Η παρουσίαση μου περιλαμβάνει μια εισαγωγή από κάποιες βασικές έννοιες των πραγματικών αριθμών, αλγεβρικές παραστάσεις και πολυώνυμα, εξισώσεις και ανισώσεις 1ου και 2ου βαθμού (μαζί φυσικά με τους τρόπους επίλυσης αυτών) και συναρτήσεις.
This document discusses comprehensive chromosomal screening at the blastocyst stage using comparative genomic hybridization (CGH). CGH allows testing of all chromosomes and avoids issues with mosaicism seen at earlier stages. Clinical results showed high pregnancy and birth rates even in older patients when euploid embryos were transferred, though pregnancy rates per cycle declined with age as more patients had only aneuploid embryos. While screening improved outcomes, age still reduced pregnancy chances due to increased aneuploidy frequency. Further randomized trials are needed to validate the approach.
The document discusses various aspects of embryo transfer techniques in IVF. It describes the typical steps, including selection of the best embryos for transfer. It notes that factors like the transferring physician's skill, catheter type, trial embryo transfer accuracy, ultrasound guidance, and uterine contractions can influence the success of embryo transfer. Research studies are summarized that found around 30% of patients had a uterine measurement discrepancy between trial transfer and ultrasound-guided transfer, and soft catheters were associated with higher pregnancy rates than firm catheters.
Η παρουσίαση μου περιλαμβάνει μια εισαγωγή από κάποιες βασικές έννοιες των πραγματικών αριθμών, αλγεβρικές παραστάσεις και πολυώνυμα, εξισώσεις και ανισώσεις 1ου και 2ου βαθμού (μαζί φυσικά με τους τρόπους επίλυσης αυτών) και συναρτήσεις.
This document discusses comprehensive chromosomal screening at the blastocyst stage using comparative genomic hybridization (CGH). CGH allows testing of all chromosomes and avoids issues with mosaicism seen at earlier stages. Clinical results showed high pregnancy and birth rates even in older patients when euploid embryos were transferred, though pregnancy rates per cycle declined with age as more patients had only aneuploid embryos. While screening improved outcomes, age still reduced pregnancy chances due to increased aneuploidy frequency. Further randomized trials are needed to validate the approach.
The document discusses various aspects of embryo transfer techniques in IVF. It describes the typical steps, including selection of the best embryos for transfer. It notes that factors like the transferring physician's skill, catheter type, trial embryo transfer accuracy, ultrasound guidance, and uterine contractions can influence the success of embryo transfer. Research studies are summarized that found around 30% of patients had a uterine measurement discrepancy between trial transfer and ultrasound-guided transfer, and soft catheters were associated with higher pregnancy rates than firm catheters.
1) A couple underwent preimplantation genetic diagnosis (PGD) for Dyskeratosis Congenita caused by a mutation in the RTEL1 gene, as they previously had an affected child.
2) Conventional PGD using short tandem repeat (STR) markers near the gene found high rates of allele drop out and no results for some embryos.
3) Reanalysis using quantitative PCR (qPCR) of single nucleotide polymorphisms (SNPs) closer to the mutation found the STR-based method misdiagnosed 21% of embryos due to undetected recombinations between the STRs and mutation.
4) qPCR allowed simultaneous analysis of multiple linked SNPs and the mutation, avoiding
This document summarizes pre-implantation genetic diagnosis (PGD) in the UK. PGD, used with in vitro fertilization, allows families with a history of genetic disorders to select embryos unaffected by the condition. The number and types of conditions authorized for PGD has increased over time. There is debate around authorizing PGD for conditions with later onset or those that reduce quality of life rather than being life-threatening. The process involves IVF, testing embryos for genetic conditions, and transferring unaffected embryos into the womb.
This document discusses the application of next-generation sequencing (NGS) technologies to preimplantation genetic diagnosis (PGD). It provides a brief history of PGD and explains the use of NGS-based PGD to detect chromosomal abnormalities in embryos before implantation. The document outlines the PGD workflow using NGS, which involves sequencing embryos and analyzing the data using hidden Markov models and other statistical methods to determine ploidy status and identify chromosomal abnormalities. Benefits of NGS-based PGD include lower costs relative to array-based methods and the ability to assess more embryos.
Dr. irene souter pgd stickler foundation (5)t7260678
This document discusses preimplantation genetic diagnosis (PGD), which involves biopsy of a single cell from each embryo followed by genetic analysis to identify normal embryos for implantation. PGD is offered to couples at risk of passing on genetic disorders, chromosomal issues, or with recurrent pregnancy loss. The process involves ovarian stimulation, egg retrieval, fertilization, embryo biopsy on day 3, genetic analysis, and embryo transfer. Common indications for PGD include single gene disorders, translocations, aneuploidy screening, and HLA matching. While mistakes can occur, studies show delivery outcomes and malformation rates are similar to ICSI. PGD has allowed many to have healthy children who would otherwise be at high risk of genetic conditions.
