Understanding the IVF Process
Summary
TLDRDr. Leo Doherty explains the in vitro fertilization (IVF) process at Reproductive Medicine Associates of New Jersey, detailing how eggs and sperm are combined outside the body, using either ICSI or conventional insemination. He discusses ovarian stimulation, egg retrieval, and the revolutionary impact of pre-implantation genetic testing for aneuploidy (PGT-A), which allows for the selection of chromosomally normal embryos, improving IVF success rates. The process of embryo transfer is also described, emphasizing the strategy of maximizing egg growth safely and debunking the myth that IVF accelerates menopause.
Takeaways
- π§ͺ In vitro fertilization (IVF) involves eggs and sperm meeting outside the human body, with sperm injected via ICSI or allowed to fertilize through conventional insemination.
- π The IVF laboratory serves as an artificial fallopian tube environment, mimicking natural interactions that would occur within the body.
- π Ovarian stimulation for IVF involves administering hormones FSH and LH in higher concentrations to promote the growth of multiple eggs.
- π₯ Egg retrieval is performed just before the eggs would naturally ovulate, under anesthesia, to collect them from the ovaries.
- 𧬠Pre-implantation genetic testing for aneuploidy (PGT-A) is a significant advancement, allowing the selection of embryos with the correct number of chromosomes for transfer.
- π PGT-A has improved success rates by enabling the transfer of fewer, chromosomally normal embryos, enhancing the chances of implantation and pregnancy.
- π¬ The IVF process typically aims to create as many embryos as safely possible and then select the chromosomally normal ones for transfer.
- π‘ Patients are assessed for their IVF protocol based on the quantity of eggs and the number of follicles determined through blood tests and ultrasound.
- π« A common misconception is that IVF uses eggs destined for future ovulation, potentially leading to early menopause; however, IVF rescues eggs destined for reabsorption.
- π§ During embryo transfer in IVF, the embryo is inserted into the uterine cavity through the cervix using a catheter, with the process monitored via ultrasound.
- πΆ The embryo transfer aims to place the embryo in the uterine cavity where it may implant and develop into a pregnancy over the following weeks.
Q & A
What is the basic concept of in vitro fertilization (IVF)?
-In vitro fertilization is a process where an egg and sperm meet outside the human body. It involves the removal of eggs from the ovaries and the introduction of sperm either through ICSI (intracytoplasmic sperm injection) or conventional insemination, allowing fertilization to occur in a laboratory setting.
How does the natural process of fertilization differ from IVF?
-In the natural process, the sperm finds its way and unites with an egg in the woman's fallopian tube. In contrast, IVF bypasses this by taking the eggs out and combining them with sperm in a controlled environment.
What is the role of the laboratory in IVF?
-The laboratory serves as an artificial fallopian tube environment, where the interactions that normally happen in the fallopian tube take place, facilitating fertilization and early embryonic development.
How does ovarian stimulation work in the context of IVF?
-Ovarian stimulation involves administering hormones FSH and LH in higher concentrations than naturally produced by the body to promote the growth of multiple eggs, as opposed to the one egg typically developed in a natural menstrual cycle.
What is the purpose of egg retrieval in IVF?
-Egg retrieval is a procedure performed just before the eggs would naturally ovulate, where eggs are withdrawn from the woman's ovaries under anesthesia to be fertilized in the laboratory.
What is pre-implantation genetic testing for aneuploidy (PGT-A) and how does it impact IVF success rates?
-PGT-A is an embryo biopsy performed in the lab to determine the chromosomal normality of embryos, identifying those with 46 chromosomes. This has revolutionized IVF by allowing for the selection of chromosomally normal embryos, improving success rates and reducing the number of embryos needed for transfer.
How has the strategy of making and selecting multiple embryos changed the IVF field?
-The strategy of creating as many embryos as safely possible and then selecting chromosomally normal embryos for transfer has revolutionized IVF. It has led to improved success rates and the ability to transfer fewer embryos than historically needed.
What is the process of embryo transfer in IVF?
-During embryo transfer, the embryo is passed into the uterine cavity through the woman's cervix using a catheter, as opposed to the natural process where the embryo travels through the fallopian tube.
Why is it recommended for patients to have a full bladder during embryo transfer?
-A full bladder allows the use of a trans-abdominal ultrasound probe to carefully guide the catheter through the cervix into the endometrial cavity, providing a clear view of the procedure.
