Fertilization

An act or process of making fertile

An act or process of fecundation, insemination, or pollination
The process of two gametes where by the somatic chromosomes
number restorenand development of new individual is initiated.

Fertilization of human egg

The sperm release enzymes that help disperse the corona radiate

Reproductive process in which a male sex cell(sperm unites with a female sex cell.
During the process , the chromosomes of the egg and sperm will merge to form a
zygote, which will divide to form an embryo. In humans sperms travel from will
merge to form the vagina through the uterus to fallopian tube, where they surround
an egg release from an ovary usually two or three days earlier. Once one sperm has
fused with the egg cell membrane the outer layer becomes impenetrable to other
sperm.
A sperm fertilizing an ovum
When semen is release into vagina the spermatozoa travel through the cervix and
body of the uterus and into fallopian tubes. fertilization of the egg cell (ovum)
,usually takes places in one of the fallopian tubes. Many sperm are release with the
possibility of just one sperm cell managing to adhere to and enter the thick
protective shell-like layer surrounding the ovum. The first sperm that penetrates
fully into the egg donates its genetics materials (DNA). The egg then polarizes ,
repelling any additional sperm. The resulting combination is called a zygote, a new
and genetically unique organism. The term conception refers variably to either
fertilization or to formation of the conceptus after its implantation in the uterus and
this terminology is controversial.
Prior to fertilization each ovum ,as gametes contains half of the genetic material
that will fuse with the male gamete, which carries the other half of the genetic
material(DNA). The ovum only carries the x female sex chromosomes whilst the
sperm carries a single sex chromosomes of either an X or a male Y chromosomes.
The resulting human zygote is similar to the majority of somatic cells because it
contains two copies of the genome in a diploid set of chromosomes. One set
chromosomes came from the nucleus of the ovum and the second set from the
nucleus of the sperm.
The zygote is male if the egg is fertilized by a sperm that carries a Y chromosomes
and it is female if the egg is fertilized by a sperm that carries an X chromosomes.
The Y chromosomes contains a gene SRY which will switch on androgen production
at a later stage,leading to development of male body type. In contrast ,the

mitochondrial genetic information of the zygote comes entirely from the mother via
the ovum.
The process of prenatal development occurs in three main stages. The first two weeks after conception
are known as the germinal stage; the third through the eighth week are known as the embryonic
period; and the time from the ninth week until birth is known as the fetal period.
The Germinal Stage
The germinal stage begins with conception, when the sperm and egg cell unite in one of the two
fallopian tubes. The fertilized egg, known as a zygote, then moves toward the uterus, a journey that
can take up to a week to complete. Cell division begins approximately 24 to 36 hours after conception.
Within just a few hours after conception, the singe-celled zygote begins making a journey down the
fallopian tube to the uterus where it will begin the process of cell division and growth. The zygote first
divides into two cells, then into four, eight, sixteen, and so on. Once the eight cell point has been
reached, the cells begin to differentiate and take on certain characteristics that will determine the type
of cells they will eventually become. As the cells multiply, they will also separate into two distinctive
masses: the outer cells will eventually become the placenta while the inner cells will form the embryo.
Cell division continues at a rapid rate and the cells then develop into what is known as a blastocyst.
The blastocyst is made up of three laters:
1.
2.
3.

The ectoderm (which will become the skin and nervous system)
The endoderm (which will become the digestive and respiratory systems)
The mesoderm (which will become the muscle and skeletal systems).