This document discusses the use of time-lapse imaging to quantify the exact timing of cell divisions during embryo development. It notes that conventional grading may miss subtle differences between embryos, but time-lapse allows for collection of data on individual embryos over time. This provides precise definitions of timing checkpoints from fertilization to the blastocyst stage.
This document discusses preimplantation genetic diagnosis (PGD), which involves in vitro fertilization combined with genetic testing of embryos to select embryos without specific genetic defects or diseases. It notes that PGD requires expertise across fertility medicine, genetics, embryology and molecular analysis. While PGD can reduce health risks for offspring and minimize inheritance of disabilities, children conceived through assisted reproductive technologies like IVF may have a slightly higher risk of birth defects. The use of PGD is increasing for conditions like single gene disorders but it has limitations such as mosaicism and laboratory errors. Guidelines and laws regulate the application of PGD and prohibit its use for non-medical sex selection.
Endometrial infusion of human chorionic gonadotropint7260678
This randomized controlled trial sought to determine if endometrial infusion of 500 IU of human chorionic gonadotropin (hCG) diluted in embryo transfer media less than 3 minutes before blastocyst embryo transfer would impact implantation and pregnancy rates. 300 infertile couples undergoing fresh or frozen embryo transfer of one or two blastocysts were randomly assigned to receive either hCG infusion or a sham infusion of media only. There were no significant differences found between the groups in the primary outcome of sustained implantation rate per embryo (48.1% in the hCG group vs 44.2% in the control group) or the secondary outcome of ongoing pregnancy rate per transfer (58.8% vs 52.0%). The study
This document discusses next generation sequencing (NGS) and its applications in preimplantation genetic diagnosis (PGD). It describes how NGS can simultaneously detect chromosome abnormalities and gene defects in single cells. Studies show NGS has the same accuracy as array comparative genomic hybridization for detecting aneuploidy, and can also detect mutations. NGS has been successfully used to analyze blastocysts and single cells to identify euploid and aneuploid embryos as well as specific gene mutations. This makes NGS useful for PGD to select embryos without chromosome issues or gene defects.
This document summarizes preimplantation genetic diagnosis (PGD), which screens embryos for genetic disorders prior to embryo transfer during in vitro fertilization (IVF). PGD can detect single-gene disorders, chromosomal abnormalities, and HLA types. It allows transferring only unaffected embryos, avoiding termination of affected pregnancies. PGD is requested for couples at high risk of passing genetic disorders to offspring or to select euploid embryos to improve IVF success rates. The document outlines the PGD process and discusses its use for various genetic conditions like recessive, dominant, sex-linked, and chromosomal disorders. While PGD aims to prevent disease transmission, some argue its use for selecting traits could enable eugenics.
This document discusses chromosome screening and preimplantation genetic screening (PGS). It notes that aneuploidy increases significantly with maternal age and is a major cause of IVF failure and miscarriage. While PGS aims to increase implantation and pregnancy rates by screening embryos for aneuploidies, studies have shown mixed results. The document outlines various problems and limitations with past PGS studies that limit conclusions that can be drawn. It also discusses the potential benefits of PGS for recurrent implantation failure, previous trisomic conceptions, and recurrent pregnancy loss. Future developments discussed include using comparative genomic hybridization to screen all chromosomes and screening at the blastocyst stage.
The document discusses individualizing controlled ovarian stimulation (COS) regimens for in vitro fertilization (IVF) based on a woman's age, ovarian reserve tests, and risk of poor or hyper response. The number of oocytes retrieved during COS is strongly associated with live birth rates, but the relationship is non-linear and very high numbers can reduce success. Tests like antral follicle count and anti-Mullerian hormone help predict ovarian response and customize protocols to optimize oocyte yield safely for each patient.
The document discusses various aspects of embryo transfer techniques in IVF. It describes the typical steps, including selection of the best embryos for transfer. It notes that factors like the transferring physician's skill, catheter type, trial embryo transfer accuracy, ultrasound guidance, and uterine contractions can influence the success of embryo transfer. Research studies are summarized that found around 30% of patients had a uterine measurement discrepancy between trial transfer and ultrasound-guided transfer, and soft catheters were associated with higher pregnancy rates than firm catheters.
