IVF has become more common and accepted as a treatment for infertility. Previously seen as a last resort, it is now often a first choice for many couples. The success rates of IVF, while lower than natural conception, have increased over time due to improvements in technology and techniques. However, there are still risks associated with IVF treatment, including potential side effects of fertility drugs, higher risk pregnancies, and birth defects. The future of IVF may include new technologies like robotic sperm, but it also raises ethical issues around human cloning and commercialization of fertility treatment.
The Theory and Pratice of Human ReproductionYuzko Olexandr
This document summarizes several studies on the health outcomes of children conceived through assisted reproductive technologies (ART) such as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Some key findings include:
- Children conceived through ART have an increased risk of birth defects compared to naturally conceived children, though the absolute risks are small.
- Studies have found possible associations between ART and rare imprinting disorders like Beckwith-Wiedemann and Angelman syndromes, though the evidence is still tentative.
- Overall, studies found that pregnancy outcomes after ICSI were similar to IVF, and neonatal outcomes and health of ICSI children were comparable to IVF children. However,
Dr. Sunita Chandra, Chairperson & Director-Rajendra Nagar Hospital & IVF Centre and Mopheus Lucknow Fertility Centre gave the talk on IVF PREGNANCY at webinar on March 27,2021
This document discusses in vitro fertilization (IVF), including:
- What IVF is and a brief history of its development
- Why it is used, typically for issues like damaged fallopian tubes or male factor infertility
- Benefits like helping more people have families but also concerns like health risks of multiple pregnancies
- The social impacts, including lack of regulation for surrogacy which led to legal dilemmas, and debates over stem cell research and "creating immortality"
1) In vitro fertilisation (IVF) is a technique where eggs are fertilised by sperm outside the body in a laboratory. Since the first successful IVF in 1978, millions of babies have been born through IVF worldwide.
2) Advances in IVF include techniques like gamete intrafallopian transfer and polar body diagnosis. Researchers are also exploring in vitro gametogenesis to produce gametes from stem cells for infertility treatment or same-sex couples.
3) While IVF has helped many couples conceive, it also carries risks like multiple births, preterm delivery, and ovarian hyperstimulation syndrome. Success rates have improved over time but depend on factors like a woman's age and the clinic's
Ahmed Walid Anwar Morad, Professor Obstetrics and Gynecology
Optional procedures alongside the standard IVF protocol to increase the chance of a live birth.
How to choose between drugs: efficacy / safety and cost effectiveness. In IVF, we have GnRHagonist and antagonists: how to choose based on best available evidence. This talk may help to answer this question
This document discusses assisted reproduction and infertility. It defines assisted reproduction as treatments that involve handling eggs, sperm, or embryos to establish a pregnancy. Infertility is defined as the inability to conceive after 1 year of unprotected intercourse. The main causes of infertility are discussed for both females and males. The document also outlines several technologies and medical procedures that can help with infertility, including in vitro fertilisation (IVF), artificial insemination (IUI), zygote/gamete intrafallopian transfer (ZIFT/GIFT), and intracytoplasmic sperm injection (ICSI). It provides brief descriptions of IVF and ICSI procedures. Preimplantation genetic diagnosis is also mentioned as a technique to test
This document discusses infertility, its causes, treatments, and success rates. It notes that infertility affects 8-12% of couples worldwide and can be caused by issues with either the male or female reproductive systems in around 30% of cases each. Common treatments discussed are fertility drugs, intrauterine insemination (IUI), in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI). Success rates for IVF decline with the woman's age but are around 40% for those under 35. The first "test tube baby" was born in 1978 in Manchester, UK.
The Theory and Pratice of Human ReproductionYuzko Olexandr
This document summarizes several studies on the health outcomes of children conceived through assisted reproductive technologies (ART) such as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Some key findings include:
- Children conceived through ART have an increased risk of birth defects compared to naturally conceived children, though the absolute risks are small.
- Studies have found possible associations between ART and rare imprinting disorders like Beckwith-Wiedemann and Angelman syndromes, though the evidence is still tentative.
- Overall, studies found that pregnancy outcomes after ICSI were similar to IVF, and neonatal outcomes and health of ICSI children were comparable to IVF children. However,
Dr. Sunita Chandra, Chairperson & Director-Rajendra Nagar Hospital & IVF Centre and Mopheus Lucknow Fertility Centre gave the talk on IVF PREGNANCY at webinar on March 27,2021
This document discusses in vitro fertilization (IVF), including:
- What IVF is and a brief history of its development
- Why it is used, typically for issues like damaged fallopian tubes or male factor infertility
- Benefits like helping more people have families but also concerns like health risks of multiple pregnancies
- The social impacts, including lack of regulation for surrogacy which led to legal dilemmas, and debates over stem cell research and "creating immortality"
1) In vitro fertilisation (IVF) is a technique where eggs are fertilised by sperm outside the body in a laboratory. Since the first successful IVF in 1978, millions of babies have been born through IVF worldwide.
2) Advances in IVF include techniques like gamete intrafallopian transfer and polar body diagnosis. Researchers are also exploring in vitro gametogenesis to produce gametes from stem cells for infertility treatment or same-sex couples.
3) While IVF has helped many couples conceive, it also carries risks like multiple births, preterm delivery, and ovarian hyperstimulation syndrome. Success rates have improved over time but depend on factors like a woman's age and the clinic's
Ahmed Walid Anwar Morad, Professor Obstetrics and Gynecology
Optional procedures alongside the standard IVF protocol to increase the chance of a live birth.
How to choose between drugs: efficacy / safety and cost effectiveness. In IVF, we have GnRHagonist and antagonists: how to choose based on best available evidence. This talk may help to answer this question
This document discusses assisted reproduction and infertility. It defines assisted reproduction as treatments that involve handling eggs, sperm, or embryos to establish a pregnancy. Infertility is defined as the inability to conceive after 1 year of unprotected intercourse. The main causes of infertility are discussed for both females and males. The document also outlines several technologies and medical procedures that can help with infertility, including in vitro fertilisation (IVF), artificial insemination (IUI), zygote/gamete intrafallopian transfer (ZIFT/GIFT), and intracytoplasmic sperm injection (ICSI). It provides brief descriptions of IVF and ICSI procedures. Preimplantation genetic diagnosis is also mentioned as a technique to test
This document discusses infertility, its causes, treatments, and success rates. It notes that infertility affects 8-12% of couples worldwide and can be caused by issues with either the male or female reproductive systems in around 30% of cases each. Common treatments discussed are fertility drugs, intrauterine insemination (IUI), in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI). Success rates for IVF decline with the woman's age but are around 40% for those under 35. The first "test tube baby" was born in 1978 in Manchester, UK.
This document discusses preimplantation genetic screening (PGS) with fresh embryo transfer. It provides an overview of PGS using comprehensive chromosome analysis (CCA) with blastocyst biopsy and either fresh embryo transfer or frozen embryo transfer. Key advantages of CCA with blastocyst biopsy include improved implantation rates, elimination of the negative effect of maternal age on implantation, and the ability to perform embryo banking which facilitates multiple cycles for patients with poor prognosis. Controlled studies show no difference in outcomes between fresh versus frozen embryo transfer when using PGS with CCA.
