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Infertility, Reproductive Technology, Contraception, & STDs

Objectives: 1. Infertility 2. Reproductive Technology

1. Infertility (Review Reproductive A&P Lecture Notes)

Female Infertility Male Infertility

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1. Fertility Drugs Ex. Clomid = Dose of pituitary LH & FSH Blocks estrogen receptors on hypothalamus Causes increased GnRH secretion Causes increased pituitary LH & FSH secretion Stimulates multiple egg development & ovulation. 80% chance of ovulation, 50% chance in getting pregnant. chance of twins, triplets, quintuplets (etc…)

- this risks of low birth weight - this risks of premature labor & birth

2. Reproductive Technologies

2. Artificial Insemination (intra-uterine insemination)

2. Reproductive Technologies

Woman takes fertility drugs Doctor monitors ovulation (as IU insemination needs to be done just before

ovulation). A “washed” and concentrated sperm sample inserted with catheter into

uterus. Woman usually been on fertility drugs (ovulated multiple eggs to ↑ chance of

working). - Timing is everything!

Click HERE for YouTube video on intra-uterine insemination.

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2. Reproductive Technologies

Woman undergoes 3 procedures: 1. Woman on fertility drugs (↑ ovulation of eggs) 2. Ovulated eggs are collected - Eggs mixed w/sperm in “tube” to create zygotes. - Best zygote” selected from among many for implanting. - Rest frozen. 3. Selected zygotes are implanted into uterus. • Not all implants “take”. • But sometimes multiple zygotes implant. • Very expensive! • Zygote personhood laws being considered

would outlaw this procedure!

3. In-Vitro Fertilization (test-tube baby)

2. Reproductive Technologies

1. Go on fertility drugs 2. Collect ovulated eggs – “follicle aspiration” (procedure 1) 3. Mix eggs with donated sperm in “dish” – “fertilization” (procedure 2) 4. Select “best embryos” to implant in uterus – “embryo transfer” (procedure 32)

3. In-Vitro Fertilization (test-tube baby)

Click HERE for YouTube video on in-vitro fertilization

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2. Reproductive Technologies

Louise Brown

- Born July 25, 1978 in England

- First “test tube baby”

- Gave birth to her own baby boy

(without aid of in-vitro) in 2006

3. In-Vitro Fertilization (test-tube baby)

IVF Success Rate

0

5

10

15

20

25

30

35

Under 35 35-37 38-40 Over 40

Age of Woman (yrs.)

% S

ucc

ess

Rat

e

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4. Intracytoplamic Sperm Injection (ICSI) 1. Woman goes on fertility drugs 2. Collect ovulated eggs (procedure 1) 3. Inject single sperm cell into each egg. 4. Select “best embryos” to implant in uterus (procedure 2)

Click HERE for YouTube video on ICSI

5. Gamete Intra-fallopian Transfer (GIFT) 1. Woman goes on fertility drugs 2. Collected eggs and sperm put directly into fallopian tubes & allow for fertilization.

6. Zygote Intra-fallopian

Transfer (ZIFT) 1. Woman goes on fertility drugs 2. Combine collected eggs with sperm in petri dish. 3. Put eggs and sperm in a dish for fertilization. 4. Resulting zygotes transferred to fallopian tubes.

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7. Ovary Transplant First done in 2004 Identical twin sisters – one donated ovarian tissue.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5375051/

Click HERE for YouTube video

Freezing Sperm

Freezing Eggs 1. Woman goes on fertility drugs. 2. Collect ovulated eggs. Then can 3. Use rapid-freezing (liquid nitrogen) for either eggs or sperm. • More difficult to freeze eggs & have them

viable than with freezing sperm

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Choosing Gender MicroSort Technique

> Normal semen sample - 50% of sperm carry X & 50% carry Y = 50 % chance of having either boy or girl.

> Technique to “pre-sort” sperm into X-bearing or Y-bearing sperm based on mass of sperm (if carry X chromosome it’s heavier).

> Can sort with success to:

~91% primarily X-bearing sperm in sample and ~76% primarily Y-bearing sperm in sample.

> Then use sample for artificial insemination or IVF

Click HERE for video on Microsort

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Pre-Implantation Diagnosis (PIGD)

> “Screen” embryos (produced by assisted reprod. Technology) for genetic disorders before implanting.

> Embryos with disorders aren’t selected.

Click HERE for YouTube video on PIGD

Review