Finally, the blastocyst arrives at the uterus and attached to the uterine wall, a process known
as implantation.
Implantation occurs when the cells nestle into the uterine lining and rupture tiny blood vessels. The
connective web of blood vessels and membranes that forms between them will provide nourishment
for the developing being for the next nine months. Implantation is not always an automatic and surefire process. Researchers estimate that approximately 58 percent of all natural conceptions never
become properly implanted in the uterus, which results in the new life ending before the mother is
ever aware she is pregnant.
When implantation is successful, hormonal changes halt a womans normal menstrual cycle and cause
a whole host of physical changes. For some women, activities they previously enjoyed such as
smoking and drinking alcohol or coffee may become less palatable, possibly part of natures way of
protecting the growing life inside her.
The Embryonic Stage

The mass of cells is now know as and embryo. The beginning of the third week after conception
marks the start of the embryonic period, a time when the mass of cells becomes a distinct human
being. The embryo begins to divide into three layers each of which will become an important body
system. Approximately 22 days after conception, the neural tube forms. This tube will later develop
into the central nervous system including the spinal cord and brain.
Around the fourth week, the head begins to form quickly followed by the eyes, nose, ears, and mouth.
The cardiovascular system is where the earliest activity begins as the blood vessel that will become
the heart start to pulse. During the fifth week, buds that will form the arms and legs appear.

By the time the eight week of development has been reached, the embryo has all of the basic
organs and parts except those of the sex organs. It even has knees and elbows! At this point,
the embryo weight just one gram and is about one inch in length.

Week 3: Beginning development of the brain, heart, blood cells, circulatory

system, spinal cord, and digestive system.

Week 4: Beginning development of bones, facial structures, and limbs (presence

of arm and leg buds); continuing development of the heart (which begins to beat),
brain, and nervous tissue.

Week 5: Beginning development of eyes, nose, kidneys, lungs; continuing

development of the heart (formation of valves), brain, nervous tissue, and
digestive tract.

Week 6: Beginning development of hands, feet, and digits; continuing

development of brain, heart, and circulation system.

Week 7: Beginning development of hair follicles, nipples, eyelids, and sex organs
(testes or ovaries); first formation of urine in the kidneys and first evidence of
brain waves.

Week 8: Facial features more distinct, internal organs well developed, the brain
can signal for muscles to move, heart development ends, external sex organs
begin to form.

By the end of the embryonic stage, all essential external and internal structures have
been formed. The embryo is now referred to as a fetus.
The Fetal Stage
Once cell differentiation is mostly complete, the embryo enters the next stage and becomes known as
a fetus. This period of develop begins during the ninth week and lasts until birth. The early body
systems and structures established in the embryonic stage continue to develop. The neural tube
develops into the brain and spinal cord and neurons form. Sex organs begin to appear during the third
month of gestation. The fetus continues to grow in both weight and length, although the majority of
the physical growth occurs in the later stages of pregnancy.
This stage of prenatal development lasts the longest and is marked by amazing change and growth.
During the third month of gestation, the sex organs begin to differentiate and by the end of the month
all parts of the body will be formed. At this point, the fetus weight around three ounces.

Weeks 912: The fetus reaches approximately 8 cm. (3.2 in.) in length; the head is
approximately half the size of the fetus. External features such as the face, neck, eyelids, limbs,
digits, and genitals are well formed. The beginnings of teeth appear, and red blood cells begin to
be produced in the liver. The fetus is able to make a fist.
Weeks 1315: The fetus reaches approximately 15 cm. (6 in.) in length. Fine hair called
lanugo first develops on the head; structures such as the lungs, sweat glands, muscles, and bones
continue to develop. The fetus is able to swallow and make sucking motions.
Weeks 1620: The fetus reaches approximately 20 cm. (8 in.) in length. Lanugo begins to
cover all skin surfaces, and fat begins to develop under the skin. Features such as finger and
toenails, eyebrows, and eyelashes appear. The fetus becomes more active, and the mother can
sometimes begin to feel fetal movements at this stage.
Weeks 2124: The fetus reaches approximately 28.5 cm. (11.2 in.) in length and weighs
approximately 0.7 kg (1 lb. 10 oz.). Hair grows longer on the head, and the eyebrows and eye
lashes finish forming. The lungs continue to develop with the formation of air sac (alveoli); the
eyes finish developing. A startle reflex develops at this time.
Weeks 2528: The fetus reaches approximately 38 cm. (15 in.) in length and weighs
approximately 1.2 kg (2 lb. 11 oz.). The next few weeks mark a period of rapid brain and nervous
system development. The fetus gains greater control over movements such as opening and
closing eyelids and certain body functions. The lungs have developed sufficiently that air
breathing is possible.
Weeks 2932: The fetus reaches approximately 3843 cm. (1517 in.) in length and weighs
approximately 2 kg (4 lb. 6 oz.). Fat deposits become more pronounced under the skin. The lungs
remain immature but breathing movements begin. The fetus's bones are developed but not yet
hardened.
Weeks 3336: The fetus reaches approximately 4148 cm. (1619 in.) in length and weighs
2.63.0 kg (5 lb. 12 oz. to 6 lb. 12 oz.). Body fat continues to increase, lanugo begins to
disappear, and fingernails are fully grown. The fetus has gained a high degree of control over
body functions.