1) Assisted reproductive techniques like egg freezing allow women to preserve their fertility for medical or social reasons.
2) Freezing eggs through vitrification has improved significantly and can provide pregnancy success rates similar to fresh eggs.
3) While egg freezing is accepted to preserve fertility for young cancer patients, there is debate around its use for social reasons due to concerns about unrealistic expectations of future fertility and the ethics of commercializing human eggs.
The document discusses the importance of assisted reproductive biotechnology in humans and animals. It notes that about 1 in 6 couples is infertile in the US and look to clinics in India and Asia for help. It also discusses efforts to save endangered species like the Pashmina goat and wild buffalo through cloning techniques. The document then goes on to discuss various causes of male and female infertility and techniques used in assisted reproduction like IVF, ICSI, and embryo transfer.
The programme “family planning” initiated in 1951.
Reproductive and child health care (ACH)
Sexually transmitted diseases (STD).Increased health facilities, better living conditions are the cause
of population explosion.
Out of 6 billion world population 1 billion are Indians.
Rapid decline in death rate, maternal mortalility rate
(MMR) and infant mortality rate (IMR) are major cause of
population growth.
Indian population growth rate is around 1.7 percent. Amniocentesis: A fetal sex determination test based on the
chromosomal pattern in the amniotic fluid surrounding the
developing embryo.
„Saheli‟ an oral contraceptive for female, developed by
CDRI.
This document summarizes common complications in the first trimester of pregnancy following assisted reproductive technology (ART). It discusses risks of multiple pregnancies, ectopic and heterotopic pregnancies, bleeding in early pregnancy, miscarriage, and ovarian hyperstimulation syndrome (OHSS). Management of OHSS and potential congenital anomalies are also covered. Complications are more common with ART due to higher rates of multiple gestations and underlying infertility issues. Careful screening and management can help reduce risks to both mother and fetus.
This document discusses the use of letrozole for fertility treatments. It begins with an introduction and outline on polycystic ovary syndrome (PCOS), unexplained infertility, fertility preservation for breast cancer patients, frozen embryo transfer, and decreasing ovarian hyperstimulation syndrome (OHSS). It then goes into more detail on each topic, providing evidence from randomized controlled trials, meta-analyses, and clinical guidelines that letrozole results in higher pregnancy and live birth rates compared to clomiphene citrate for PCOS and unexplained infertility. It also discusses how letrozole can be used during fertility preservation for breast cancer patients to prevent high estrogen levels. The document concludes by stating letrozole may
The document summarizes recent developments in human embryo morphology and genetic testing. It describes the historical discoveries of human oocyte and embryo development from the ancient Egyptians to modern IVF techniques. It also discusses current methods to select the best embryos through morphology assessment, preimplantation genetic testing for aneuploidy and genetic defects, analysis of mitochondrial content, and potential biomarkers in embryo culture media. The future of IVF is moving towards single euploid embryo transfers with comprehensive genetic and mitochondrial analysis to achieve the highest implantation rates.
This document outlines a proposed transdisciplinary study to assess in vitro maturation (IVM) of oocytes as an alternative infertility treatment compared to conventional in vitro fertilization (IVF). The study would have three pillars: 1) comparing the biology of IVM and IVF through animal studies; 2) evaluating the clinical efficacy, safety, costs and psychological impacts of IVM versus IVF through human studies; and 3) studying pregnancy complications and birth outcomes from IVM, IVF and spontaneous pregnancies using population health data. The goal is to provide a comprehensive evaluation of IVM across biological, clinical, economic and population levels to determine its potential as a treatment option for infertile couples.
Selection of an embryo from a large number of embryos and then placing it to the uterus is known as selective embryo transfer. This fertility preservation process is usually done after the process of IVF cycle and cancels the risks of spontaneous transfer of multiple embryos. Have a look at the detailed description of elective single embryo transfer in the following ppt.
Dr. irene souter pgd stickler foundation (2)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.
Dr. irene souter pgd stickler foundation (1)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 couples to have healthy children who would otherwise be at high risk of genetic conditions
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. While mistakes can occur, studies show PGD results in similar delivery outcomes and malformation rates as ICSI. PGD effectively avoids birth of children with genetic defects but requires genetic counseling given technical limitations.
Class progestrogens and antiprogestrogensRaghu Prasada
This document discusses progestogens and antiprogestogens, including their mechanisms of action, physiological targets, uses, and side effects. It focuses on several classes of progestogens used in oral contraceptives and hormone replacement therapy. It also describes mifepristone (RU-486) as an antiprogestogen used to terminate early pregnancies by antagonizing progesterone receptors and inducing uterine contractions. Precautions and contraindications for its use are outlined.
This document discusses endoscopy procedures in gynecology. It lists the advantages of laparoscopy over laparotomy as well as the indications and potential complications of laparoscopy and hysteroscopy. Laparoscopy is indicated for diagnostic purposes such as evaluating infertility, endometriosis, or adnexal masses, and for operative procedures including sterilization, treating ectopic pregnancies, or removing ovarian cysts. Potential complications include injuries to vessels or internal organs. Hysteroscopy is used diagnostically to examine intrauterine lesions or anomalies and operatively for procedures like myomectomy, sterilization, or removing uterine devices. Complications can include hemorrhage, uterine perforation, or infection
Laparoscopy is a minimally invasive surgical technique that allows visualization of the abdominal organs through small incisions. It has many applications in gynecological endoscopy including diagnostic laparoscopy to investigate causes of infertility, ovarian cysts, ectopic pregnancy, and endometriosis. Key steps in the laparoscopy procedure are pneumoperitoneum creation, trocar insertion, visualization of organs, and completion with gas evacuation. It provides diagnostic and therapeutic benefits over laparotomy with less pain and faster recovery.
Progesterone is a hormone that prepares the uterus for pregnancy and maintains pregnancy. It is produced naturally by the ovaries and placenta during pregnancy. Synthetic progestins are also used as contraceptives and for hormone replacement therapy. Progestins work by converting the estrogen-primed endometrium to a secretory state and maintaining it to support pregnancy. They also have other effects throughout the body. Mifepristone is a progesterone antagonist that is used to terminate early pregnancies by blocking the effects of progesterone and causing abortion.
Laparoscopy is a minimally invasive surgical technique used in gynecology. The two main types are laparoscopy and hysteroscopy. Laparoscopy allows surgeons to examine the abdominal cavity and perform surgery using small incisions and long thin instruments inserted through the abdominal wall. It has advantages over open surgery like less pain, shorter hospital stays, and quicker recovery times. Complications can include bleeding, infection, and injury to nearby organs. Laparoscopy has a long history dating back to the early 19th century and has increasingly replaced open surgery for many gynecological conditions since the 1960s as techniques have advanced.
This document discusses drugs used in reproductive health, focusing on estrogens and progestins. It provides details on the types and actions of natural and synthetic estrogens and progestins, including their mechanisms of action, pharmacokinetics, indications, and side effects. It also discusses related drugs like antiestrogens, selective estrogen receptor modulators, aromatase inhibitors, antiprostegins, and mifepristone.
