IN VITRO FERTILIZATION (IVF) Rels 300 / Nurs 330 12 November
2014 300/330 - appleby1
Slide 2
25 July 1978: 1 st test tube Baby On left: Physiologist Robert
Edwards Middle: baby Louise Joy Brown (Middle woman, unidentified)
Right: Gynecologist Patrick Steptoe Parents: Lesley & John
Brown after 9 years of infertility After 80 embryo transfer
failures, 1 st successful pregnancy and birth 300/330 -
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Slide 3
Currently, over 4 million test tube Babies have been born
Robert Edwards received the 2010 Nobel prize for medicine. the
world's first "test tube baby" was born in July 1978. IVF
technology allowed Lesley & John Brown to experience pregnancy
& birth, in spite of Lesleys blocked fallopian tubes 300/330 -
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Slide 4
In response, the Vatican protested the awarding of the prize,
saying that: Conception occurs separate from the couples conjugal
union Embryos that are fertilized but not implanted are destroyed
300/330 - appleby4 The President of the Pontifical Academy for Life
said that without Edwards there would not be freezers full of
embryos waiting to be transferred to a uterus, or, more likely,
used for research or left to die, abandoned and forgotten by all.
http://catholic.org/hf/family/story.php?id=39343
Slide 5
James Watson, co-discoverer with Crick of the structure of DNA,
and fellow Nobel Laureate from 1953, had this to say about IVF: All
hell will break loose, politically and morally, all over the world.
The Atlantic, June 2012 300/330 - appleby5
Slide 6
What is IVF? IVF is a process whereby ova and sperm are placed
together in a glass dish (in vitro = in glass) in a laboratory
setting If fertilization occurs, and the early embryos successfully
begin to grow in the dish, then the embryos are transferred into
the womans uterus If one or more embryos are successful in
achieving implantation, then a pregnancy has begun 300/330 -
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Slide 7
5 Steps 1.Ovulation induction: fertility drugs are used to
cause production of multiple ova (usually 3 or more, up to 15 or
20) and to control the exact timing of the ovulation 2.Follicular
aspiration: ripe ova within their follicles are surgically removed
from the womans ovaries using a hollow catheter 3.Ova and sperm are
combined in a glass dish in a nutrient-rich medium (ratio of 50,000
to 1) 300/330 - appleby7
Slide 8
4.Dish containing ova and sperm is placed in an incubator to
provide a temperature-controlled environment; eggs are monitored
for fertilization and cell division (Spare embryos may be
discarded, frozen, or donated) After 17 days, a pregnancy test will
be done, followed by an ultrasound if pregnancy has been confirmed
5.Healthy fertilized zygotes are transferred to the womans uterus
through the cervix using a catheter; generally 1 to 3 embryos per
transfer 300/330 - appleby8
Slide 9
Medical Risks associated with IVF Hormonal stimulation of
womans ovaries to produce multiple ova risk of ovarian
hyperstimulation Severe abdominal pain Nausea or vomiting Decreased
urination Shortness of breath Up to 10 lb. weight gain within 3 to
5 days Risks associated with anesthesia Risks of bleeding,
infection Risks of damage to the bowel, bladder or blood vessels
Potential for a multiple pregnancy with risk of premature delivery
Potential risks from donor sperm or ova 300/330 - appleby9
Slide 10
Variations of IVF ICSI intracytoplasmic sperm injection if
sperm are few or inactive a single sperm is inserted into the ovum
with a catheter GIFT gamete intrafallopian transfer ova and sperm
are collected and then transferred to the fallopian tubes so that
fertilization takes place within the womans body 300/330 -
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Slide 11
IVF with donors OVA Donation of healthy ova no longer needed by
another IVF woman Purchase of ova from a donor catalogue Altruistic
donation from a family member or friend; http://www.mountsinai.
on.ca/care/fertility/serv ices/egg-donation http://www.mountsinai.
on.ca/care/fertility/serv ices/egg-donation SPERM Donation of sperm
no longer needed for AI or IVF Purchase of sperm from a donor
catalogue Altruistic donation from a family member or friend
Purchase online; http://www.mountsinai. on.ca/care/fertility/serv
ices/donor- insemination http://www.mountsinai.
