by mtoom


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What sorts of patients can IVF help? (4) *
  • Advanced reproductive age
  • Male infertility
  • Blocked/damaged tubes
  • Unexplained infertility
What sort of patients cannot be helped by IVF? (1)
Cannot fix implantation problems
When you do IVF you need to harvest some eggs. Medically, how do you induce lots of eggs?
Give FSH
When you induce eggs with FSH, you get lots of estradiol which causes LH spike and ovulation. Medically, how do you prevent ovulation?
  • How are eggs subsequently extracted? 
GnRH antagonist to prevent ovulation
  • Removed using transvaginal ultrasound needle biopsy
How to determine the FSH dose for ovarian hyperstimulation? (4) *
Trade-off between the following factors:
  • Patient's age
  • Day 3 FSH
  • Antral follicle count
  • BMI 
Selecting FSH dose is a trade-off between what two things?
Probability of pregnancy on the one hand, and ovarian hyperstimulation syndrome on the other.
Physiologically, the LH surge causes what three things in relation to the egg and ovulation?
  • Allows eggs to break free from wall and float in follicular fluid
  • Allows rupture of follicle and stretching of muscle fibres
  • Allows egg to mature (move to meiosis)
What is IVF?
Sperm fertilizing egg in glass dish
What is ICSI?
Sperm injected into cell
What is IUI?
Injecting semen into vagina or oviducts
Describe how embyro transfer is done?
  • What must the uterus have?
Embryos are injected into implantation site using a catheter
  • The uterus must have a corpus luteum that can be maintained hormonally 
How many embryos are put back into the patient during embryo transfer?
Depends on the patient's age
  • If 36, then 2
  • If 37-40, then 2-3
  • If >40, then 4-5 
Why does the number of embryos used to implant depend on the patient's age? *
Because increasing number of embryos are chromosomally abnormal at an older age
What method can preserve women's fertility?
  • Caveats? 
Freezing embryos
  • New technology, not easy and not cheap 
What are the general fertility options? (6)
  • Sperm donation
  • Egg donation
  • Single women
  • Gestational carrier
  • Surrogacy
  • Fertility preservation
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