The document discusses progestogens, which include progesterone and synthetic progestins. Progesterone is secreted naturally, while progestins have progesterone-like effects. Both are used for obstetric and gynecologic purposes. Therapeutically, progestogens are used to support early pregnancy, treat menstrual disorders, provide luteal phase support in assisted reproduction, and relieve symptoms of conditions like endometriosis. While generally effective, studies on uses like threatened miscarriage and preterm labor have been limited by small sample sizes. Natural progesterone generally has fewer side effects than progestins. The document examines various progestogen types and routes of administration.
This document discusses preimplantation genetic screening (PGS) with fresh embryo transfer. It provides an overview of PGS using comprehensive chromosome analysis (CCA) with blastocyst biopsy and either fresh embryo transfer or frozen embryo transfer. Key advantages of CCA with blastocyst biopsy include improved implantation rates, elimination of the negative effect of maternal age on implantation, and the ability to perform embryo banking which facilitates multiple cycles for patients with poor prognosis. Controlled studies show no difference in outcomes between fresh versus frozen embryo transfer when using PGS with CCA.
1) Assisted reproductive techniques like egg freezing allow women to preserve their fertility for medical or social reasons.
2) Freezing eggs through vitrification has improved significantly and can provide pregnancy success rates similar to fresh eggs.
3) While egg freezing is accepted to preserve fertility for young cancer patients, there is debate around its use for social reasons due to concerns about unrealistic expectations of future fertility and the ethics of commercializing human eggs.
The document discusses the importance of assisted reproductive biotechnology in humans and animals. It notes that about 1 in 6 couples is infertile in the US and look to clinics in India and Asia for help. It also discusses efforts to save endangered species like the Pashmina goat and wild buffalo through cloning techniques. The document then goes on to discuss various causes of male and female infertility and techniques used in assisted reproduction like IVF, ICSI, and embryo transfer.
The programme “family planning” initiated in 1951.
Reproductive and child health care (ACH)
Sexually transmitted diseases (STD).Increased health facilities, better living conditions are the cause
of population explosion.
Out of 6 billion world population 1 billion are Indians.
Rapid decline in death rate, maternal mortalility rate
(MMR) and infant mortality rate (IMR) are major cause of
population growth.
Indian population growth rate is around 1.7 percent. Amniocentesis: A fetal sex determination test based on the
chromosomal pattern in the amniotic fluid surrounding the
developing embryo.
„Saheli‟ an oral contraceptive for female, developed by
CDRI.
This document summarizes common complications in the first trimester of pregnancy following assisted reproductive technology (ART). It discusses risks of multiple pregnancies, ectopic and heterotopic pregnancies, bleeding in early pregnancy, miscarriage, and ovarian hyperstimulation syndrome (OHSS). Management of OHSS and potential congenital anomalies are also covered. Complications are more common with ART due to higher rates of multiple gestations and underlying infertility issues. Careful screening and management can help reduce risks to both mother and fetus.
This document discusses the use of letrozole for fertility treatments. It begins with an introduction and outline on polycystic ovary syndrome (PCOS), unexplained infertility, fertility preservation for breast cancer patients, frozen embryo transfer, and decreasing ovarian hyperstimulation syndrome (OHSS). It then goes into more detail on each topic, providing evidence from randomized controlled trials, meta-analyses, and clinical guidelines that letrozole results in higher pregnancy and live birth rates compared to clomiphene citrate for PCOS and unexplained infertility. It also discusses how letrozole can be used during fertility preservation for breast cancer patients to prevent high estrogen levels. The document concludes by stating letrozole may
The document summarizes recent developments in human embryo morphology and genetic testing. It describes the historical discoveries of human oocyte and embryo development from the ancient Egyptians to modern IVF techniques. It also discusses current methods to select the best embryos through morphology assessment, preimplantation genetic testing for aneuploidy and genetic defects, analysis of mitochondrial content, and potential biomarkers in embryo culture media. The future of IVF is moving towards single euploid embryo transfers with comprehensive genetic and mitochondrial analysis to achieve the highest implantation rates.
This document outlines a proposed transdisciplinary study to assess in vitro maturation (IVM) of oocytes as an alternative infertility treatment compared to conventional in vitro fertilization (IVF). The study would have three pillars: 1) comparing the biology of IVM and IVF through animal studies; 2) evaluating the clinical efficacy, safety, costs and psychological impacts of IVM versus IVF through human studies; and 3) studying pregnancy complications and birth outcomes from IVM, IVF and spontaneous pregnancies using population health data. The goal is to provide a comprehensive evaluation of IVM across biological, clinical, economic and population levels to determine its potential as a treatment option for infertile couples.
Selection of an embryo from a large number of embryos and then placing it to the uterus is known as selective embryo transfer. This fertility preservation process is usually done after the process of IVF cycle and cancels the risks of spontaneous transfer of multiple embryos. Have a look at the detailed description of elective single embryo transfer in the following ppt.
Dr. irene souter pgd stickler foundation (2)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.
Dr. irene souter pgd stickler foundation (1)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 couples to have healthy children who would otherwise be at high risk of genetic conditions
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. While mistakes can occur, studies show PGD results in similar delivery outcomes and malformation rates as ICSI. PGD effectively avoids birth of children with genetic defects but requires genetic counseling given technical limitations.
Class progestrogens and antiprogestrogensRaghu Prasada
This document discusses progestogens and antiprogestogens, including their mechanisms of action, physiological targets, uses, and side effects. It focuses on several classes of progestogens used in oral contraceptives and hormone replacement therapy. It also describes mifepristone (RU-486) as an antiprogestogen used to terminate early pregnancies by antagonizing progesterone receptors and inducing uterine contractions. Precautions and contraindications for its use are outlined.
This document discusses endoscopy procedures in gynecology. It lists the advantages of laparoscopy over laparotomy as well as the indications and potential complications of laparoscopy and hysteroscopy. Laparoscopy is indicated for diagnostic purposes such as evaluating infertility, endometriosis, or adnexal masses, and for operative procedures including sterilization, treating ectopic pregnancies, or removing ovarian cysts. Potential complications include injuries to vessels or internal organs. Hysteroscopy is used diagnostically to examine intrauterine lesions or anomalies and operatively for procedures like myomectomy, sterilization, or removing uterine devices. Complications can include hemorrhage, uterine perforation, or infection
Laparoscopy is a minimally invasive surgical technique that allows visualization of the abdominal organs through small incisions. It has many applications in gynecological endoscopy including diagnostic laparoscopy to investigate causes of infertility, ovarian cysts, ectopic pregnancy, and endometriosis. Key steps in the laparoscopy procedure are pneumoperitoneum creation, trocar insertion, visualization of organs, and completion with gas evacuation. It provides diagnostic and therapeutic benefits over laparotomy with less pain and faster recovery.
Progesterone is a hormone that prepares the uterus for pregnancy and maintains pregnancy. It is produced naturally by the ovaries and placenta during pregnancy. Synthetic progestins are also used as contraceptives and for hormone replacement therapy. Progestins work by converting the estrogen-primed endometrium to a secretory state and maintaining it to support pregnancy. They also have other effects throughout the body. Mifepristone is a progesterone antagonist that is used to terminate early pregnancies by blocking the effects of progesterone and causing abortion.