 Weeks 3638: The fetus reaches 4853 cm. (1921 in.) in length is considered to be full-term
by the end of this period. Lanugo has mostly disappeared and is replaced with thicker hair on the
head. Fingernails have grown past the tips of the fingers. In a healthy fetus, all organ systems are
functioning.

The end of the third month also marks the end of the first trimester of pregnancy. During the second
trimester, or months four through six, the heartbeat grows stronger and other body systems become
further developed. Fingernails, hair, eyelashes and toenails form. Perhaps most noticeably, the fetus
increases quite dramatically in size, increasing about six times in size. The brain and central nervous
system also become responsive during the second trimester. Around 28 weeks, the brain starts to
mature much faster with activity that greatly resembles that of a sleeping newborn.
During period from seven months until birth, the fetus continues to develop, put on weight, and
prepare for life outside the womb. The lungs begin to expand and contract, preparing the muscles for
breathing.
While prenatal development usually follows this normal pattern, there are times when problems or
deviations occur.

Common problems
Although 90 percent of babies born in the United States are considered healthy,
abnormalities may arise during prenatal development that are considered congenital
(inherited or due to a genetic abnormality) or environmental (such as material derived
abnormalities). In other cases, problems may arise when a fetus is born prematurely.

Congenital abnormalities
In some cases abnormalities may arise during prenatal development that cause physical
malformations or developmental delays or affect various parts of the body after the child
is born. The cause may be a small mutation in or damage to the genetic material of cells,
or a major chromosomal abnormality (each normal cell has two copies each of 23
strands [called chromosomes] of genetic material, and abnormalities can arise if there
are three copies of a strand or only one). Sometimes the abnormality is inherited from
one or both parents; in other cases, the defect occurs because of an error in prenatal
development.

Some abnormalities are minor and do not affect the long-term prognosis once the child
is born. At the other end of the spectrum, abnormalities may be so severe that fetal
demise is inevitable. Approximately 10 to 15 percent of pregnancies end before the
twentieth week, a process called miscarriage or spontaneous abortion; congenital
abnormalities account for a significant proportion of miscarriages. Genetic
abnormalities account for approximately 5 percent of miscarriages.

Maternal derived abnormalities

The age, health status, nutritional status, and environment of the mother are all closely
tied to the health of a growing embryo or fetus. Some examples of environmental factors
that may lead to developmental abnormalities include:

Age: As of 2004, research showed that babies born to mothers between the ages of
seventeen and thirty-five tend to be healthier. One reason is that the risk of certain
congenital abnormalities such as Down syndrome increases with mother's age
(particularly mothers over forty). Another reason is that the risk of having pregnancy or
birth complications is greater with women over the age of thirty-five.

Health status: In some cases a mother may pass a viral or bacterial infection to the fetus,
such as in human immunodeficiency virus (HIV). In other cases, a mother's illness
may cause congenital malformations; an example is rubella , which can cause heart
defects, deafness, developmental delays, and other problems in a fetus if the mother
contracts it during pregnancy.

