Week 2: infertility and IVF

Question 1

Define infertility

Answer 1

12 months of trying

“unprotected intercourse”

Question 2

Optimal timing of coitus for fertilzation

Answer 2

Timing of ovulation
14 days before next menses
12-24 hours after positive ovulation predictor kit
Sperm wait for egg
Every 1 - 2 days
No harm from daily ejaculation
?Decrease in sperm count with greater frequency
-up to 5 days before ovulation

Question 3

Simple fertility treatment

Answer 3

1. Ovulation induction
Oral medications that increase FSH
-Clomiphene = estrogen receptor antagonist
-Letrozole = aromatase inhibitor (prevents synthesis of estradiol)
-FSH injections
2. Intra-uterine insemination (IUI)
Improves sperm transport
Often combined with fertility meds

Question 4

Why do embryos from older oocytes implant at lower rate?

Answer 4

Oocyte quality:
     Cell division
      DNA replication
      Implantation
Older cells = less max. energy	 production
Older oocytes = 
	more chromosomal errors
	less implantation
	more miscarriages

Question 5

Take home points

Answer 5

Embryo development
-Normally takes place within the fallopian tube
-Can be achieved in the laboratory (IVF)
-Inner cell mass contains stem cells
-Implantation takes place 7 days after ovulation
PGD
-Allows for diagnosis of genetic disease
-The only effective method of gender selection
Uterus
-Must be receptive to allow implantation
-Maintains receptivity with age

Question 6

Take home points 2

Answer 6

-Infertility is a common disease
Oocytes
-Can be retrieved from follicles
-Age determines pregnancy success
-Cryopreservation allows for fertility preservation
-Donation allows for pregnancy after menopause
Sperm
-Fertilize naturally via binding to oocyte
-Can be injected into the oocyte (ICSI)