Laparoscopy is a minimally invasive surgical technique used in gynecology. The two main types are laparoscopy and hysteroscopy. Laparoscopy allows surgeons to examine the abdominal cavity and perform surgery using small incisions and long thin instruments inserted through the abdominal wall. It has advantages over open surgery like less pain, shorter hospital stays, and quicker recovery times. Complications can include bleeding, infection, and injury to nearby organs. Laparoscopy has a long history dating back to the early 19th century and has increasingly replaced open surgery for many gynecological conditions since the 1960s as techniques have advanced.
This document discusses drugs used in reproductive health, focusing on estrogens and progestins. It provides details on the types and actions of natural and synthetic estrogens and progestins, including their mechanisms of action, pharmacokinetics, indications, and side effects. It also discusses related drugs like antiestrogens, selective estrogen receptor modulators, aromatase inhibitors, antiprostegins, and mifepristone.
The document discusses progestogens, which include progesterone and synthetic progestins. Progesterone is secreted naturally, while progestins have progesterone-like effects. Both are used for obstetric and gynecologic purposes. Therapeutically, progestogens are used to support early pregnancy, treat menstrual disorders, provide luteal phase support in assisted reproduction, and relieve symptoms of conditions like endometriosis. While generally effective, studies on uses like threatened miscarriage and preterm labor have been limited by small sample sizes. Natural progesterone generally has fewer side effects than progestins. The document examines various progestogen types and routes of administration.
This document provides an overview of common investigations in gynecology, including blood tests, urine analysis, cervical and vaginal discharge collection and examination, exfoliative cytology (Pap smear), colposcopy, culdocentesis, hormonal assays, and imaging techniques. The key points covered include how various samples are collected, what they are tested for, and what normal and abnormal results may indicate.
1) Early pregnancy ultrasound is used to evaluate normal and abnormal early pregnancies through assessing gestational sac location, structure, viability, dating and number. It can also screen for fetal abnormalities and assist with procedures.
2) Sonographic signs of normal early pregnancy include identifying the gestational sac, yolk sac, embryo/fetus and presence of cardiac activity. Dating is based on mean sac diameter from 5-9 weeks and crown-rump length from 6-12 weeks.
3) Abnormal findings include failed early pregnancy, pregnancy of uncertain viability, pregnancy of unknown location, ectopic pregnancy, molar pregnancy, and retained products of conception. Precise diagnosis requires correlating ultrasound findings with hCG
Ultrasound uses sound waves to produce images of fetuses in the womb. There are different types of ultrasound including 3D and 4D that provide moving 3D images. Doppler ultrasound evaluates blood flow. Ultrasounds during pregnancy allow doctors to check the heartbeat, date the pregnancy, check fetal growth and anatomy, and screen for potential issues. Early ultrasounds around 5-6 weeks can detect a gestational sac and fluttering heartbeat, while later ultrasounds show increased fetal size, development of organs and other features.
Laparoscopy is a minimally invasive surgical procedure that involves inserting a narrow telescope through a small incision in the abdomen to visualize internal organs. It can be used both diagnostically to investigate issues like infertility, masses, or suspected abnormalities, and therapeutically to treat conditions like endometriosis, myomas, ectopic pregnancies, and more. Potential risks include injuries to internal organs from trocar insertion or diathermy, bleeding, infection, and port site complications. Careful patient selection and surgical technique can help reduce risks.
This document discusses techniques for fetal age estimation using obstetric ultrasound. It begins with an introduction to obstetric ultrasound, describing its history and uses. It then covers ultrasound technology and transducer principles. The main uses of obstetric ultrasound are established as determining fetal number, position, growth and detecting abnormalities. Examination types like transabdominal and transvaginal ultrasound are described. The document outlines fetal assessment and measurements used in each trimester to estimate gestational age, including crown-rump length in the first trimester and biometric parameters like biparietal diameter in later stages. Fetal age estimation is emphasized as fundamental to obstetric care, with ultrasound providing a reliable method.
Basic ultrasound in O&G can be used to confirm and date pregnancies, screen for abnormalities, and evaluate problems in early pregnancy. Key applications include using scans from 4-5 weeks to detect a gestational sac and fetal pole, measuring the crown-rump length from 6-12 weeks to date the pregnancy, screening for issues like ectopic pregnancy or miscarriage, and assessing fetal growth and anatomy later in pregnancy. Ultrasound is also used for gynecological conditions like fibroids, cysts and infertility workups.
1) A basic gynaecological ultrasound examines the normal anatomy of the uterus and ovaries and evaluates changes throughout the menstrual cycle.
2) Abnormal findings may include fibroids, adenomyosis, ovarian cysts, endometriosis, or cancers. Fibroids appear as well-defined masses inside the uterus that can have varying echogenicity. Adenomyosis causes a diffusely infiltrative, inhomogeneous appearance of the myometrium.
3) Ovarian cysts are evaluated based on size, persistence over menstrual cycles, and characteristics that may indicate malignancy like irregular walls, ascites, or strong blood flow. Postmenopausal bleeding requires further histological evaluation
Thromboembolic disease In obstetrics and GynaecologyAboubakr Elnashar
This document discusses thromboprophylaxis in pregnancy and the postpartum period. It notes that pulmonary embolism is a leading cause of maternal mortality in the UK and Egypt. Pregnancy increases the risk of thromboembolic events due to factors like stasis, increased coagulation, and trauma during delivery. The document provides guidance on assessing risk factors and implementing thromboprophylaxis for women during pregnancy, following cesarean sections or vaginal deliveries, and when traveling. It discusses treatment options like heparin, LMWH, aspirin, and stockings and provides dosing, monitoring, and contraindication information.
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1. The document discusses new concepts in infertility including updated WHO reference values for semen analysis, the use of ICSI for male factor infertility, and success rates varying based on the cause of infertility.
2. ICSI, where surgically retrieved sperm are injected into eggs, has become an established procedure for couples with male subfertility to have a biological child, with reassuring post-natal outcomes reported so far.
3. The success of IVF depends on the type of infertility, with male factor infertility seeing live birth rates around 40% and female factor infertility around 25%, higher than other causes of infertility.
Doctor, will I be able to have a baby ? Fertility after cancer Dr Aniruddha Malpani
This document discusses fertility preservation options for cancer patients. It notes that chemotherapy and radiation can damage fertility, but fertility preservation techniques exist to help mitigate this, including freezing eggs, sperm, ovarian tissue or testicular tissue. It recommends that oncologists discuss these options proactively with patients to give them hope for biological children after cancer. Specific techniques are described such as in vitro fertilization with eggs or sperm frozen before treatment. Referral to fertility specialists is advised so patients can explore preservation options before starting cancer treatment.
Baby-making : what the new reproductive treatments mean for families & society V Somasundram
A book review presentation on Baby-making : what the new reproductive treatments mean for families & society by Bart Fauser & Paul Devroey for H6792, Science & Technology Sources & Services.
Presented by Nurashikin Jasni & V Somasundram on 16 October 2012
Since the birth of Louise Brown, the first baby born through in vitro fertilization, in 1978, assisted reproductive technology has advanced significantly. The success rate of in vitro fertilization (IVF) has risen dramatically over the last four decades as a result of developments in incubation methods, micromanipulation technology, and a general understanding of assisted reproduction.
