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GGE > Embryos - Assisted Reproduction > Flashcards

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
Q

ZP and polar bodies

A
26
Q

progress from 2 cell stage to blastocyst

A
27
Q

with IVF, when does embryo transfer take place

A

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
Q

luteal support with IVF

A

progesterone (P4) necessary for pregnancy maintenance

premature luteolysis in some superovulatory regimens

P4 supplementation until menses occur or woman has +ve pregnancy test

29
Q

ICSI - intracytoplasmic sperm injection

procedure

A

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
Q

indications of ICSI

A
  • 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
Q

assisted hatching indications

A

couples having IVF with

  • female partner > 37
  • poor quality embryos - excessive fragmentation, slow rates of cell division
32
Q

assisted hatching procedure

A

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
Q

further advances and uses of assisted conception technology

A

cryopreservation of sperm, embryo, oocyte, ovarian tissue

growth of human follicles and oocytes in vitro

in vitro maturation and transplantation of human spermatozoa

34
Q

definition of infertility

A

inability to conceive after 1 year of unprotected and regular sexual intercourse

35
Q

primary infertility

A

couples have never had children

36
Q

secondary infertility

A

couples initiated conception in the past and are only now having difficulty

37
Q

proportion of partner affected by infertility

A

female partner - 35%

male partner - 35%

both partners - 20%

unknown cause - 10%

infertility more common with increasing age

38
Q

Highest to lowest - most common causes of female infertility

A

disorders of ovulation

fallopian tube disorders

pelvic adhesions

endometriosis

hyperprolactinemia

39
Q

male infertility causes

A

abnormal semen parameters - count, motility, morphology

40
Q

main techniques for assisted reproductive technology

A

IUI

IVF - embryo transfer

ICSI

Assisted hatching

41
Q

Preimplantation Genetic Diagnosis (PGD)

A

identify genetic conditions in embryo before ET (embryo transfer)

Haemophilia

CF

Aneuploidy

42
Q

when is PGD performed

A

with IVF

8 cell stage (3 days old) embryo biopsy

obtain 1-2 blastomeres for genetic testing

43
Q

3 day old embryos

A
44
Q

how is PGD analysis performed (preimplantation genetic diagnosis)

A

multicolour fluorescence in situ hybridisation (FISH)

polymerase chain rxn (PCR)

45
Q

Interphase nucleus

A
46
Q

chromosomal abnormalities

A

GGE (33 decks)

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