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    Embryo Transfer

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    Gerwyn Gervacio C
    Embryo transfer is the final step of in vitro fertilization where embryos created from eggs and sperm in a lab are placed into the uterus with the goal of establishing a pregnancy. It is a simple procedure done 2-3 days after fertilization using ultrasound guidance to carefully place 1-2 embryos into the uterine cavity. The first successful embryo transfers were in animals in the late 19th century, with human success in the 1980s and improving techniques since. Hormone preparations help ready the uterus to receive embryos, which have the highest chance of pregnancy the younger the woman. However, embryo implantation is complex and not all embryos result in babies.

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    Embryo Transfer

    Uploaded by

    Gerwyn Gervacio C
    244 views13 pages
    Embryo transfer is the final step of in vitro fertilization where embryos created from eggs and sperm in a lab are placed into the uterus with the goal of establishing a pregnancy. It is a simple procedure done 2-3 days after fertilization using ultrasound guidance to carefully place 1-2 embryos into the uterine cavity. The first successful embryo transfers were in animals in the late 19th century, with human success in the 1980s and improving techniques since. Hormone preparations help ready the uterus to receive embryos, which have the highest chance of pregnancy the younger the woman. However, embryo implantation is complex and not all embryos result in babies.

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    Embryo transfer is the final step of in vitro fertilization where embryos created from eggs and sperm in a lab are placed into the uterus with the goal of establishing a pregnancy. It is a simple procedure done 2-3 days after fertilization using ultrasound guidance to carefully place 1-2 embryos into the uterine cavity. The first successful embryo transfers were in animals in the late 19th century, with human success in the 1980s and improving techniques since. Hormone preparations help ready the uterus to receive embryos, which have the highest chance of pregnancy the younger the woman. However, embryo implantation is complex and not all embryos result in babies.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    244 views13 pages

    Embryo Transfer

    Uploaded by

    Gerwyn Gervacio C
    Embryo transfer is the final step of in vitro fertilization where embryos created from eggs and sperm in a lab are placed into the uterus with the goal of establishing a pregnancy. It is a simple procedure done 2-3 days after fertilization using ultrasound guidance to carefully place 1-2 embryos into the uterine cavity. The first successful embryo transfers were in animals in the late 19th century, with human success in the 1980s and improving techniques since. Hormone preparations help ready the uterus to receive embryos, which have the highest chance of pregnancy the younger the woman. However, embryo implantation is complex and not all embryos result in babies.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
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    The document discusses various concepts related to education and learning. It covers topics like curriculum development, teaching methods, assessment techniques and more.

    The main topics discussed include curriculum design, teaching approaches, assessment strategies, role of technology in education and challenges in the education system.

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    WHAT IS AN EMBRYO TRANSFER?


    Embryo transfer refers to a step in the process of assisted reproduction in which embryos are placed into the uterus of a female with the intent to establish a pregnancy. This technique (which is often used in connection with in vitro fertilization (IVF)), may be used in humans or in animals, in which situations the goals may vary. Embryo transfer is a simple procedure that follows in vitro fertilization(IVF) and is often considered the simplest and final step of the in vitro fertilization process. The objective of this procedure is to facilitate conception following fertilization from the in vitro fertilization procedure.

    In vitro fertilisation (IVF) is a process by which egg cells are fertilised by sperm outside the body. The term in vitro, from the Latin root meaning in glass, is used, because early biological experiments involving cultivation of tissues outside the living organism from which they came, were carried out in glass containers such as beakers, test tubes, or petri dishes.

    WHAT IS THE HISTORY OF EMBRYO TRANSFER?


    The first successful embryo transfer was performed in 1890 using rabbit embryos. The first bovine embryo was recovered by Hartman, Lewis, Miller and Swett in 1930 at the Carnegie Laboratory of Embryology in Baltimore. In the 1950s, embryo transfer technology in cattle expanded with the first successful transfer performed by Umbaugh and the first calf born through a joint effort by the USDA and the University of Wisconsin. Until the 1970's progress was slow, with many ideas ending in failure. As nonsurgical methods advanced through the efforts of Elsden, Hasler, Seidel and others, the commercial use of embryo transfer exploded. In 2002, over 25,000 ET calves were registered in the United States.


         

    TIMELINE OF EMBRYO TRANSFER


    1974 The first foal produced by embryo transfer was born (Japan) 2 1974 First report of successful superovulation of mares (Wisconsin) 1976 Long-distance transport of equine embryos first reported (England) 1982 Foal born following transfer of a frozen-thawed embryo (Japan) 1984 Production of twins following bisection of an equine embryo (Colorado) 1987 Technique for successful cooling of equine embryos reported (Colorado)
         

    1988 Birth of first foal following gamete intrafallopian transfer (Colorado) 1991 Birth of first foal produced by in vitro fertilization (France) 1996 First foal produced from intracytoplasmic sperm injection (Colorado) 2002 Report of 2 foals born following transfer of vitrified oocytes (Colorado) 2003 Birth of a mule foal produced by cloning (Idaho) 2003 Birth of first horse foal produced by cloning (Italy)

    FRESH VERSUS FROZEN


    Embryos can be either fresh from fertilized egg cells of the same menstrual cycle, or frozen, that is they have been generated in a preceding cycle and undergone embryo cryopreservation, and are thawed just prior to the transfer. The outcome from using cryopreserved embryos has uniformly been positive with no increase in birth defects or development abnormalities, also between fresh versus frozen eggs used for intracytoplasmic sperm injection (ICSI).

