Lecture 9 - Assisted Reproduction Flashcards
What is the primary function of HCG produced by the early trophoblast?
It prevent degradation of the corpus luteum so it continues to produce progesterone.
What is IUI and what are its indications?
Intra uterine insemination- injecting sperm into endometrial cavity. Not very different to intercourse so only used in special circumstances. Indications: -Same sex couples -couples unable to have intercourse -HIV patients -If sperm need treatment beforehand
Before doing IUI how can you tell if a woman is ovulating?
Measuring FSH and LH for spike at ovulation.
Why is IUI not funded by the NHS?
Very expensive (£500) for very little benefit.
Which hormone can be used to trigger ovulation and why?
HCG because it is structually homologous with FSH and LH.
How is egg release controlled for IVF?
GnRH agonists or antagonists (prevents premature LH surge) are given to control menstrual cycle and then FSH is given when eggs are needed.
Why does IVF need lots of councelling?
It has a high psychological impact, also high hormone levels cause physical effects.
What are the indications for IVF?
Tubal disease PCOS Male factor (with ICUS) Endometriosus Other techniques failed (IUI) No eggs - donor eggs No uterus - host surrogacy Pre implantation genetic diagnosis
How are eggs collected for IVF?
Transvaginally or transabdominally via ultrasound guidance.
What hormone must be given to IVF mothers throughout pregnancy?
Must be given progesterone as there is no corpus luteum to produce it.
What is ICSI and when is it used?
It is intracytoplasmic sperm injection and is used in cases where there is sperm failure.
There is no demonstratable benefit of using ICSI over IVF when there is nothing wrong with the sperm.
How are embryos from IVF selected?
Based on size and shape in order to get the most healthy one.
What is a debated disadvantage of ICSI?
It removes the natural selection of the sperm having to compete with one another to fertilise the egg. This means that the egg is not fertilised with the best sperm.
What are the problems with IVF?
Multiple pregnancies Overian hyperstimulation syndrome Risks of egg retreival e.g. bladder problems Risks of congential abnormalities Very invasive Very expensive - £3.5k
How many eggs survive after cryopreservation?
Only around 1 in 10 eggs survive freeze thaw.