Nutritional status: A well-balanced diet rich in nutrients such as folic acid , calcium,
iron, zinc, vitamin D, and the B vitamins is recommended for pregnant women. Certain
vitamin and mineral deficiencies can interfere with normal prenatal development. For
example, a deficiency in folic acid during the early stages of pregnancy may lead to
neural tube defects such as spina bifida . Mothers are recommended to eat

approximately 300 additional calories a day (above and beyond a normal non-pregnancy
diet) to support the fetus's growth and development.

Other environmental factors: Exposure to certain substances called teratogens (agents

that may interfere with prenatal development) during pregnancy may cause embryonic
or fetal malformations. Examples of teratogens include alcohol, thalidomide, cocaine,
certain seizure medications, diethylstilbestrol (DES), and the anti-acne drug Accutane.

Prematurity
Advances in medical care have made it possible for many infants born prematurely to
survive and develop normally. The earlier the gestational age, the greater the chance of
death or significant medical problems. Whether or not a premature infant will survive is
intimately tied to his or her gestational age:

21 weeks or less: 0 percent survival rate

22 weeks: 010 percent survival rate

23 weeks: 1035 percent survival rate

24 weeks: 4070 percent survival rate

25 weeks: 5080 percent survival rate

26 weeks: 8090 percent survival rate

27 weeks: greater than 90 percent survival rate

Parental concerns
Many parents have questions or concerns about the prenatal development of an existing
or anticipated child and what steps they should take to ensure their child's health.
During prenatal visits to an obstetrician, a pregnant mother should be educated in
proper nutrition and prenatal care; often, prenatal vitamins are prescribed to avoid
nutritional deficiencies. Prenatal testing is often recommended to parents-to-be as a

means of assessing the fetus's health and the risk of developing certain conditions. Some
common prenatal tests that relate to prenatal development are as follows:

blood tests to check for diseases that could affect the fetus, such as HIV, hepatitis B , or
other sexually transmitted diseases

blood tests to check if the mother carries a protein called Rh factor on her red blood
cells; if she does not and her baby does (determined by whether the father is Rh-positive
or not), she will require treatment to prevent a potentially damaging reaction to the baby

chorionic villus sampling, a prenatal test that takes a tiny sample of the placenta with a
needle to test for chromosomal abnormalities

nuchal fold or nuchal translucency screening test, which measures a small space at the
back of the fetus's neck using ultrasound; fetuses with larger nuchal folds have a greater
risk of having a chromosomal abnormality

amniocentesis, a test that takes a sample of the fluid that surrounds the fetus in the
uterus to identify certain genetic disorders, congenital malformations, or the maturity of
the fetus's lungs

TYPES OF BIRTH
VAGINAL DELIVERY
When you arrive, you'll be assessed to be sure you are in active labor. If so, you and your partner
will be escorted to one of our childbirth suites where you will labor and deliver your baby. You can
play your music, dim the lights, use a warm water labor tub, shower -- enjoy your experience. Our
labor nurses will be there for you, to coach and provide as much, or as little, support as you desire.
Most women decide in advance whether to have an epidural, or to experience labor naturally without
pain medication. Some women elect to see how labor is going before making their
decision. Whichever you decide, our staff is here to help you achieve your birth preference.
If you choose to have an epidural, we will administer it when youre ready. Our anesthesiologists and
anesthetists are on-site and available, 24 hours a day, 7 days a week. If you chose to deliver without
pain medication, we will support your decision. We do this because you and your baby are the
center of our world.

