are in early pregnancy, what needs to be given in order to maintain the pregnancy?
progesterone
(also in IVF, they give exogenous progesterone until 10 weeks because there is not corpus luteum)
why is the embryo transferred at day 6-7 in IVF?
that is when it would normally be in the uterus.
used to be transferred day 3-4, but physiologically the embryo would still be in the tube, a very different environment
fertilization occurs in the […]
ampulla
(why its a common location for ectopic)
inner cell mass of the blastocyst
becomes the
fetus
outer cell mass of the blastocyst becomes the
placenta/fetal membranes
IVF has a higher success rate with […] transfer due to stage matching
blastocyst
(vs. used to be day 3-4 cleavage stage; also lower twin rate)
blastocyst approaches uterine wall is called […]
blastocyst attaches to uterine wall is called […]
adplantation
adhesion
then, invasion/embedding
less than […] sperm is considered indication for ICSI
5 million
in Controlled Ovarian Hyperstimulation,
[…] antagonists are used daily to prevent ovulation
followed by […] agonist to trigger oocyte maturation
GnRH
hCG or GnRH
(retrieval is 34-36 hours after trigger)
injection of sperm directly into mature oocyte (metaphase II)
ICSI
most important predictory of IVF success at time of egg retrieval
advanced oocyte age (>35 years)
(more granular)
most errors in meiosis resulting in aneuploid occur during what phase?
meiosis 1
(defects in spindle assembly)
as oocyte age increases, rates of […] increase and rates of successful […] decrease
as oocyte age increases, rates of [aneuploidy] increase and rates of successful [implantation] decrease
there is no evidence to support a […] cutoff for offering infertility treatment
BMI
salpingitis due to untreated, asymptomatic […] is a primary cause of tubal infertility
chlamydia/gonorrhea
if you have a communicating hydrosalpinx, […] is recommended before embryo transfer to prevent cytotoxic fluid reflux
salpingectomy
direct testing of IVF embryo for single inherited disease
preimplantation genetic testing- monogenic (PGT-M)
(ex. CF)
direct testing of IVF embryo for large scale chromosomal abnormalities
preimplantation genetic testing- aneuploidy (PGT-A)
(decreases chance of miscarriage and time to ART in women of AMA)
insemination should be done between […] hours after oocyte retrieval for the best chance of fertilziation
3-5
fully mature oocytes have [..]N number of chromosomes
1N
each with two chromatids
when should oocyte retrieval be scheduled in relation to the hormonal injection give to mature oocytes?
34-36 hrs
[…] is used to trigger oocyte maturation with an IVF cycle
hCG
why is hCG used instead of LH to stimulate oocyte development?
less expensive
longer half life
high levels of […] suppress ovulation
estradiol
what is the order of event for standard fertilization
sperm preparation
sperm incubation for capacitation
activation of acrosomal digestion
cortical reaction
prepared sperm for standard insemination are incubated in protein rich medium to achieve […]
capacitation
the process by which spermatozoa become capable of going through the acrosomal reaction and fertilizing an oocyte
capacitation
after sperm membrane fuses with the oocyte membrane, microvilli on the oocyte surround the sperm head and the oocyte releases […]
cortical granules
the presence of hydrosalpinx with communication to the uterine cavity decreases rate of […] by about 50%
implantation