on.ca/care/fertility/serv ices/donor- insemination 300/330 -
appleby11 EMBRYO Excess frozen fertilized embryos from previous IVF
cycles; http://www.mountsina i.on.ca/care/fertility/se
rvices/embryo- freezing http://www.mountsina
i.on.ca/care/fertility/se rvices/embryo- freezing Purchase from an
IVF clinics excess inventory Prenatal adoption of spare
embryos
Slide 12
http://www.mountsinai.on.ca/care/fertility/fee-schedule-august-2014.pdf
http://www.mountsinai.on.ca/care/fertility/fee-schedule-august-2014.pdf
IVF fee schedule
http://www.mountsinai.on.ca/care/fertility/fee-schedule-august-2014.pdf
http://www.mountsinai.on.ca/care/fertility/fee-schedule-august-2014.pdf
300/330 - appleby12 250 Dundas Street West, Suite 700 Toronto, ON
M5T 2Z5 (416) 586-4748
MISSION 300/330 - appleby14 To locate stunning, well motivate
candidates To accept no more than 5% of our 1,200 + monthly egg
donor applications To be instrumental in setting & surpassing
industry standards To provide competitive program costs To provide
reliable financial auditing To provide secure and confidential
records To provide cycle coordination To honor the responsibility
of creating families Create a username and password to view our
Database of Egg Donors Database of Egg Donors ONE OF OUR REAL EGG
DONOR ANGELS
Frozen Egg Donor Cycle 5 mature eggs = $16,500 plus transfer
fees Fresh Egg Donor Cycle Unknown quantity of eggs = $38,000 -
$60,000 300/330 - appleby16
http://www.eggdonation.com/egg-donor-bank.php Frozen Eggs Available
from egg donor 1019 only. We have had a 100% success rate with
transfers from this donor cycle, both fresh and frozen.
Choose a Donor ! http://www.ctfertility.com/
http://www.ctfertility.com/find-egg-donors Sample Profile for egg
donor #254, http://www.ctfertility.com/sample-egg- donor-profile
http://www.ctfertility.com/sample-egg- donor-profile 300/330 -
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Slide 19
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Slide 20
MUMBAI, India Rotunda-The Center for Human Reproduction MUMBAI,
India Rotunda Clinic offers comprehensive IVF services: IUI, IVF,
ICSI Donor Egg IVF, Embryo Adoption, Surrogacy Embryo Retrieval
through Puncture/ Aspiration, Overseas IVF Patient Program,
Gestational Surrogacy & Gestational Carrier ART Program 300/330
- appleby20
Slide 21
Why choose Egg and/or Embryo Storage? When fertility is at risk
due to illness or surgery. To delay childbearing until a later
date. Egg/Embryo storage gives women who have completed IVF
treatment the option to preserve the unused embryos for potential
use in the future. Your IVF center has limited storage space. Your
IVF center is closing. 300/330 - appleby21
Slide 22
http://www.embryoadoption.org/sitemap/index.cfm Adopters Embryo
Adoption 101 Terminology Defined Videos Personal Stories Adopter
FAQs News Articles Embryo Adoption Agencies Home Study Providers
Clinics with Donation Donors Embryo Adoption 101 Terminology
Defined Videos Personal Stories Donor FAQs Counselor Support
Network News Articles Where to Donate Webinar Registration Glossary
300/330 - appleby22
Slide 23
CASE STUDY 60-YEAR-OLD CALGARY MOTHER WELCOMES TWINS Ranjit
Hayer tried for decades to have a child, enduring multiple
miscarriages, surgery, even the trauma of being robbed by a
fertility doctor. Finally, after a successful IVF treatment, the
Calgary woman gave birth to twins at age 60. She is believed to be
among the oldest Canadian women to give birth.
http://www.cbc.ca/news/canada/calgary/60-year-old-calgary-mother-
welcomes-twins-1.844372
http://www.cbc.ca/news/canada/calgary/60-year-old-calgary-mother-
welcomes-twins-1.844372 300/330 - appleby23
Slide 24
60-year-old MOM We can do so much but the question is, should
we do it just because we can do it? 300/330 - appleby24
Slide 25
Evaluating reproductive technologies Whose personal dignity and
autonomy are promoted or harmed? What are the potential benefits of
reproductive technologies? Who are the beneficiaries? What are the
potential risks and harms of reproductive technologies? Who is most
likely to be harmed? Are there justice issues in the provision of
reproductive services? Issues of fairness, equality, equitable
access? 300/330 - appleby25