How does the IVF process affect a woman's egg reserve and the potential for early menopause?
-Contrary to a common misconception, IVF does not cause early menopause by using eggs destined for future ovulation. Instead, it rescues eggs that would have been reabsorbed, giving them a chance to grow and be fertilized.
How do physicians assess individual patients for their IVF protocol?
-Physicians assess patients based on the quantity of eggs within their ovaries each month, using blood tests and ultrasound to determine the number of follicles and decide on the appropriate dosage of FSH and LH medications.
Outlines
π§ͺ In Vitro Fertilization Process and Techniques
Dr. Leo Doherty, a physician at Reproductive Medicine Associates of New Jersey, explains the in vitro fertilization (IVF) process, which involves eggs and sperm meeting outside the human body. He describes two methods of fertilization: intracytoplasmic sperm injection (ICSI) and conventional insemination. The IVF laboratory is likened to an artificial fallopian tube environment. Ovarian stimulation is discussed, where hormones FSH and LH are used in higher concentrations to grow multiple eggs, followed by an egg retrieval procedure. The introduction of pre-implantation genetic testing for aneuploidy (PGT-A) is highlighted as a significant advancement in the field, allowing for the selection of chromosomally normal embryos, thereby improving success rates across all ages.
π Enhancing IVF Success with Embryo Selection
The general IVF strategy is to create as many embryos as safely possible and then select those that are chromosomally normal for transfer, revolutionizing the field. The process of embryo transfer in IVF is described, where the embryo is inserted into the uterine cavity through the cervix, using a catheter guided by trans-abdominal ultrasound. The importance of a full bladder during this procedure is noted to facilitate the transfer. The selection of individual IVF protocols for patients is based on the quantity of eggs within their ovaries, with the potential for growth and development assessed through blood tests and ultrasound.
π« Debunking Misconceptions about IVF and Egg Usage
A common misconception about IVF is addressed, where patients fear that using eggs for IVF will lead to early menopause. Dr. Doherty clarifies that the IVF process rescues eggs that would have otherwise been reabsorbed, giving them a chance to grow. He explains the natural monthly 'race for ovulation' where a group of eggs is destined to either ovulate or disintegrate, and how IVF stimulation allows these eggs to be utilized, thus not depleting the overall egg reserve.
Mindmap
Keywords
π‘In vitro fertilization (IVF)
π‘Ovarian stimulation
π‘Follicle stimulating hormone (FSH)
π‘Luteinizing hormone (LH)
π‘Egg retrieval
π‘Intracytoplasmic sperm injection (ICSI)
π‘Conventional insemination
π‘Pre-implantation genetic testing for aneuploidy (PGT-A)
π‘Embryo transfer
π‘Menopause
π‘Follicles
Highlights
Dr. Leo Doherty explains in vitro fertilization (IVF) as a process where egg and sperm meet outside the human body.
Traditional fertilization occurs in vivo, with sperm naturally finding and uniting with an egg in the fallopian tube.
In IVF, eggs are removed and sperm is injected via ICSI or allowed to fertilize through conventional insemination.
The IVF laboratory serves as an artificial fallopian tube environment for fertilization to occur.
Ovarian stimulation for IVF involves higher concentrations of FSH and LH hormones to grow multiple eggs.
Egg retrieval is performed just before the eggs would naturally ovulate.
Pre-implantation genetic testing for aneuploidy (PGT-A) has revolutionized the IVF field by allowing the selection of chromosomally normal embryos.
PGT-A improves success rates by enabling the transfer of fewer, chromosomally competent embryos.
The IVF strategy is to create and select chromosomally normal embryos for transfer, enhancing pregnancy chances.
Embryo transfer in IVF is performed by inserting the embryo through the cervix into the uterine cavity.
Patients are instructed to have a full bladder for ultrasound-guided embryo transfer.
The ultrasound can visualize the moment the embryo is transferred into the uterine cavity.
IVF protocols are personalized based on the quantity of eggs and the number of follicles.
Blood tests and ultrasound determine the appropriate medication dosage for ovarian stimulation.
A common misconception is that IVF uses eggs destined for future ovulation, potentially causing early menopause.
IVF actually rescues eggs destined for reabsorption, giving them a chance to grow and be fertilized.