This document summarizes several studies on preimplantation genetic screening (PGS) using array comparative genomic hybridization (aCGH). Key findings include:
1) A pilot study of PGS using aCGH in "good prognosis" IVF patients under 35 found a 49.4% aneuploidy rate and an ongoing clinical pregnancy rate of 69%.
2) A randomized controlled trial in patients under 35 found higher pregnancy and ongoing pregnancy rates with day 5 biopsy and day 6 transfer plus aCGH (70.9% and 69.1%) compared to the control group without aCGH (45.8% and 41.7%).
3) Data from over 2000 patients showed eup
This study evaluated the impact of standard- and high-dose GnRH antagonists compared to a GnRH agonist on endometrial development in women undergoing controlled ovarian stimulation for oocyte donation. Thirty-one women were treated with either a standard dose of ganirelix, a high dose of ganirelix, or buserelin. Endometrial biopsies on days 2 and 7 after HCG administration found that development was similar in the standard- and high-dose ganirelix groups and comparable to natural cycles, but development was arrested in the buserelin group. Gene expression patterns after ganirelix more closely matched natural cycles than after buserelin. The study concluded that
1) The likelihood of abnormal embryos and non-chromosomal implantation failure increases with maternal age, ranging from 54% of embryos being abnormal for women under 35 to 82% for women 41-42.
2) A study found chromosomally abnormal embryos detected by array CGH had delayed blastulation compared to normal embryos.
3) Studies have found both positive and no effects of preimplantation genetic screening using day 3 embryo biopsy and FISH, with some finding a negative effect. A recent study found day 3 biopsy reduced implantation rates compared to blastocyst biopsy or no biopsy.
4) Data suggests preimplantation genetic testing for aneuploidies by methods like array C
This document summarizes recent research on embryo implantation and selection techniques presented at the 2006 ESHRE conference. It discusses factors that influence implantation rates, such as embryo morphology, endometrial receptivity, preimplantation genetic diagnosis (PGD), and blastocyst culture. Several studies presented found that morphological features like early cleavage and blastocyst formation correlated with successful implantation. PGD and blastocyst biopsy were shown to improve implantation and birth rates compared to cleavage-stage biopsy. However, mosaicism remains a challenge for PGD accuracy. Overall, the goal of this research is to better understand factors influencing implantation and develop techniques to select the most viable embryos.
The document outlines the key stages of human embryonic development from fertilization through the fetal period. It begins with fertilization and the early cleavage stages. Around 3 days post-fertilization, the embryo reaches the morula stage and enters the uterus. It then forms a blastocyst with an inner cell mass and trophoblast cells. Around day 6, the blastocyst implants into the uterine wall and the trophoblasts begin to produce hCG. Organ systems rapidly develop through week 8, after which the fetal period of growth begins until birth.
Implantation begins around 6 days after fertilization and is usually complete by 11-12 days. The blastocyst implants in the endometrium through enzymes produced by the trophoblast. Trophoblast cells penetrate the endometrium and develop into two layers. By 10 days the conceptus is fully embedded and a blood supply is established. The formation of the bilaminar embryonic disc and primary chorionic villi occurs around 13 days. Ectopic pregnancies can occur if implantation is outside the uterus, most commonly in the fallopian tubes.
1. The stages of pregnancy and development include fertilization, embryonic development, fetal development, growth, and childbirth.
2. Fertilization occurs when a sperm cell fertilizes an egg cell in the fallopian tubes. The zygote then undergoes cell division and implants in the uterus.
3. During embryonic development, the embryo undergoes differentiation and formation of the three primary layers and organs.
4. The fetal stage involves continued growth and maturation of all body systems until birth.
1) The document describes the key stages of human embryonic development from fertilization through the formation of the basic body plan and extraembryonic membranes over the first 8 weeks.
2) It explains how the three primary germ layers (ectoderm, mesoderm and endoderm) form and give rise to the major tissues and organ systems.
3) The role and formation of the embryonic membranes - amnion, yolk sac and allantois - as well as the placenta for nutrient exchange are covered.
Day 0-1: Fertilization and early zygotic transcription.
Day 1-3: Cleavage stages and compaction to morula.
Day 3-5: Blastocyst formation with inner cell mass and trophectoderm, hatching from zona pellucida.
Day 6-9: Implantation into endometrium and initiation of placenta formation through lacunae and trophoblast invasion.
Pre-implantation genetic diagnosis (PGD) involves testing a single cell from an 8-cell embryo during in vitro fertilization (IVF) to screen for genetic disorders and improve the chances of a normal pregnancy. A cell is removed from the embryo and tested using fluorescence in situ hybridization (FISH) to check chromosome number and size, or polymerase chain reaction (PCR) to test for specific genetic mutations. Embryos found to be free of genetic disorders based on testing are then implanted into the uterus, while affected embryos are not transferred. PGD allows couples at risk of passing on genetic diseases to potentially have healthy children.