NATURAL CHILDBIRTH
It Starts with Your Natural Childbirth Class

Sign up for our four-week series to prepare for your natural childbirth. Taught at MoBap by
experienced doulas/nurses, these classes will teach you about the natural birth process and give
you techniques to manage your labor. Many couples choose to take our advanced skills workshop,
specially designed for couples looking to practice different labor management techniques.
Labor Nurse Doula Friendly
When you arrive at the Childbirth Center, youll find our staff well versed in natural childbirth
techniques. Our nurses love to assist in natural deliveries, and will be with you for as much or as
little time as you need during labor, and of course, through the delivery.
If you have chosen to engage a doula to assist you with your birth, please know that our nursing staff
welcomes doulas and will work with them to optimize your birth experience.
Freedom of Movement
Position changes are very helpful during natural childbirth, often providing additional comfort.
Therefore, we encourage and support your ability to move around freely whether its walking the
halls, changing positions, rocking on a birthing ball or using a squat bar. We also offer intermittent
fetal monitoring or telemetry monitoring to allow for greater freedom of movement (if the
circumstances of your labor and delivery permit). We have a number of options to support your
preference for position changes.

Labor & Delivery Suites Designed for your Comfort

Our labor and delivery rooms were specially-designed to provide a peaceful, comfortable
environment. You may bring your own music to help with relaxation. You may also choose to wear
your own clothing or gown during labor.

Hydrotherapy Options
For natural childbirth experiences, water can be very helpful during labor. Each room has a shower
with a seat and detachable shower head. You can also reserve a birth tub for immersion
hydrotherapy during labor.
Skin-to-Skin Contact and Mother-Baby Bonding
We encourage mother-baby bonding throughout your stay at the hospital. After delivery, if your baby
is doing well, she will be placed directly on your chest to jump-start the bonding process. This skinto-skin contact will also help keep baby warm and secure. You also may choose to start
breastfeeding at this time.
Early Assessment & Apgar Scoring
Early assessments and Apgar scoring can be done while your baby is in your arms. Routine
procedures, such as weight and measurements, can be delayed to allow additional bonding time
after birth, and for the initial feeding. Weighing, assessing and bathing your baby will take place in
the labor and delivery room to avoid separating you and your baby.

After your birth, youll be moved to our Mother-Baby wing. Here the nurses are especially trained to
care for both you and your baby. We offer 24-hour rooming in, so that you and your partner can stay
together while bonding with your baby. Nap time signs are available so that you and baby can rest
together, undisturbed, day or night.
We follow the mother-baby philosophy when it comes to caring for our new moms and babies. This
means the same nurse who takes care of you also takes care of your newborn, providing you with
uninhibited, 24/7 access to your baby. We know its the little things that can make the biggest
difference. Our mother-baby nurses pay attention to the needs of each new mom, taking the time to
listen and offer their unconditional support.

SCHEDULED CESAREAN DELIVERY

If you are scheduled for a cesarean delivery (c-section), you will first be admitted to a birth suite.
There, your labor and delivery nurse will complete your admission history and assess you and your
baby. To prepare you for the c-section, your nurse will assist you with an antibacterial wipe and clip
the hair from just below the belly button to the pubic area.
Also, an anesthesia provider will visit you to discuss your anesthesia options. Cesarean births are
usually done with spinal anesthesia, which means you will be awake and alert when your baby is
born. If you are having a spinal, it will be placed in the operating suite prior to the start of the
cesarean section. After you receive your spinal, your nurse will place a catheter (a thin flexible tube)
into your bladder to keep it empty, and place compression stockings on your legs to help prevent
blood clots. Your baby will be born within the first few minutes of the cesarean section, and will be
dried and warmed, all within your sight. Your partner can be with you throughout the cesarean, and
can take plenty of pictures of your beautiful new baby. At the completion of the cesarean, your baby
will be placed in your arms, or skin to skin if you wish, as you move, together as a new family, into
recovery.

