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MED6112 - Embryo > Lecture 14 - clinical overview of IVF > Flashcards

Lecture 14 - clinical overview of IVF Flashcards

1
Q

What sperm parameters are measured?

A

Morphology (4-5%)
Count (15 mil/mL)
Progressive motility (32%)

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2
Q

What are some common sperm defects?

A

Oligospermia (low count)
Asthenospermia (reduced fertility)
Teratospermia (abnormal morphology)
Azoospermia (no sperm in semen, can be obstructive or non-obstructive)

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3
Q

How do they check/obtain sperm?

A

Percutaneous epididymal sperm aspiration (PESA)

Testicular sperm extraction (TESE) - need to dissect sperm out of the tissue

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4
Q

What can be done if a male has ejaculation problems?

A

Electroejaculation or alkylate the urine and collect sperm from there if there is retrograde ejaculation problems

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5
Q

What is the aim of ovarian stimulation?

A

Grow follicle to maturity

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6
Q

How long does it take to grow a follicle to maturity?

A

Primordial to antral - 3-4 months

Antral to ovulatory - 2 weeks

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7
Q

What does injection of FSH do?

A

Prolongs window of recruitment - recruit more follicles

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8
Q

What is the LH surge dependent on?

A

Oestrogen

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9
Q

What is the problem with ovarian stimulation and the LH surge?

A

There are more follicles therefore the levels of oestrogen are higher and so the LH surge occurs prematurely - premature ovulation

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10
Q

What can be done in order to block the premature LH surge?

A

GnRH antagonists stop LH release

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11
Q

What is the function of LH in the normal cycle?

A

Allows completion of meiosis
Makes egg looser (b.d. hyaluronic acid with hyaluronidase)
LH must be given artificially

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12
Q

What are the 4 steps for controlled ovarian hyperstimulation?

A
  1. Choice of protocol
  2. Dose (age, body weight, ovarian reserve, antral follicle count)
  3. Follicular monitoring (scan, serum oest and progesterone)
  4. Triggering of ovulation
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13
Q

What cna be used to measure ovarian reserve?

A

Baseline FSH, LH and AMH

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14
Q

What are the steps for IVF?

A
  1. Ovarian stimulation and monitoring
  2. Egg collection (sedation)
  3. Insemination/ICSI
  4. Fertilisation check
  5. Embryo culture
  6. Embryo transfer
  7. Luteal support
  8. Pregnancy test
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15
Q

Why are blastocyst transfers more successful than embroy?

A

They have undergone MZT so the more viable embryos can be identified

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16
Q

What are some complications of IVF?

A

Multiple pregnancies
Ectopic pregnancy
Ovarian hyperstimulation syndrome

17
Q

What is the future research for IVF?

A

Embryo culture systems, time-lapse morphokinetics, metabolomics and proteomics, epigenetics, PGD/PGS, embryo-endometrial dialogue

MED6112 - Embryo (12 decks)

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