The number of 'runners in the race' for ovulation decreases with age, affecting the potential for natural conception.
IVF stimulation maximizes the growth of eggs that would otherwise be lost in the natural cycle.
Transcripts
I'm Dr Leo Doherty a physician here of
Reproductive Medicine Associates of New
Jersey I see patients in the Somerset
and Freehold locations
in vitro fertilization is the process by
which an egg and a sperm meet outside of
the human body in Vivo sort of the
old-fashioned way the sperm will find
its way and Unite with an egg in the
woman's fallopian tube in vitro
fertilization is the process by which
the eggs are removed from the ovaries
and then sperm is either injected
through a process called ixy or
intracytoplasmic sperm injection or
allowed to fertilize through what's
called conventional insemination where
we put a certain number of sperm around
each egg and allow fertilization to take
place in the laboratory environment
essentially the in vitro laboratory is a
very fancy artificial fallopian tube
environment so the interactions that
normally happen in the fallopian tube
happen within the in vitro fertilization
Laboratory
ovarian stimulation typically occurs
every month in a woman's normal
menstrual cycle where the brain tells
the pituitary gland to make two hormones
called FSH follicle stimulating hormone
and LH luteinizing hormone in quantities
that are sufficient to make one egg
develop within the ovary ovulate and be
available for potential fertilization
the ovarian stimulation that we do for
in vitro fertilization involves giving
the same hormones but in higher
concentrations to promote the growth of
multiple eggs once the eggs reach a
certain size just before they would
normally ovulate we do an egg retrieval
procedure to withdraw them from the
women's ovaries under anesthesia
there are methods to improve embryo
selection and one of the one of the
biggest game changers in the field has
been pre-implantation genetic testing
for anupility or pgta that is an embryo
biopsy performed in the laboratory that
allows us to know which embryos do and
do not have the correct number of
chromosomes which is 46 chromosomes this
is revolutionized the field this is
something that we utilize heavily at
Reproductive Medicine Associates of New
Jersey and it has allowed us to have
excellent success rates transferring
less embryos than was historically
needed to achieve good success rates so
by knowing which embryos are
chromosomally normal and and therefore
competent to have a chance to implant
and develop into a pregnancy we can
better select which embryo to transfer
and improve success rates across all
ages the general strategy of IVF which
is make as many embryos as you can
safely and then select the individual
chromosomal normal embryos that are
competent to produce a pregnancy and
transfer those has revolutionized the
field
typically an embryo transfers itself
into the uterus from above through the
fallopian tube when we do an embryo
transfer in the in vitro fertilization
process the embryo is passed in a
catheter through the woman's cervix into
the uterine cavity from below so instead
of coming in from above through the
fallopian tube it's inserted through the
cervix using a catheter so we typically
instruct our patients to arrive with a
full bladder to allow us to use a
trans-abdominal ultrasound probe to
watch the catheter be carefully guided
through the cervix into the endometrial
cavity and then it's actually a very
cool process you can see when we push
the plunger to to eject the embryo into
the uterine cavity we can see a little
flash of fluid on the ultrasound screen
you can see right where the embryo will
hopefully set up shop for the next 38
weeks
we assess individual patients for their
IVF protocol based on the quantity of
eggs within their ovaries each month
women's born with a fixed number of eggs
and gradually over time as she gets uh
less young or older there are less
runners in the race monthly for
ovulation so every month there is a
group of eggs out of the thousands that
are present and the ovaries that could
potentially grow and develop
we are able using blood tests and
ultrasound to determine the number of
follicles in the monthly race for
ovulation and then decide how much of
the FSH and LH medications to use to
maximize the growth in a safe way
one of the most common misconceptions I
hear from patients is that by doing IVF
they're going to use eggs that were
destined for ovulation sometime in the
future and they they may go into
menopause earlier as a result
I always like to talk about the number
of runners in the race for ovulation
each month every month there is a group
of eggs that are destined to either
ovulate or get
reabsorbed and
essentially disintegrate so what we do
in the IVF stimulation process is rescue
the eggs that were destined for
reabsorption and give them a chance to
grow so every month you're going to
either use or lose the runners in the
race and by stimulating the additional
runners in the race that we're not going
to get selected by the women's own
hormones we give them a chance to grow
as well
Browse More Related Video
5.0 / 5 (0 votes)