Assisted reproductive technologies

What are some indications for ART?

- Unexplained infertility but during the ART
the reason CAN be found.
- Male factors sperm and ejaculation
- Female factors tubal disease,
endometriosis, cervical factor, PCOS
- Egg donation
- Sperm donation
- Surrogacy
- Pre-implantation genetic diagnosis
- Combination of factors
Cholesterol factors
Hormone factors
General treatment protocols
Recruit follicles egg collection 8-15 eggs is good.
Quality eggs.
Patient can get sick from follicle stimulation drugs.
Know how to draw this

Sperm has to be swimming in the right direction

DNA fragmentation generally can repair DNA
damage by females. Smokers will cause more DNA
fragmentation.
Drugs used in ovarian stimulation

Pill can control the cycle.

DHEA weak testosterone (pretestosterone)
Steroids remove the natural killer cells. Risk of
cleft pallet
Case study
Old men and young women
Vasectomy reverse the procedure (15 years, is
quite long may not be done). Testicular sperm
aspiration. Sperm donation

BMI with treatment?

Over 35 = needs to be healthy first before
treatment.
AMH What is it used for?
Antimullerian hormone follicle reserve.
Important to determine DOSE before going on
treatment.
Whats tested in the sperm?

ICSI
Needle inside embryo.
Embryo development
DAY1 look at fertilisation
Grow embryos to day 5
Pick the best embryo, the person still running =
the best one to pick up
Embryo transfer = the hardest part. Embryo
implantation. Endometrium problem or embryo
problem.
Ovarian hyperstimulation syndrome
Complication of ovarian stimulation. Varying
degrees of severity. Ascites

Treatment is symptomatic
Multiple pregnancy
American is more expensive = put more embryos
back.
Egg freezing
2015 lecture finished here.