Embryo transfer involves removing embryos from female cattle of superior genetics and implanting them into recipient females. This allows one donor cow to produce many offspring, improving herd genetics faster. The process begins by synchronizing donor and recipient estrous cycles then flushing embryos from the donor 7 days after breeding. Embryos are examined before transferring viable ones into recipients. While expensive, embryo transfer can increase genetic gains if used with donor cows having desirable traits.
Embryo transfer is a process where an embryo is collected from a donor female and transferred to a recipient female to complete its development. It allows genetically superior females to produce more offspring than through natural reproduction. Embryo transfer is used in cattle, horses, goats, sheep and other domestic and non-domestic species. The process involves superovulating the donor female, collecting embryos 6-9 days after breeding, and transferring high quality embryos into a synchronized recipient female. Embryo transfer maximizes genetic gains and production from elite females.
This document provides an overview of embryo transfer (ET) in cattle. It describes the ET process, which involves removing embryos from a genetically superior donor cow and transferring them to recipient cows. The goal of ET is to efficiently produce genetically superior offspring. The document outlines the steps of synchronizing donor and recipient cows, flushing embryos from the donor, examining and transferring high quality embryos to recipients. It notes that ET is an expensive but effective way to introduce superior genetics into a herd within a short time period.
This document discusses the process of embryo transfer in beef cattle. It involves collecting embryos from a superovulated donor cow through artificial insemination and flushing, and then transferring the embryos to synchronized recipient cows to complete gestation. The key steps are superovulating the donor cow, artificially inseminating her, flushing her uterus 7 days later to collect embryos, processing and evaluating the embryos, and then transferring high quality embryos into synchronized recipient cows 16 days after their estrus cycles have been aligned through hormone treatments.
The document discusses embryo transfer, which is a process where an embryo is collected from a donor female and transferred to a recipient female to complete its development. Embryo transfer allows a genetically superior female to produce more offspring than through natural reproduction. Key aspects discussed include selecting donor females, inducing superovulation in donors to release multiple eggs, inseminating donors, non-surgical and surgical embryo recovery methods, evaluating and storing embryos, and transferring embryos into recipient females through non-surgical or surgical methods.
This document discusses the process of embryo transfer in beef cattle. It involves collecting embryos from a superovulated donor cow through artificial insemination and flushing, and then transferring the embryos to synchronized recipient cows to complete gestation. The key steps are superovulating the donor cow, artificially inseminating her, flushing her uterus 7 days later to collect embryos, processing and evaluating the embryos, and then transferring high quality embryos into synchronized recipient cows 16 days after their estrus cycles have been aligned through hormone treatments. While expensive, embryo transfer allows for increasing the number of offspring from genetically superior cows and marketing their embryos.
This document discusses the process of embryo transfer in beef cattle. It involves collecting embryos from a superovulated donor cow through artificial insemination and flushing, and then transferring the embryos to synchronized recipient cows to complete gestation. The key steps are superovulating the donor cow, artificially inseminating her, flushing her uterus 7 days later to collect embryos, processing and evaluating the embryos, and then transferring high quality embryos into synchronized recipient cows 16 days after their estrus cycles have been aligned through hormone treatments.
This document provides an overview of embryo transfer (ET) in cattle. It describes the ET process, which involves removing embryos from a genetically superior donor cow and transferring them to recipient cows. The goal of ET is to efficiently produce genetically superior offspring. The document outlines the steps of synchronizing donor and recipient cows, flushing embryos from the donor, examining and transferring high quality embryos to recipients. It notes that ET is an expensive but effective way to introduce superior genetics into a herd within a short time period.
10. 為何要「訂做寶寶」？
3.挑選胚胎的性別(訂做性別寶寶)
歐洲人類生殖與胚胎學協會(European Society
for Human Reproduction & Embryology)在
2002年的報告中指出，三個具有其會員資格的
生殖機構，該年使用「胚胎植入前基因診斷」決
定胎兒性別，累計超過70次。
17. 生命倫理方法論架構
基本倫理學：目的論(結果論)、義務論
。
生命倫理學：尊重自主原則(principle of
respect for autonomy)、行善原則
(principle of beneficence)、不傷害原則
(principle of nonmaleficence)、正義原則
(principle of justice)。
專業倫理守則：醫學會、醫師公會及專業
學會之倫理守則、準則及建議行為。
24. 生命倫理四原則
尊重自主原則(principle of respect for
autonomy)
行善原則(principle of beneficence)
不傷害原則(principle of nonmaleficence)
正義原則(principle of justice)。