Abortion can have serious physical and psychological complications. It is linked to increased risks of cancer, uterine damage, cervical lacerations, ectopic pregnancy, and complications in future pregnancies like preterm birth. Multiple abortions further increase these risks. Abortion is also associated with negative health behaviors and poorer overall health and well-being afterwards. It is a traumatic experience for many women that can be perceived as a violation, especially if the pregnancy was wanted or the abortion was forced.
Ethical issues associated with fertility treatmentChris Willmott
Dr. Chris Willmott gave a presentation on the ethical issues associated with fertility treatment. He discussed various fertility procedures like IVF, egg/embryo donation, and surrogacy. He also outlined some of the debates around who should have access to treatment, how many embryos should be transferred, the fate of leftover embryos, genetic screening of embryos, and resource allocation issues. The talk examined arguments both for and against different procedures from various ethical perspectives.
Birthdefect risk following assisted reproductive technologymothersafe
1) ART procedures like IVF are associated with an increased risk of preterm birth, low birth weight, and multiple births compared to spontaneously conceived pregnancies. Studies have also found an increased risk of birth defects, though results are inconsistent.
2) The risk of birth defects may be 1.5-2 times higher in ART pregnancies compared to non-ART pregnancies. Certain defects like gastrointestinal and cardiovascular defects appear to have a significantly higher risk.
3) The causes of increased birth defect risk are unknown but could include the ART procedures themselves damaging embryos, genetic issues in infertile patients, or imprinting defects from embryo culture media or abnormal sperm imprinting. Larger, more rigorous studies are still needed
Similar to Ivf commercialization in element in gynaecology (9)
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
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Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
11. Evaluation of decreasing sperm count Decreasing
sperm quality & Quantity just in Data???????
Environmental Health Perspectives 108 (10) (Oct. 10, 2000); E. Carlsen et al.
British Medical Journal 305 (Sept. 12, 1992).
12. Reduction in sperm density Decreasing
sperm quality & Quantity just in
Data??????? What is reality
13. Reduction in sperm density Decreasing sperm
quality & Quantity just in Data???????
Journal of Andrology,Vol. 28, No. 2, March/April 2007
14. Reduction in sperm morphology quality Decreasing
sperm quality & Quantity just in Data???????
What is relity !!
Journal of Andrology,Vol. 30, No. 5, September/October 2009
15. Impact of the New WHO Guidelines on Diagnosis and Practice
of Male Infertility 1 Reality
1.The Open Reproductive Science Journal, 2011, 3, 7-15
24. Figure 2. Prevalence of primary infertility and secondary infertility, presented as the percent of women who
seek a child, and as the percent of all women of reproductive age, in 1990 and 2010.
Mascarenhas MN, Flaxman SR, Boerma T, Vanderpoel S, et al. (2012) National, Regional, and Global Trends in Infertility Prevalence Since
1990: A Systematic Analysis of 277 Health Surveys. PLoS Med 9(12): e1001356. doi:10.1371/journal.pmed.1001356
http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001356
25. Absolute change in prevalence of primary and secondary infertility, measured as the percent of women who
seek a child and as the percent of all women of reproductive age, between 1990 and 2010.
Mascarenhas MN, Flaxman SR, Boerma T, Vanderpoel S, et al. (2012) National, Regional, and Global Trends in Infertility Prevalence Since
1990: A Systematic Analysis of 277 Health Surveys. PLoS Med 9(12): e1001356. doi:10.1371/journal.pmed.1001356
http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001356
26. In Vitro Fertilisation (IVF) is a last resort in
Past !!!!!!!!!!!!
But Now it’s first
choice !!!
35. Indications
Previous: tubal factor only
FallopianTube Damage/Tubal Factor
Bilateral blocked Fallopian tubes
Failed reversal ofTubectomy
The only options for treating significant tubal
damage are surgical repair or bypassing the tubes
with IVF.This decision must be carefully
individualized in each situation.
36. Indications
Present:
Male Factor Infertility
Failed reversal ofVasectomy/Tubectomy
Obstructive azoospermia
Endometriosis
Severe endometriosis
Age Related Infertility
Premature Menopause
Anovulation
Unexplained Infertility
Preimplantation GeneticTesting (PGT
38. Facts on IVF
Facts
truth: IVF is only the last option
truth: IVF is only for affluent people
truth: IVF is limited to a younger population only
truth: IVF is successful in all cases
truth: IVF requires admission in the hospital
truth: IVF always result in multiple pregnancies like
twins or triplets
truth: IVF babies have a significantly high risk of
birth defects and malformations
truth: IVF is not at all covered by insurance
truth: IVF is dangerous
39. Acceptance by people
Present : reality-
Who Does it Help?
In-Vitro Fertilization and Side effects
Woman’s Painful journey
Maternal Age and Blastocyst Development high
failure rate
Frozen Blastocyst Cycles
The Future
45. Why it was not accepted by drs as
routine?
ICSI: Should it be Restricted to Male Infertility
Drugs to induce ovulation
Ova harvesting
Embryo transfer
The outcome
LACK OF CONFIDENCE
LACK OF SENIORS SUPPORT
LACK OF KNOWLEDGE FROMWHERETO LEARN
HOWTO ESTABLISH LAB etc…..
Success rate
58. Technology burden on Doctors!!!!
Previous & Present:
-Ease of getting equipment & loansWho will Pay???
-support of companiesWe have to oblige them!!
-disposables& media
-hormones( refine technology)
-ovum pick up
-embryo transfer( role of USG)
-endocrinology & lab support
-availability of embryologyst
- knowledge & skill
- ICSI ,IMSCI, PICSI,PGS, PGD,ERRAY , LAH, STEMCELL
etc…..
60. Pseudo Benefits
Fast conception
Early identification of factor
Demand & supply
Dhiraj & dhakka
Multiple pregnancy
LSCS
Both party happiness
Remote centre franchise for drs
61. Service at door step full
commercialization
By companies
By doctors
By laboratories
62. Medicine updates
Side effects !!!
Previous:
Clomiphene citrate
Present:
Various options
GnRH Agonists
GnRH Antagonists
Gonadotropins
hCG
Progesterone
Medrol
Doxycycline
Side Effects !!!!!
