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Embryos - Assisted Reproduction Flashcards

1
Q

1st 6 days of embryonic development

A
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2
Q

penetration of sperm into ZP

A
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3
Q

1st division by mitosis

A
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4
Q

2 cell stage

4 cell stage

morula

A
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5
Q

Process of implantation

A
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6
Q

IUI

A

intrauterine insemination

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7
Q

ICSI

A

intracytoplasmic sperm injection

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8
Q

GIFT

A

gamete intrafallopian transfer

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9
Q

ZIFT

A

zygote intrafallopian transfer

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10
Q

PESA

A

percutaneous epididymal sperm aspiration

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11
Q

ET

A

embryo transfer

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12
Q

TESE

A

testicular sperm extraction

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13
Q

SUZI

A

subzonal sperm injection

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14
Q

PGD

A

preimplantation genetic diagnosis

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15
Q

most common types of assisted conception

A

IUI

IVF

ICSI

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16
Q

required procedures for assisted reproduction

A

superovulation - hormonal manipulation to enhance ovulation and release multiple oocytes during ovulatory cycle

sperm preparation

assisted fertilisation

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17
Q

how is superovulation carried out

A

human menopausal gonadotrophin - taken from urine of postmenopausal women - follicle stimulating hormone (FSH) and leutinising hormone (LH) activity

Recombinant FSH

recombinant LH

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18
Q

sperm preparation procedure

A

select PMNS (progressively motile normal sperm)

remove seminal plasma, WBCs and bacteria

sperm capacitation - coating of sperm with seminal plasma proteins to allow sperm to become fertile - in vivo or in test tube

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19
Q

intrauterine insemination procedure

sperm vol

success rate

A

sperm sample deposited in uterus just before release of an oocyte in a natural or stimulated cycle

soft catheter

give hCG at injection or up to 24 hours later

sperm vol = 0.2-0.3ml

pregnancy rates = 15% per cycle

20
Q

gamete intrafallopian transfer procedure

A

Laparoscopic technique in which oocyte and sperm placed in fallopian tube - allowing in vivo fertilisation

superovulation

US guided transvaginal oocyte retrieval

0.1-0.2ml sperm with 2-3 oocytes

21
Q

in vitro fertilisation procedure

A

taking oocyte from woman

fertilising them in the lab with her partner’s sperm

transferring resulting embryos back to her uterus 3 or 5 days later

superovulation → insemination → embryo transfer → luteal support

22
Q

superovulation with IVF - how does it occur

A

gonadotrophin stimulation

monitoring follicular development

US guided transvaginal oocyte retrieval

occyte fertilisation with sperm

23
Q

containers used with IVF insemination

what is each oocyte inseminated with

how is fertilisation later detected

A

test tubes, petri dishes, multi-well dishes

each oocyte inseminated with 0.5-1 ml PMNS (progressively motile normal sperm)

fertilisation detected 12-20 hours later by presence of:

  • 2 pronuclei in oocyte cytoplasm
  • 2 polar bodies in perivitelline space
24
Q

Syngamy

A

combination of maternal and paternal pronuclei 24 hours after insemination

further cleavage occurs at 24 hour intervals

25
ZP and polar bodies
26
progress from 2 cell stage to blastocyst
27
with IVF, when does embryo transfer take place
embryos transferred to uterus on 2nd or 3rd day after IVF 4-8 cell embryos 2-3 embryos transferred in 20 ul of culture fluid transabdominal US (ultrasound) to see fluid placed in uterus cryopreserve excess embryos
28
luteal support with IVF
progesterone (P4) necessary for pregnancy maintenance premature luteolysis in some superovulatory regimens P4 supplementation until menses occur or woman has +ve pregnancy test
29
ICSI - intracytoplasmic sperm injection procedure
injection of single sperm into single oocyte in order to achieve fertilisation Superovulation → US guided transvaginal oocyte retrieval → IVF oocytes injected with sperm using special microscopes, needles and micromanipulation equipment
30
indications of ICSI
* low sperm conc, motility, abnormal morphology * antisperm antibodies * fertilisation failure after conventional IVF * ejaculatory disorders * absence of vas deferens or obstruction of ejaculatory ducts
31
assisted hatching indications
couples having IVF with * female partner \> 37 * poor quality embryos - excessive fragmentation, slow rates of cell division
32
assisted hatching procedure
embryo held with a specialised holding pipette a needle used to expel an acidic solution against ZP small hole made in ZP embryo washed and put back in culture in incubator ET shortly after hatching procedure
33
further advances and uses of assisted conception technology
cryopreservation of sperm, embryo, oocyte, ovarian tissue growth of human follicles and oocytes in vitro in vitro maturation and transplantation of human spermatozoa
34
definition of infertility
inability to conceive after 1 year of unprotected and regular sexual intercourse
35
primary infertility
couples have never had children
36
secondary infertility
couples initiated conception in the past and are only now having difficulty
37
proportion of partner affected by infertility
female partner - 35% male partner - 35% both partners - 20% unknown cause - 10% infertility more common with increasing age
38
Highest to lowest - most common causes of female infertility
disorders of ovulation fallopian tube disorders pelvic adhesions endometriosis hyperprolactinemia
39
male infertility causes
abnormal semen parameters - count, motility, morphology
40
main techniques for assisted reproductive technology
IUI IVF - embryo transfer ICSI Assisted hatching
41
Preimplantation Genetic Diagnosis (PGD)
identify genetic conditions in embryo before ET (embryo transfer) Haemophilia CF Aneuploidy
42
when is PGD performed
with IVF 8 cell stage (3 days old) embryo biopsy obtain 1-2 blastomeres for genetic testing
43
3 day old embryos
44
how is PGD analysis performed (preimplantation genetic diagnosis)
multicolour fluorescence in situ hybridisation (FISH) polymerase chain rxn (PCR)
45
Interphase nucleus
46
chromosomal abnormalities

GGE (33 decks)

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