    UTERINE PREPARATION
    In the human, the uterine lining (endometrium) needs to be appropriately prepared so that the embryo(s) can implant. In a natural or stimulated cycle, the embryo transfer takes place in the luteal phase at a time where the lining is appropriately undeveloped in relation to the status of the present Luteinizing Hormone. In a cycle where a "frozen" embryo is transferred, the recipient woman could be given first estrogen preparations (about 2 weeks), then a combination of oestrogen and progesterone so that the lining becomes receptive for the embryo. The time of receptivity is the implantation window. Limited evidence also supports removal of cervical mucus before transfer.

    How does it work?


    Step 1. Two to three days after the eggs are fertilised, the best quality embryos are selected to be transferred to your womb. If you are under the age of 40, one or two embryos can be replaced. If you have good quality embryos, those that are not transferred can be frozen. Step 2. The doctor or nurse doing the embryo transfer inserts a speculum into your vagina. A fine tube (catheter) is passed through the cervix, normally using ultrasound guidance. The embryos are passed down the tube into the womb.

    There is good and consistent evidence of benefit in ultrasound guidance, that is, making an abdominal ultrasound to ensure correct placement, which is 12 cm from the uterine fundus. Anesthesia is generally not required. Single embryo transfers in particular require accuracy and precision in placement within the uterine cavity. The optimal target for embryo placement, known as the maximal implantation potential (MIP) point, is identified using 3D/4D ultrasound. After insertion of the catheter, the contents are expelled and the embryos are deposited.

    How

    does it work?

    After expulsion, the duration that the catheter remains inside the uterus has no effect on pregnancy rates. Limited evidence suggests avoiding negative pressure from the catheter after expulsion. After withdrawal, the catheter is handed to the embryologist, who inspects it for retained embryos. Step 3. It is generally recommended that you lead a gentle lifestyle during the few days after embryo transfer.

    Step 4. About two weeks after the embryo transfer, you will be given a pregnancy blood test. If it is positive, you will have a scan about two weeks later. In the process of zygote intrafallopian transfer (ZIFT), eggs are removed from the woman, fertilised, and then placed in the woman's fallopian tubes rather than the uterus.

    What medications may be given along with the procedure?


    The physician will assess individual situations and decide whether additional medications are needed. The patient may receive an injection of hCG after the embryo transfer to help the ovaries produce more progesterone during the embryonic implantation phase.

    In some cases, she may also be instructed to self-administer two additional hCG injections on specific days following the transfer.

    The embryo transfer completes the medical treatment in the IVF cycle and most clinics provide "luteal phase support" after the transfer , usually with estrogen tablets and progesterone suppositories, to increase the chances of implantation. However, this period is often the hardest part of an IVF cycle for the patient, because of the agony and suspense of waiting to find out if a pregnancy has occurred. This can be determined by a blood test , which measures the level of the hormone, HCG ( human chorionic gonadotropin) only 10 to 14 days after the transfer. For many patients, these 14 days are often the longest days of their life !

    It is normal to blame yourself for something you may or may not have done during this time if you do not conceive. Therefore, try not to do anything for which you will blame yourself if you do not get pregnant. In general the following guidelines are offered: No tub baths or swimming for 48 hours after replacement No douching or tampons No intercourse or orgasms until the fetal heartbeat is seen on ultrasound, or the pregnancy test is negative Do not undertake excessive physical activity such as jogging, aerobics, or tennis No heavy lifting You may return to "work" after 24 hours of bed rest (getting up for bathroom and meals only) and one to two days of light activity. It's safe to travel 2-3 days after the transfer.

    Why doesn't every embryo become a baby?

    The enigma of embryo implantation - why doesn't every embryo become a baby? While modern technology is very good at making embryos in the laboratory, we still cannot control the implantation process. Many patients who do not get pregnant after an embryo transfer start believing that their bodies are defective, and that they have "rejected" the embryo.

    They feel that if they failed to become pregnant even after the doctor transferred 3-4 good quality embryos, that they are flawed. However, you need to remember that embryo implantation is a very complex process, which consists of a series of phases in which the embryo has to appose and attach itself to the maternal endometrium and invade into it.

    What risks are

    What are my chances of getting there with pregnant after embryo transfer? embryo transfer?

    There are minimal risks with the embryo transfer procedure. The procedure is usually painless, although some women experience mild cramping.

    Female fertility diminishes with age, so if you are using your own eggs, on average, the younger you are, the higher your chances of success. In the year 2010 for women receiving stimulated IVF using fresh embryos created with their own eggs, the percentage of cycles reaching embryo transfer that resulted in a pregnancy (national average) was: 40.2% for women aged under 35 35.2% for women aged between 35-37 28.6% for women aged between 38-39 20.8% for women aged between 40-42 9.9% for women aged between 43-44 3.9% (0/81) for women aged 45 and over

    The Cost of IVF


    The cost of a single IVF treatment cycle in some clinic is US $ 4000. However, this costs varies from clinic to clinic, depending on the program and the items included in the fee. It is important to get an itemized listing from the selected program of what costs are included in the treatment cycle. Try to find your "total" medical cost - how much you will have to spend out of your own pocket for the entire treatment. Many clinics do not include the cost of certain procedures ( such as ultrasound scans) and these can then add up to quite a bit ! Other expenses to be aware of include time missed from work and travel and lodging expenses. The number of treatment cycles needed to achieve pregnancy will, of course, determine the final cost.

    Embryo transfer in animals


    Embryo transfer techniques allow top quality female livestock to have a greater influence on the genetic advancement of a herd or flock in much the same way that artificial insemination has allowed greater use of superior sires. ET also allows the continued use of animals such as competition mares to continue training and showing, while producing foals. Embryo transfer is also used in laboratory mice. For example, embryos of genetically modified strains that are difficult to breed or expensive to maintain may be stored frozen, and only thawed and implanted into a pseudopregnant dam when needed.

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