68. Conclusion
Understand the reproductive potential of couple
undergoing IVF
Success of ICSI
(few data)
Male Factors Infertility IVF
~40% live birth ratesVery low as compare
to normal pregnancy
Female Factors Infertility IVF
Higher results than other infertility causes
~25% live birth rates Very low as compare to normal
pregnancy
Analyses of sperm count data suggest a global downward trend but the results are inconclusive. An increase in male reproductive disorders like cryptorchidism and testicular cancer raise the question of common risk factors. Data on testicular cancer trends are usually based on population-based cancer registries with good validity. The corresponding data from fertility studies need careful consideration in terms of methods and results.Fisch and co-workers determined whether geographic variations in sperm count might bias the conclusions drawn from studies of semen quality. Briefly, of the 61 studies in the meta-analysis of Carlsen et al. [1] only 20 included more than 100 individuals. A reanalysis of these 20 studies revealed that the majority of studies published before 1970 were from USA, mainly New York. These studies represented locations with the highest sperm counts. In contrast, after 1970, most of the studies were from locations not included earlier. Selection bias due to geographical and ethnic variations could account for the observed decline in sperm quality [8]. However, when the subgroup of studies from the USA (28 studies, including data on 8.329 men) was analyzed separately, a similar trend of decreasing mean sperm values was observed [1]. On the other hand, Lipshultz argued that when all the larger studies containing only New York data are excluded from the meta-analysis, a second linear regression analysis detects no decline in sperm density [9].The sperm count issue has been extensively investigated since 1992 and the decrease is supported by additional studies. For example, it was reported that sperm counts of 1351 fertile men (semen donors) in Paris decreased by 2.1 percent per year from 89 × 106/ml in 1973 to 60× 106/ml in 1992 (p < 0.001) [10]. Sperm motility also decreased in these individuals. The mean seminal volume was 3.8 ml and did not change during the period from 1973 to 1992. Irvine et al. also examined sperm quality in 571 semen donors in Scotland by birth cohort groups [11]. They reported a significant decrease in median sperm concentration, total number of sperm in the ejaculate and total number of motile sperm in donors born between 1970 and 1974 compared to men before 1959.On the other hand, several studies confirm that in some locations sperm counts have not decreased over the past 20 to 25 years. More importantly, the results clearly show a remarkable variability in sperm counts at different geographical locations. The mean sperm counts in 302 men in the Toulouse area were unchanged over the period from 1977 to 1992 [12] and their mean sperm count (83 × 106 ml) was significantly higher than observed in the Paris study [10]. Furthermore, it was reported that the highest sperm counts recorded in Finland were found in men from rural areas accompanied by a low incidence of testicular cancer [13]. These findings suggest that urban lifestyle or environmental factors might be an important etiological factor of testicular malfunction and disease.Fisch et al. [14] conducted a study comprising 1,283 men who banked sperm before vasectomy in three different sperm banks in the United States from 1970-1994. A slight but significant increase in mean sperm concentration from 77 × 106 ml to 89 × 106 ml over the past 25-year period was found. Furthermore, marked differences in semen characteristics between the New York, Minnesota, and California sperm banks were found. Sperm concentration and motility was highest in New York and lowest in California.It was argued that the data set analyzed by Carlsen et al. [1] was not equally distributed between the decades: 79% of the publications and 88% of the volunteers of all studies were clustered between 1970 and 1990. If joint-analyses were conducted with studies from this period only, an increase in sperm concentrations would become evident. Thus, only 21% of the studies and 12% of the volunteers analyzed before 1970 have caused the regression to have a statistically negative slope [15,16].Looking at sperm count studies which have been published since 1992, it becomes evident that over the past 20 years, sperm quality has decreased in some but not all locations. The results also show that sperm counts can vary widely between and within countries. These major geographical differences suggest that the results of the former meta-analyses of sperm count may be biased by geographical confounding.
Interactive regression model for mean sperm density by year and geographic region, after controlling for proven fertility, abstinence time, age, specimen collection method, method of counting sperm, whether the study was included by Carlsen et al. (1), and interaction of region and study year.
Oligospermia, also oligozoospermia, refers to semen with a low concentration of sperm and is a common finding in male infertility. Often semen with a decreased sperm concentration may also show significant abnormalities in sperm morphology and motility (technically "oligoasthenoteratozoospermia"). There has been interest in replacing the descriptive terms used in semen analysis with more quantitative information.[2]
The World Health Organization (WHO) has established new reference values for semen characteristics in its 5th edition manual which are lower than those previously reported. Several questions arise after a careful examination of the proposed new values, especially regarding the implications of these references for diagnosis and treatment of male infertility. Despite the notable advance of using controlled studies involving couples whose time to pregnancy was less than 12 months to generate the new limits, reference studies are limited with regard to the population analyzed and the methods used for semen evaluation. As such, it seems unreasonable to assume that reference values represent global semen characteristics of fertile men as proposed in the 5th edition WHO manual. Caution should be exercised to not overinterpret the new reference values as they may fail to accurately discriminate populations of fertile and infertile men. Properly performed semen analyses coupled with an adequate examination of the man can give valuable information related to the organs producing “semen”, a highly complex fluid, and thus help in better understanding of the physiology of the reproductive organs and the causes of their dysfunctions. The present commentary discusses concerns related to the publication of the new reference values for semen parameters such as the impact on patient referral, diagnosis, treatment of recognized conditions such as varicocele and indications of assisted reproductive modalities. We conclude that more debate is needed before the adoption of the proposed WHO current reference values by andrology laboratories around the world. For those considering to adopt them, a better approach would be the presentation of reference values by percentiles rather than solely the lower cutoff limits. The time has come for technological developments that bring robust and costeffective clinically useful sperm function tests to replace, at least partially, the shortcomings of routine semen analysis
Infertility prevalence is indexed on the female partner; age-standardized prevalence among women aged 20–44 y is shown here. Horizontal lines indicate the 95% uncertainty interval.
By PiyumiBuddhakoralaIn Vitro Fertilisation (IVF) is a last resort” said Professor Deepal S. Weerasekera, Clinical Director of the Prarthana Centre for IVF.It is a process by which egg cells are fertilized by sperm outside the womb. It is a major treatment in infertility when other methods of assisted reproductive technology – such as medication to induce ovulation, tablets to improve sperm count and certain operations to relieve obstructions in the womb – have failed. IVF involves hormonally controlling the ovulatory process: removing eggs from the woman’s ovaries and letting sperm fertilize them in a fluid medium in order for the embryo (fertilized egg) to form. After three days the embryo is then transferred to the patient’s uterus in an attempt to establish a successful pregnancy. The first “test tube baby,” Louise Brown, was born in 1978 in London.Dr. Weerasekera explains the advantages of IVF treatment which is that even if a fallopian tube is blocked or the woman has a disease which prevents her from conceiving, she can still get pregnant in such a way that it is possible to take an egg from another woman, the sperm of the husband, fertilize it and deposit it in her womb. This is called oocyte donation.There are two main methods of conceiving; IVF, which is standard and ICSI. Intro Cytoplasmic Sperm Injection is the process by which a needle is injected straight through to the egg with the sperms in it.Even with such optimism for conceiving present, when all else fails, Dr Weerasekera points out that there is a 30-40% success rate for IVF, not only in Sri Lanka but worldwide.The process of Controlled Ovarian Stimulation is done so as to extract more than one egg from the womb. If ten were to be extracted all 10 will be fertilised. Two of the fertilized eggs, at the most, are put back into the womb and the rest are frozen. By this procedure, if the fertilization is not successful, the couple may resort to one of the frozen embryos which, according to Dr. Weerasekera, can last for five years. This method is known as Frozen Embryo Transfer (FET).There are three methods involved before the IVF procedure takes place; Laparoscopy, Hysteroscopy, and Dye Insufflation. Laparoscopy involves insertion of a camera through a small cut in the naval. Hysteroscopy is a procedure that involves insertion of a small camera through the vagina to visualize the cavity of the womb. Dye Insufflation is done to test whether the fallopian tubes are blocked or not. Such methods can be used to find out the exact state of the cavity of the womb, patency and function of the tubes, diseases affecting the function of the tubes, state of ovaries and any diseases affecting the ovaries. All these are important factors to diagnose early when there is a delay in conceiving so that early treatment can be instituted. Dr. Weerasekera advises that after six months of ‘trying’ a couple should seek medical help.A major drawback of IVF is the cost — Rs. 200,000 at the least. IVF is not available in state hospitals. The people of this country are not too aware of such a facility available and therefore go abroad. ‘Prarthana’ has delivered 60 babies within the span of five years.
