FERTILITY TREATMENT AND IVF

TYPES OF TREATMENT & THE PSYCHOLOGICAL EFFECTS

What's is IVF? IVF stands for in vitro fertilisation

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Follicle tracking

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Clomiphene Citrate (Clomid)

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Ones woman’s experience of clomid

http://www.healthtalkonline.org/Pregnancy_children/Pregnancy/People/Interview/1215/Category/

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Gonadotrophin ovulation induction programme

Pre treatment:

Normal semen analysisNormal laparoscopy and dye test, or normal Hysterosalpingogram (HSG)Body mass index <30Both partners to be non smokers

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Ovarian hyperstimulation syndrome(OHSS)

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Criteria for admission to IVF waiting list

• Stable relationship 3 years or more• No previous children (either partner)• Age under 38 (37 or less)• Must not be on any treatment other than Clomiphene Citrate or treatment for

prolactinoma from the NHS fertility clinic. Not currently on an ovulation programme

• Tubal damage - not within 2 years of surgery unless bilateral reocculsion or surgery not done

• Unexplained 3 years• True ovulation disorder: • Ovulation with clomiphene - after 1 year of correction of ovulation assuming

ovulates every cycle• Ovulation with gonadatrophins - on waiting list after 6 cycles unless difficulty -

must stop treatment to get on waiting list• Failed treatment (no ovulation) - on IVF waiting list if not suitable for ovarian

diathermy. If suitable (raised LH or raised androgens) then diathermy first

• Endometriosis - not under current treatment except for symptomatic endometriosis (pain)

• Male factor as unexplained count under 5x10 on 3 occasions or motility under 20% on 3 occasions where direct admission possible to list

• BMI <30

• Must have had investigations below as a minimum:

• LH, FSH (<10)

• An assessment of ovulation by luteal phase progesterone

• Semen analysis

• Laparoscopy or HSG (normally laparoscopy)

• Rubella

IVF

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Egg retrieval

http://www.youtube.com/watch?v=aUQJuYe3D4g&feature=related

Fertilisation

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Two pronuclei

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Embryo

Feelings around IVF: A woman’s point of view

• http://www.healthtalkonline.org/Pregnancy_children/Pregnancy/People/Interview/308/Category/37/Clip/4995/assisted-conception#assisted-conception

Husbands thought’s

• http://www.healthtalkonline.org/Pregnancy_children/Pregnancy/People/Interview/308/Category/37/Clip/4996/assisted-conception#assisted-conception

TYPES OF ART (assisted reproductive

technology)

• GIFT

http://www.youtube.com/watch?v=k2LcWjAAoDM

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ZIFT

http://www.viddler.com/explore/helplibrary/videos/125/

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Intrauterine Insemination (IUI)

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Intra cytoplasmic sperm injection (ICSI)

http://www.youtube.com/watch?v=LYQVxd1MHuk&feature=related

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HFEAWho are they and what do

they do?

• Human Fertilisation and Embryology Authority (HFEA) are a regulatory body that ensures the safe practice of in vitro techniques

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‘Put One Back Campaign’

• The HFEA promotes the use of returning one embryo back to the uterus through infertility treatment to prevent multiple births

• This campaign is supported by:

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reference list Draper. R. 2009. Patient UK. Available from: http://www.patient.co.uk/doctor/Ovarian-Hyperstimulation-Syndrome.htm [Accessed 4th November 2009] Fertllity Authority, 2009. Available from: http://www.fertilityauthority.com/tests-and-medications/medications/ovulation-inducing-medications [Accessed 4th November 2009] Fertlity Expert, 2009. Available from: http://www.fertilityexpert.co.uk/chapter-five-fertility-statistics.html [Accessed November 4th 2009] Gurevich, R., 2009. About.com:fertility. Available from: http://infertility.about.com/od/infertilitytreatments/a/clomid101.htm [Accessed 4th November 2009] Healthtalk online, 2009. Available from: http://www.healthtalkonline.org/Pregnancy_children/Pregnancy/Topic/2080/ [Accessed 4th November 2009] Human Fertilisation and Embryology Authority, 2009. Available from: http://www.hfea.gov.uk/GIFT.html [Accessed November 4th 2009] Manheimer, E., Zhange, G., Udoff, L., Haramati, A., Langenberg, P., Be rman, B., Bouter, L.M, 2008. Effects of acupuntures on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systermatic review and meta-analysis. British Medical Journal. Available from: http://www.bmj.com/cgi/content/abstract/336/7643/545 [Accessed 4th November 2009] NICE., 2004. Fertility: assessment and treatment for people with fertility problems. London. Available from: http://www.nice.org.uk/nicemedia/pdf/CG011niceguideline.pdf [Accessed November4th 2009] West. Z. 2009. Zita West, Available from: http://www.zitawest.com/area.php?section=7 [Accessed 4th November 2009]