The document outlines the process of in vitro fertilization (IVF) or test tube babies. It discusses how eggs are extracted from a woman and fertilized with sperm in a lab dish, then the embryo is transferred back into the woman's uterus in the hopes of establishing a pregnancy. Key steps include ovarian stimulation to develop multiple eggs, egg retrieval surgery, fertilizing the eggs with sperm in the lab, culturing the embryos for 2-6 days, and then transferring 1-3 embryos back into the uterus. The world's first "IVF baby" Louise Brown was born in 1978 in England using this technique.

1. MS.SHILPI DAMOR
DEPARTMENT OF ZOOLOGY
PODDAR INTERNATIONAL COLLEGE

2. BASIC OUTLINE
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1
• Type of Assisted Reproductive Technology (ART) or process of making TEST
TUBE BABY .
2
• In -Vitro means in lab or in controlled condition While fertilization is Fusion
of male and female gamete.
3
• Eggs and sperm are combined outside the womb(uterus) in a specialized
laboratory.
4
• The fertilized egg (zygote) cultured for 2-6 days in a growth medium.
5
• Transferred to the mother's uterus with the intention of establishing a
successful pregnancy (Embryo Transfer).

3. HISTORY
First case of invitro Fertilization of
Human Egg (1944):Dr. Pincus and a
lab technician Miriam Menkin.
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The world's First "IVF Baby" Louise Joy
Brown is born on July 25th, 1978 in England.
Dr. Robert Edwards and Dr. Patrick Steptoe
First case of invitro fertilization in
Animal (Rabbit) (1934):Dr. Gregory
Pincus .

4. PODDARINTERNATIONALCOLLEGE,JAIPUR
Physiology of Normal Fertilization

5. Infertility : “A disease of the reproductive system defined by the
failure to achieve a clinical pregnancy after 12 months or more of
regular unprotected sexual intercourse.
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6. PODDARINTERNATIONALCOLLEGE,JAIPUR

7. PROTOCOL OF IVF
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Ovarian Stimulation
Egg Retrieval
Sperm Collection
Fertilization In The Laboratory
Embryo Culture
Embryo Transfer

8. Ovarian Stimulation
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TYPES OF OVARIAN STIMULATION
Natural Cycle Unstimulated,
Spontaneous Cycle
Single Oocyte No Medication
Modified Natural
Cycle
Semi Natural,
Controlled Natural
Cycle IVF
Single Oocyte hCG only,
GnRH & FSH
Mild Soft, Minimal
stimulation, Friendly
IVF
2-7 Oocytes Low dose FSH, hMG,
Oral compounds and
GnRH
Conventional Standard routine >8 Oocyte GnRH or
Antagonised
conventional
FSH/hMG

11. Egg Retrieval
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13. PODDARINTERNATIONALCOLLEGE,JAIPUR
When the eggs are mature and ready, the woman undergoes an
ultrasound guided egg retrieval procedure under light sedation.
The eggs are retrieved from the patient using a transvaginal technique
called transvaginal oocyte retrieval involving an ultrasound-guided
needle piercing the vaginal wall to reach the ovaries.
Through this needle follicles can be aspirated, and the follicular fluid
is passed to an embryologist to identify ova.
Usually takes between 20 to 40 minutes;10-30 eggs retrieved.

14. Sperm Collection
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15. PODDARINTERNATIONALCOLLEGE,JAIPUR
If semen is being provided by
a sperm donor, it will usually
have been prepared for
treatment before being frozen
and quarantined, and it will be
thawed ready for use.
In the meantime, semen is
prepared for fertilisation by
removing inactive cells and
seminal fluid in a process
called Sperm Washing.

16. Fertilization
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17. Fertilization is started by adding 10,000- 50,000 motile sperms to about 100 μl
to 1 ml culture medium in which the oocytes is being incubated.
The oocytes is examined after 12-13 hrs.
A normally fertilized oocyte (actually a zygote now) contains two pronuclei and
two polar bodies. Any zygote other than this and having abnormalities and
granulation of any kind are rejected.
The first division in the zygote occurs about 24-30 hrs after insemination, but
each subsequent division takes about 10-12 hrs.
Therefore, if an oocyte fails to divide by 30 hrs after insemination, it should not
be used for implantation.
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18. PODDARINTERNATIONALCOLLEGE,JAIPUR

19. Embyo Culture
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20. After fertilization, the embryos are allowed to grow in special media for 3
– 5 days until they have reached optimal growth.
The main durations of embryo culture are until cleavage stage (day two to
four after co-incubation) or the blastocyst stage (day five or six after co-
incubation).
Embryo culture until the blastocyst stage confers a significant increase in
live birth rate per embryo transfer.
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21. Embryo Transfer
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22. Embryo transfer is the process of placing embryo inside the uterine
cavity and is the last step of IVF.
It is a painless procedure
1-3 embryos are then transferred into the uterus 3-5 days after egg
retrieval.
Under ultrasound guidance, a thin long catheter containing the
embryos is passed through the cervix into the uterus where the
embryos are placed.
After embryo transfer, 3-5 days of pelvic rest is recommended.
A pregnancy test is scheduled 12 days later.
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23. Risks
1. Multiple pregnancy – up to 30%, mostly twins.
2.Ovarian hyperstimulation syndrome (OHSS) – ovarian
enlargement with multiple cysts in association
3.Ovarian torsion –twisting of ovaries, may require
surgery.
4.Increased rate of abortion
5.Premature delivery, low birth weight baby etc
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24. REFERENCES
• Elements of Biotechnology by P.K. Gupta; pg.112
• Biotechnology Expanding Horizons by B.D.Singh; pg.282
• www.ivf-worldwide.com
www.ivf.com
• www.advancedfertility.com
• Wikipedia
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THANKS