ASSISTED REPRODUCTIVE TECHNOLOGIES

Andrea Miller, Aquilla Reed , Ellen Salomon

Overview

• Infertility and Subfertility

• Infertility Tests

• Various Assisted Reproductive Technologies

• Extra Embryos

Infertility vs SubfertilityInfertility:

“The inability to conceive a child after a year of frequent intercourse without the use of contraceptives.” (Lewis 2007)

Subfertility:The ability to conceive a child, but

taking longer then usual.

Causes of Infertility and

SubfertilityFemalesSpontaneous Ovulation

Secretions that Attack Sperm

Blocked Uterine Tubes

Endometriosis

MalesLow Sperm Count

Immobile Sperm

Production of antibodies towards sperm

Infertility TestsTypically Males Are Checked First For:

Sperm Count

Motility

Genetic Abnormalities (i.e. deletions of the Y chromosome, IgA antibody production)

Physical Abnormalities (i.e. varicose veins on scrotum)

Infertility Treatments For Women

SurgeryHormone therapyDoucheOral

Contraceptives

Sperm Donation and Inauterine Insemination Doctor places donated sperm into a woman’s

reproductive tract, the cervix or uterus.

Catalogs can aid a couple in choosing the sperm from which their child may acquire certain characteristics, such as eye color, hair color, body type, intelligence, and interests.

Problems: Some sperm donors may develop genetic diseases later on life after they have already donated their sperm.

Donated Uterus and Surrogate Mother

The woman from a couple in a relationship may not have a uterus or she may not be able to maintain a pregnancy so a surrogate mother allows herself to be inseminated with the man’s sperm. She carries the child to term and gives it over to the couple, signing a statement of her intentions. She is paid for her help.

Donated Uterus and Surrogate Mother

Sometimes a surrogate mother may just lend her uterus to a couple’s already fertilized ovum. The woman of the couple may have healthy ovaries, but may not have a functional uterus. This kind of surrogate mother is just the gestational mother, not the genetic.

Problems: However, when the surrogate mother is not only the gestational mother, but also the genetic mother, at the end of the nine months, she may not want to give the baby up

In Vitro Fertilization

Sperm and oocyte join in a lab dish and are then placed in either the mother’s or surrogate mother’s uterus. The embryo, should, if everything goes as planned, implant itself to the uterine lining. It costs from $6,500 to 15,000 per attempt with the success rate being only 29%. IVF may be used if a woman’s fallopian tubes are blocked.

In Vitro FertilizationProblems: Children born from IVF have

twice the birth defects (9%) than children conceived by intercourse. This may in part mirror the parent’s medical issues. The success rate being 30%.

Intracytoplasmic Sperm Injection (ICSI) Sperm is microinjected into a female

cell. ICSI may be used if a man has a low sperm count, high percentages of abnormal sperm, and immature sperm. It can be more effective, its success rate being 30%.

Problems: ICSI may transmit infertility.

Gamete Intrafallopian

Transfer (GIFT)Some of a woman’s largest oocytes are

removed and a man’s most active cells are removed from his sperm sample. Together, the sperm cells and eggs are inserted in the woman’s fallopian tube, past the spot where it may be blocked. This technique has a 27% success rate and it costs less than IVF.

Zygote Intrafallopian Transfer (ZIFT)

An already fertilized egg is inserted into the woman’s fallopian tube and hopefully makes its way to the uterus. This method has a 29% success rate.

Problems: GIFT and ZIFT may not work

if a woman has scarred uterine tubes.

Oocyte Banking and DonationOocytes are frozen in nitrogen that is in

liquid form at -30 or -40 Celsius. This is done at metaphase or sometimes at the second meitotic division. Over 100 babies have been born from these frozen oocytes.

Oocyte Banking and DonationProblems: The oocyte may lose a

chromosome if the spindle (where the chromosomes are aligned), comes apart when the cell freezes. This could ruin development. By freezing oocytes, retention of polar bodies may lead to a diploid oocyte. However, these difficulties may be avoided if ovarian tissue is frozen, stored, thawed, then reimplanted in certain areas, such as under the skin of her forearm or abdomen or inside the pelvic cavity close to the ovaries. It is a useful tool for cancer patients.

DonationYounger women, many going through

IVF may donate their extra oocytes to older women seeking motherhood. The older woman then goes through IVF, GIFT, or ZIFT. Success is 20-50%.

Embryo AdoptionA couple whose female may have a

functioning uterus but unhealthy ovaries has another woman inseminated with the prospective father’s sperm. If the woman becomes pregnant, the embryo is flushed out gently a week later and inserted into the uterus of the woman with the unhealthy ovaries through the cervix. The embryo is genetically the child of the inseminated woman, but it is born from the hopeful mother of the couple.

Cytoplasm DonationCytoplasm from the oocytes of younger

women are injected into the oocytes of older women to rejuvenate them. However, the children resulting from this method are highly monitored because it is unknown as to what health problems they may receive from having two sources of mitochondria.

Preimplantation Genetic Diagnosis (PGD)This procedure finds any genetic or

chromosomal defects before pregnancy occurs. An early embryo is selected, one that has not yet “implanted” itself. One cell (blastomere) from an embryo with eight cells is removed. The cell gets karyotyped or its DNA is amplified. It then is probed for certain genes that the parents carry. Healthy embryos are then selected.

Preimplantation Genetic Diagnosis (PGD)The success rate is 97%. Inaccuracy occurs

when somatic mutation happens in the blastomere or during the DNA amplification. This method has chosen thousands of children that have escaped many different kinds of inherited diseases. It also helps the prevent the risk of miscarriages due to chromosomal abnormalities.

Problems: It may cause some ethical boundaries to be crossed when it is used for sex selection. As of now it is only supposed to be used to avoid passing on X-linked diseases.

• 1790 First inauterine insemination of humans

• 1953 Sperm can be frozen• 1978 First child born from IVF-Louise Joy

Brown• 1984 First child born from oocyte donation• 1989 First children born that had been

conceived after having the PGD procedure• 1992 First child born who’d had the PGD

procedure done to avoid a specific inherited disease

• 2002 First meeting between a child and their donor father

• 2004 First child born from fertilized oocyte from the reimplantation of ovarian tissue

Works Cited

http://66.139.74.160/kp3.sized.jpghttp://www.hollywoodjesus.com/movie/friends/Kudrow.jpghttp://www.srhs.org/oncology/images/

prostate/ProstateHormo.jpghttp://www.womensenews.org/images/ci/

birthcontrolpills.gifhttp://www.beaumontpressroom.com/

images/stock/cardiology/open%20_heart_%20surgery.jpg

Lewis Ricki. Human Genetics. McGraw Hill: Boston. 2007.