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In Vitro Fertilisation - IVF

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Scarlett Rafferty

on 3 June 2014

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Transcript of In Vitro Fertilisation - IVF

In Vitro Fertilisation - IVF
What is IVF?
Why IVF?
Stages of IVF
In Vitro Fertilisation is more commonly known as IVF (NHS Online, 2014). 'In Vitro' means 'in glass' (Boyle, 2008).
IVF occurs when an egg is fertilised by a sperm outside of the body (Givens, 2001).

The technique was developed in the late 1970’s to help certain infertile couples (Givens, 2001).

IVF falls under the Assisted Reproduction Technology umbrella, also known as ART, which is a term used to describe a range of infertility treatments (Stoppard, 2000).

Female Infertility
Male Infertility
Blocked Fallopian tubes
Altered hormone levels, leading to a failure to ovulate or implant
Cervical mucus that halts, repels or kills sperm (Boyle, 2008)
A low sperm count. Samples that are found to have fewer than 20 million sperm are considered abnormally low (Boyle, 2008)
Production of large number of abnormal sperm. More than 4 per cent (Riess, 2001).
Production of antibodies that make the sperm stick together (Reiss, 2001)
"World's First Test Tube Baby"
Stage 1
Stage 2
Stage 3
Stage 4
For Men
Stage 5
Stage 6
Suppressing The Natural Monthly Hormone Cycle
A woman is given a drug that will suppress the natural hormone cycle (NHS Online, 30.05.2014).
This will be given as either a self-administrated daily injection, or a nasal spray (Human Fertilisation Embryology Authority Online, 30.05.2014).

2 weeks
Boosting The Egg Supply
After the natural monthly hormone is suppressed, the woman is given a hormone called Follicle Stimulating Hormone, FSH (NHS Online, 30.05.2014).

This hormone increases the number of eggs been produced, meaning more eggs can be fertilised. this gives a greater choice of embryos to use during treatment (HFEA Online, 30.05.2014).


12 days
Checking On Progress
Through out the drug treatment, the chosen clinic will monitor the ovaries by using a vaginal ultrasound (HFEA Online, 30.05.2014).

34-38 hours
before the eggs are due to be collected, a final hormone injection is administrated to help the eggs to mature (Boyle, 2008).
Collecting The Eggs
By using ultrasound guidance, the eggs are able to be collected (Stoppard, 2000).
The woman will be under sedation so that she does not feel anything (NHS Online, 30.05.2014).

A needle will be inserted through the vagina and into each ovary, where the eggs will be collected with the needle (HFEA Online, 30.05.2014).

Fertilising The Eggs
The eggs are mixed with either the partners sperm or a donors sperm in the laboratory for
16-20 hours
(Boyle, 2008).

The eggs that have been fertilised will grow in a laboratory incubator for
1-2 days
. The best embryos will be chosen for transfer (HFEA Online, 20.05.2014).

Medication, either progesterone or HCG, will be given to help prepare the lining of the womb for embryo transfer (NHS Online, 30.05.2014).
Embryo Transfer
The embryo transfer is done either
2-3 days
after egg collection or
5-6
days after egg collection (Stradder, 2000).

The process beguines by inserting a speculum into the vagina. A fine tube (catheter) is passed through the cervix, normally using ultrasound guidance. The embryos are passed down the tube and into the womb (HFEA Online, 31.05.2014).

The procedure is usually pain free (NHS Online, 31.05.2014).
If there are any embryos left over, and are suitable, they may be frozen for future IVF treatments (Boyle, 2008).
If the male partner is contributing his sperm for IVF, he will be asked to produce a fresh sample of sperm at the time the eggs are collected (Givens, 2001).

The sperm are washed and spun at a high speed, so the healthiest and most active sperm can be selected (NHS Online, 30.05.2014).

Donated sperm, it is removed from frozen storage, thawed and prepared in the same way (staddard, 2000).
Figure 3: Anon, n.d. Sperm Shape
Source: Advanced Fertility Services, 2013 [accessed 30.05.2014]
Figure 2: Anon, n.d. IVF Procedure
Source: IVF Infertility, 2013 [accessed 30.05.2014]

At 11.47pm on 25 July 1978, the world's first IVF baby was born at Oldham and District Hospital in Greater Manchester. Her name was Louise Joy Brown and she weighed 5lb 12oz (Britannica Online, 31.05.2014).

Her parents became the first to successfully undergo IVF (The Independent News Online, 31.05.2014).
Louise Brown
Statistics
(Human Fertilisation Embryology Authority Online, 31.05.2014)
How Many Women Have IVF Treatment?
48,147 women had IVF treatment in 2011 (Human Fertilisation Embryology Authority, 31.05.2014).
How Successful is IVF Treatment?
The latest figures (2010) show that 25.6% of IVF treatments using a woman's own fresh eggs resulted in a live birth (Human Fertilisation Embryology Authority, 31.05.2014).
How Many Twins or Triplets are Born Following IVF Treatment?
In 2008 23.6% of fresh and frozen IVF cycles resulted in a multiple birth, but since then clinics have been working hard to reduce this number. Data for the first half of 2009 show the figure dropped to 22.0% (Human Fertilisation Embryology Authority, 31.05.2014).
Percentage of Births Resulting From IVF?
Around 2% of babies born in the UK are conceived by IVF (Human Fertilisation Embryology Authority, 31.05.2014).
If a woman's fallopian tubes are damaged
In cases of server endometriosis
Immune problems
Older women who have deteriorating egg production
(Staddard, 2000)
A couple may choose IVF as one of them are infertile:
Figure 4: Anon. n,d. Louise Brown
Source: Daily Planet, 2013 [accessed 31.05.2014]
Figure 5: Anon. n,d. Louise Brown
Source: ITV UK, 2013 [accessed 31.05.2014]
Her birth attracted controversy at the time.
Religious leaders expressed concern over the use of a
rtificial intervention
and some raised fears that science was creating babies who could experience medical difficulties later in life (BBC News Online, 31.05.2014).
Injection location is either the thigh, abdomen or upper arm (Boyle, 2008).
A study by the International Committee for Monitoring Assisted Reproductive Technology estimated that over three million IVF babies were born around the world between 1978 and 2006 (Boyle, 2008).
Robert Edwards (1925-2013)
Edwards was a british medical researcher who developed the technique of In-Vitro Fertilization (IVF) (Britannica Online, 31.05.2014).

Edwards, together with British gynecologist Patrick Steptoe, were able to produce the first live baby born from IVF in 1978 (BBC News Online, 30.05.2014).

Edwards was awarded the 2010 Nobel Prize for Physiology or Medicine for his discoveries (Britannica Online, 31.05.2014).



Figure 1: Anon. n,d. Robert Edwards, 2014
Source: Bourn Hall Clinic [accessed 30.05.2014].
Cost
IVF treatment varies across the country and often depends on local CCG policies (NHS Online, 01.05.2014).
Priority is often given to couples who can not have children and/or don't already have children (Starddard, 2001).
If a couple is not eligible for NHS funding there is the option of approaching a private fertility clinic directly (NHS Online, 01.06.2014).
On average, one cycle of IVF costs about
£5000
(HFEA Online, 01.06.2014).
If a couple is thinking about going overseas to receive treatment the safety and the standards of care received may not be at the same standards as in the UK (HFEA Online, 01.06.2014).
Clinics in other countries may or may not be regulated to local standards and regulations (BBC New Online, 01.06.2014).
The London Woman's Clinic
Price List
Figure 6:Anon. n,d. Price List
Source: The London Woman's Clinic [accessed 01.06.2014]
By Scarlett Rafferty
Full transcript