By PiyumiBuddhakoralaIn Vitro Fertilisation (IVF) is a last resort” said Professor Deepal S. Weerasekera, Clinical Director of the Prarthana Centre for IVF.It is a process by which egg cells are fertilized by sperm outside the womb. It is a major treatment in infertility when other methods of assisted reproductive technology – such as medication to induce ovulation, tablets to improve sperm count and certain operations to relieve obstructions in the womb – have failed. IVF involves hormonally controlling the ovulatory process: removing eggs from the woman’s ovaries and letting sperm fertilize them in a fluid medium in order for the embryo (fertilized egg) to form. After three days the embryo is then transferred to the patient’s uterus in an attempt to establish a successful pregnancy. The first “test tube baby,” Louise Brown, was born in 1978 in London.Dr. Weerasekera explains the advantages of IVF treatment which is that even if a fallopian tube is blocked or the woman has a disease which prevents her from conceiving, she can still get pregnant in such a way that it is possible to take an egg from another woman, the sperm of the husband, fertilize it and deposit it in her womb. This is called oocyte donation.There are two main methods of conceiving; IVF, which is standard and ICSI. Intro Cytoplasmic Sperm Injection is the process by which a needle is injected straight through to the egg with the sperms in it.Even with such optimism for conceiving present, when all else fails, Dr Weerasekera points out that there is a 30-40% success rate for IVF, not only in Sri Lanka but worldwide.The process of Controlled Ovarian Stimulation is done so as to extract more than one egg from the womb. If ten were to be extracted all 10 will be fertilised. Two of the fertilized eggs, at the most, are put back into the womb and the rest are frozen. By this procedure, if the fertilization is not successful, the couple may resort to one of the frozen embryos which, according to Dr. Weerasekera, can last for five years. This method is known as Frozen Embryo Transfer (FET).There are three methods involved before the IVF procedure takes place; Laparoscopy, Hysteroscopy, and Dye Insufflation. Laparoscopy involves insertion of a camera through a small cut in the naval. Hysteroscopy is a procedure that involves insertion of a small camera through the vagina to visualize the cavity of the womb. Dye Insufflation is done to test whether the fallopian tubes are blocked or not. Such methods can be used to find out the exact state of the cavity of the womb, patency and function of the tubes, diseases affecting the function of the tubes, state of ovaries and any diseases affecting the ovaries. All these are important factors to diagnose early when there is a delay in conceiving so that early treatment can be instituted. Dr. Weerasekera advises that after six months of ‘trying’ a couple should seek medical help.A major drawback of IVF is the cost — Rs. 200,000 at the least. IVF is not available in state hospitals. The people of this country are not too aware of such a facility available and therefore go abroad. ‘Prarthana’ has delivered 60 babies within the span of five years.
Today on twitter I have read three different posts on how to tell the infertile couple you are pregnant. This is funny because for the last 2.5 weeks I have suspected that my sister-in-law is pregnant and not telling me since she knows what we are going through. I feel with this whole IVF treatment it makes your senses even more heighten to seeing and knowing symptoms of pregnancy.I have 3 types of online support that I am using to get through this IVF cycle, obviously this one where I can blog about what is going on with my cycle. Twitter, where I follow other infertile couples on their journeys through IVF, and BabyCenter, which I have a little group of 11 girls who are all the same age as me 24-26, going through IVF this May cycle with me. After reading those blogs and talking to the girls on my BabyCenter group I have realized a couple of things personally about telling the infertile couple you are pregnant.I think it depends where you are in your infertility journey. My group on BabyCenter group are all first time IVFers, only 2 have done IUIs, and a couple took Clomid. We have barely been on this journey. So we are still excited whenever we hear of someone being pregnant. However, talk to us a couple of years from now if we have not had any children, and have spent thousands and thousands of dollars, we may not be as excited. I think the infertility journey can definitely wear you down.I also believe it depends on age. At 26, I know that I will probably keep doing treatments until I either am done having kids, or I get tired. Either way I have years ahead of me that I could potentially become pregnant. In my cohort at Dr. T’s office I am the youngest by 3 years.For me specifically, we have a male factor issue that was easily identified. My husband did have testicular cancer at 6 months old, so we already knew with chemotherapy and medication there could potentially be a problem. It was very sweet one day his mom and I went to lunch one day and she told me that she was sorry for making the decision that affected his fertility. I told her, that if she didn’t make that decision I probably wouldn’t have such a sweet husband.This is how I look at it. Right now I am at the age where everyone is getting pregnant. I am one of those people who truly believe that everyone has their own struggles, whether its school related, financial, family etc. The Huz and I have an extremely blessed life, great families on both sides and have not really had to worry about anything. So the way I look at it now is that our struggle is fertility, and if this is the most difficult struggle we go through, I’ll take it. The Huz is such a wonderful man, and I couldn’t imagine a better person to go through this with. So when people are trying to figure out how to be sensitive to the infertile couples need, I would look at where they are at in their journey, how old there are, and be sensitive to that. Every couple handles news different, just make sure you do your research before you drop the bomb.Hoping everyone is having a great day! Peace, Love and Baby Dust!
This Nick Galifianakis cartoon was originally published on July 22, 2011 for the feature Carolyn Hax: Tell Me About It in The Washington Post and other syndicated newspapers. The illustration deals with babies, feeling loved, wanted, you were a choice, obligation, playroom, fertility, infertile, desperate, kid, children, attempt, pregnancy, IVF, in vitro fertilization, baby catalog, older parents, trying really hard, preference, value of life, partial, jealous, biased, favoring, buying a baby and knowing how much you’re worth.
Since the birth of the first IVF baby almost 30 years ago, dramatic developments have occurred in in vitro fertilization (IVF). IVF was initially designed to overcome the problem of tubal infertility but is now widely held to represent the treatment of choice for unexplained infertility, male factor, endometriosis, and ovarian dysfunction resistant to ovulation induction.1,2 The introduction of intracytoplasmic sperm injection (ICSI) has rendered severe forms of male infertility amenable to treatment and further widened the scope of IVF.3 High-profile publicity given to the latest achievements with IVF has led to its perception as a panacea for all those having difficulty in conceiving a pregnancy. This has been reflected in the rapid expansion of indications for IVF and an estimated current annual number of IVF cycles worldwide approaching 500000.4 The degree to which IVF merits this growth in application remains unclear, however, since prospective randomized trials comparing the effectiveness of IVF with simpler fertility treatments remain scarce.Hi, I’m Lynne, and I am asking for your support for my dear family members, Marga and David. A while back, when Marga said to David, “It takes a village to conceive a child,” she was talking about their emotionally supportive community and the team of practitioners involved in their journey to conceive. Little did they know they would also need a village of financially supportive friends to make this happen! (Read the full story below).If you feel moved to contribute to this heartful and worthy cause, I am asking for asuggested donation of $30 by clicking on the PayPal button below. Less than $30, or more, is also appreciated! The money goes directly to Marga and David’s IVF fund.Thank you for contributing to their baby-making journey, and for being part of their village!