UNPLANNED CESAREAN DELIVERY

Sometimes, circumstances of labor and delivery change, and cesarean birth becomes necessary for
the health and safety of mom and /or baby. Your physician and health care team will explain the
indication for cesarean and help prepare you for the procedure. At MoBap, we are committed to
cesarean birth being a family-friendly experience, as you celebrate welcoming your baby into the
world.
Your labor nurse will help you remove any jewelry, clip the hair from your belly button to your pubic
bone, and clean your skin with an anti-bacterial wipe. Your anesthesia provider will meet with you
prior to moving to the cesarean suite to discuss pain management. If you already have an epidural
for labor, it can be dosed more heavily to keep you comfortable throughout your cesarean birth. If
you do not have anesthesia in labor, a spinal anesthetic can be placed in the cesarean birth suite. In
the event of an emergency, the decision may be made to use general anesthesia (put you to sleep).
Rest assured that emergencies, while occurring in only 1% of births, are handled with skill and
speed.
Your partner will be given special clothes to wear to accompany you to the cesarean suite. You can
bring your camera and you baby book for footprints. Your baby will be dried and warmed, all within
your sight, and given to you and your partner as soon as possible. At the completion of your
cesarean, your baby will be placed in your arms, or skin to skin if you wish, as you move, together as
a family, to recovery.

Vaginal Birth after C-Section (VBAC)

If you previously had a C-section and desire to experience a vaginal birth, you may be eligible for a
VBAC (vaginal birth after cesarean) with your next pregnancy.
VBACs at MoBaps Childbirth Center
At MoBap, we have a number of obstetricians who regularly manage VBACs for their maternity
patients. In fact, we are one of the few St. Louis hospitals to advocate VBACs when appropriate.
Thats because our obstetricians are backed by a team experienced in VBAC deliveries, including
trained nurses, 24/7 anesthesiologists and other medical specialists. We take pride in being able to
offer this delivery option to our patients. After all, our goal is to help you experience delivery in a way
thats right for you.
For more information about VBAC and other labor and delivery options available at Missouri Baptist,
call (314) 996-5751 or email us.
Why consider a VBAC?
According to the American College of Obstetricians and Gynecologists, a VBAC is a safe, suitable
choice for most women who have had one prior cesarean.
A VBAC offers a number of advantages compared to a repeat C-section, including:

Fewer complications, including a reduced risk for infection and less blood loss

Shorter recovery time and hospital stay

Greater participation in the birth process, including holding and breastfeeding your baby
sooner than if you undergo a repeat C-section

Impact on future pregnancies, particularly if youre planning to have a large family. Repeat Csections get more complicated each time, while repeat VBACs tend to become progressively
easier.

Are you a candidate for a VBAC?

In order to be considered for a VBAC, you should meet the following criteria:

Have undergone only one prior low transverse uterine incision (C-section) with no other
uterine incisions

Currently experiencing a healthy and problem-free pregnancy. More importantly, the reason
your previous child was delivered by C-section is not a factor with this pregnancy.

It is preferable that labor begins naturally on or before your due date

Of course, every case is different; therefore, you must consult with your obstetrician to determine is
VBAC is an appropriate option for you.
Finding a supportive OB/GYN and Hospital
For many women, the greatest obstacle to having a VBAC is finding an obstetrician andhospital that
support this type of delivery. According to a 2006 national survey, 57 percent of women interested in
VBACs were unable to find a supportive care provider or hospital.

SCHEDULED INDUCTION
If you have gone past your due date or you and your baby are ready, your doctor may schedule you
for an induction, where you will be given medication to start your labor. On the day of your induction,
you are admitted to a birth suite, where your doctor and nurses will administer an IV and connect
you to a fetal heart monitor. Then, they will add Pitocin a labor-inducing hormone into your IV.
Your contractions will begin shortly thereafter, increasing gradually until you are in active labor.
Note that unless medically necessary for your health or your baby's health, inductions are not done
prior to your 39th week of pregnancy. We follow this policy at MoBap (also recommended by
the American Congress of Obstetricians and Gynecologists) for the health of your baby.