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tech and health - reproductive technologies Flashcards

1
Q

types of reproductive technologies: RT

A
  1. assisted reproductive technology (ART)
  2. contraception
  3. emerging technologies
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2
Q

Assisted reproductive technology (ART)

A
  • treat infertility
  • includes all fertility treatments where eggs or embryos are handled
  • only application of RT used routinely
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3
Q

Assisted reproductive technology (ART): examples

A
  1. artificial insemination
  2. in vitro fertilization and embryo transfer (IVF-ET)
  3. surrogacy
  4. mitochondrial replacement therapy (MRT)
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4
Q

embryo transfer

A

one or several embryos placed into uterus to start pregnancy (embryos belong in womans uterus)

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5
Q

oocyte

A

egg cell produced in ovaries

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6
Q

zygote

A

fertilized cell

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7
Q

Assisted reproductive technology (ART): laparoscopy

A

direct visualization of peritoneal cavity, ovaries, outside of tubes and uterus

laparoscopy is an instrument like a telescope with a fiber optic system that brings light into the abdomen (long fountain pen)

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8
Q

Assisted reproductive technology (ART): cryopreservation

A

cells (embryos, eggs, sperm) or whole tissues are preserved by cooling to low sub-zero temperatures (77K or -196C)

at these low temps, any biological activity (biochemical reactions leading to cell death) is effectively stopped - stop clocking on aging process

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9
Q

Assisted reproductive technology (ART): in vivo fertilization

A

fertilization of ripe egg WITHIN UTERUS for nonsurgical transfer to an infertile recipient

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10
Q

Assisted reproductive technology (ART): in vitro fertilization (IVF)

A

egg cells are fertilized by sperm OUTSIDE UTERUS

phases
1. superovulation (stimulation of egg production, injection horomones)

  1. egg retrieval form ovary
  2. fertilization/ insemination (outside)
  3. embryo transfer (into recipient uterus)
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11
Q

indications for IVF -ET

A

fallopian tube disease

endometriosis (unnatural growth of tissues in uterus –> growth outside uterus)

male infertility (bad motility)

genetic disorder

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12
Q

ultrasound retrieval method (IVF?)

A
  • to locate and perform removal
  • doctor places needle inside guide which is attached to an ultrasound vaginal instrument
  • once pt gets anesthetic, the doctor uses ultrasound instrument to locate follicles with eggs
  • doctor guides needle through vaginal wall and aspirates the fluid containing the eggs into a small tube
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13
Q

Assisted reproductive technology (ART): IVF when eggs can’t easily be penetrated by sperm

A

intracytoplasmic sperm injection (ICSI) - single sperm injected directly into egg

  • 2018 FDA approval: device to choose mature sperm for ICSI relying on sperm actively swimming through membrane filter in chip - motility
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14
Q

Assisted reproductive technology (ART): 1. artificial insemination

A

injecting sperm directly into uterus

  • infertility: not enough motile sperm
  • man has genetic disoerder
  • no male partner present
  1. ovarian stimulation
  2. semen collection
  3. lab processing and washing
  4. artificial insemination
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15
Q

artificial insemination: semen prep

A
  • separate motile sperm from seminal plasma (fluid portion of semen where spermatozoa are suspended) and foreign material)
    • WBCs, bacteria, and dead spermatozoa produce oxygen radicals that negatively influence the ability of normal spermatozoa to fertilize the egg
  • sperm wash w ax and protein is added to ejaculate
  • centrifugation (spinning to separate molecules)
    -seminal fluid is eliminated from the sample and sperm are concentrated for insemination (20-40 min)
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16
Q

intracytoplasmic sperm injection (ICSI)

A

ART to treat infertility like sperm-related infertility

enhances fertilization phase of IVF by injecting a single sperm into a mature egg

  1. intrauterine insemination
  2. intracervical insemination
  3. intratubal insemination (fallopian)
  4. intravaginal insemination

process:
- sperm placed into reproductive tract of female to impregnante w/o intercourse
- sperm placed into__ artificially:
- cervix (intracervical insemination ICI more popular)
- uterus (intrauterine insemination IUI)

*woman is gestational (preg) and genetic mother
*father is genetic father

*increased likelihood of MULTIPLE BIRTHS if drugs are used for a stimulated cycle

17
Q

Assisted reproductive technology (ART): IVF-related

A

infertile, prevent sperm and egg from travelling through fallopian tube

SUPEROVULATION: medications to stimulate ovaries to produce multiple eggs (letrozole/ gondotropins FSH)
- higher costs and risks than laproscopy and less info about embryo development than IVF, so rarely used

18
Q

Assisted reproductive technology (ART): GIFT (gamete intrafallopian transfer)

A

uses multiple eggs collected from ovaries

sperm and eggs placed in FALLOPIAN TUBE for fertilization in natural site (woman must have at least 1 normal tube)

  1. removing eggs
  2. eggs placed into thin flexible catheter with sperm
  3. gametes (egg and sperm) injected into fallopian tubes using laproscopy and anesthesia
    *higher % of pregnancy after this is younger, 37%
19
Q

Assisted reproductive technology (ART): ZIFT (zygote intrafallopian transfer)

A

uses IVF!!
recommended for woman. gone through IVF many times without success

EGGS MIXED WITH SPERM IN LAB

  1. eggs stimulated and collected using IVF
  2. eggs mixed with sperm in lab
  3. fertilized eggs (zygotes) are returned to fallopian tubes with laparoscopic surgery then into uterus (goal is for zygote to implant in the uterus and develop into fetus)

very invasive!! bc 2 surgical procedures

can be more successful than GIFT bc fertilization is already done when implanted

ADVANTAGE over IVF bc less eggs used, lessening risk of MULTIPLE BIRTHS

20
Q

IVF, GIFT or ZIFT

A

improved success rates w IVF, so less GIFT done
- IVF doesn’t need anesthesia (GIFT) or laparoscopic intervention (GIFT and ZIFT)
- GIFT patients are usually ones who require diagnostic laparoscopy or laparoscopy for endometriosis and you can combine the procedures to save money

21
Q

mitochondrial replacement therapy (MRT)

A

MRT allows children of parents with mitochondrial disease to get NuDNA from their parents and healthy mitochondria from donor without mitochondrial disease

a new form of reproductive IVF which replaces woman’s abnormal MtDNA with donors healthy one

PRONUCLEAR TRANSFER TECHNIQUE - can detect unhealthy mitochondria, and take only mother’s nucleus to put it into donor eggs mitochondria resulting in mothers DNA in healthy mitochondria

mitochondria generate chemical energy for cell’s biochemical reactions
-stored in ATP (MtDNA = circular)

  • many diseases associated with defective mitochondria, some are life threatening to children of diseased parents –> failure of metabollically active organs (leigh syndrome)
22
Q

risks of ART

A

there are higher risks for ___ if you use ART
- miscarriage
- multiple pregnancies
- low birth weight

23
Q

utilization of ART

A

only 5% of candidates use the medical service due to COST and LACK OF ACCESSIBILITY - not all insurers cover this, so can only the wealthy afford it?

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