We are just beginning to understand the implications of blastocyst transfer for both practitioners and patients. ,We believe infertility treatment centers will soon be able to reliably grow blastocysts and accurately assess which embryos are destined to implant and develop into an ongoing pregnancy. When that happens, the transfer of a single blastocyst will become the norm. And today's risk of high-order multiples will become a memory. The future holds much hope, much promise, and considerably fewer risks.
Producing healthy human beings with high immunity is also a positive side of eugenics, and this has been proven to be true. For example, in Los Angeles, genetic scientist have used high technology techniques to subtract the possibilities of inheriting sickle cell anemia in a family of black race. The possibilities of getting sickle cell anemia was eradicated by excising or eliminating the sickle cell gene by the combination of in-vitro fertilization and genetic engineering on a cell taken from an embryo which is still developing in its early stage.There's another light side of eugenics such as controlling world population. This issue has created many controversies among public because according to eugenics, only mentally healthy couples and couples without severe health conditions are allowed to reproduce. Scientist who supports eugenics believe that, a mentally healthy parent would produce a mentally stable individual with good thoughts and personality. This is because traits and personalities of parents are carried down through genes to generation after generation. Thus, the number of crimes and violence can be decreased as more people would have modified genes which prevent them to have perverted thoughts.As a whole, positive eugenics gives way to producing individuals with good traits and better mental and physical well being. A better trait can be anything from good resistance of disease or high immunity level and healthy body condition. Eugenics is a strategised evolution for the life of mankind. Eugenics is a pathway for producing high quality offspring.However, eugenics causes world ethical issues. One of the issues raised is abortion. Some babies are born and started out their life with trouble and engaged with accident and fatal disease that cannot be cured as well as babies with disease such chromosomal or recessively inherited disease as Down syndrome, Tay-Sachs disease, and thalassemia major. Babies with these diseases usually die early or fail to reproduce.
Embryo BankingA NOVEL WAY OF TREATING INFERTILITY THROUGH MEDICALLY ASSISTED REPRODUCTION.A full-fledged ,professionally managed,“EMBRYO BANK.”Bridging the GAP between “Waiting Lives” and “Desirous Parents”Laser Assisted HatchingVitrification of Oocytes, Embryos and Sperms.Sperm Retrieval Techniques like Tesa,Pesa,Tese Our latest additions are equipment for Intracytoplasmic Morphologically Selected Sperm Injection(IMSI ) and the Laser for Assisted Hatching of embryos.We have started an “EMBRYO BANK” that is a Novel way for achieving Medically Assisted conception. Ankur Embryo BankBRIDGING THE GAP BETWEEN “WAITINGLIVES” AND “DESIROUSPARENTS”!!At Ankur Embryo Bank, we offer a novel treatment of Embryo Donation to infertile patients. Embryo Donation is the newer method of family building which combines assisted reproductive technology with adoption, so that instead of adopting a baby the infertile couples adopt embryos The procedure is called ‘Adoption’ because the couple who adopts the embryo has no ‘Genetic connection’ to it. However ,unlike the traditional baby adoption ,the recipient mother undergoes pregnancy and labour to get a “true” sense of motherhood. At, Ankur Embryo Bank, we handle Embryo Donation like a closed adoption. There is no contact between the donor couple and the recepients who never see each other.Unlike the traditional adoption,the couple doesnot have to go through legal process, but they have to undergo a medical treatment.The couple therefore ‘biologically adopts the embryo. There are many reasons for a couple to prefer Embryo Adoption to traditionally adopting a child .It offers a unique opportunity to an infertility affected woman to be pregnant,to bond with her child prior to birth, and then to actually give birth.Embryo Adoption also offers couples the privacy and secrecy so that they do not have to worry about the social acceptance of their adopted and born baby. Additionally, Embryo Adoption can be much more affordable than the traditional adoption in countries like US. Moreover,inIndia,certain groups like Christians and Muslims cannot adopt .Embryo Adoption can be an extremely valid and attractive option for them.
Embryo Banking in IVF: An Approach That Arrests the Adverse Effects of the Biological Clock29JUNASK DR. SHER A QUESTION An ever increasing number of American women first seek IVF treatment in their late 30’s or early 40’s.This trend is in large part due to the fact that more and more women are choosing to defer childbearing until they have fulfilled their career aspirations. While such deliberate deferment is understandable, it nevertheless poses significant problems, because women in their late 30’s and early 40’s have about one half the chance of having a baby following IVF than do women in their early to mid 30’s. There are two primary reasons for this:First is the fact that advancing age beyond 35 years is accompanied by an inevitable and progressive increase in chromosomal egg abnormalities (aneuploidy) which lead to “incompetent” embryos that cannot propagate viable pregnancies. That is why we see a profound and steady decline in IVF success rates as well as an increase in chromosomal miscarriages and birth defects such as Down’s syndrome with advancing maternal age.Second, as women get older, there occurs a progressive decline in their ovarian egg supply. This so-called “diminished ovarian reserve” (DOR) results in less eggs being accessible via egg retrieval and consequentially, fewer “competent” embryos available for transfer to the uterus.Most women/couples would like to have more than one child. This desire is no less prevalent in older women. However, by the time the older woman decides to do IVF, goes through the process successfully, has a baby, completes breastfeeding, and thereupon re-establishes regular menstruation in order to try for another IVF baby, a period of 2-3 years will have elapsed. While such a hiatus would usually be of little consequence to a young woman, for an older woman such a delay could seriously impact her “biological clock” so as to drastically reduce her chance of having another baby with her own eggs.Egg/embryo banking offers a potential solution for older women and those with DOR who wish to minimize the relentless effect of the biological clock. The process involves undergoing several IVF stimulation/egg retrieval procedures in relatively quick succession, and then freezing/banking all viable embryos for future dispensation, rather than having them transferred to the uterus immediately. Such embryo “stockpiling” would literally stop the biological clock in its tracks, allowing for the subsequent elective thawing of one or two frozen embryos at a time in future frozen embryo transfer (FET) cycles. This process would avert the risk of progressive declining egg/embryo “competency” over time.The concept of embryo banking/stockpiling would not have been feasible even 5 years ago, since it was not until quite recently that we became able to reliably identify chromosomally normal (“competent”) embryos for selective banking. Embryo freezing technology has also evolved dramatically over that time. Just a few years ago, the freezing process took a serious toll on embryos, severely damaging up to 50% of them in the freeze/thaw process. But that was then…Today, through the adaptation of comparative genomic hybridization (CGH) technology to egg and/or embryo selection we are able to much better identify “competent” embryos for banking and stockpiling. In addition, the recent introduction of much improved egg/embryo freezing through ultra-rapid cryopreservation (i.e. vitrification) eliminates most of the potential damage incurred to “competent” embryos during the freezing and thawing process. In fact, in IVF centers of excellence, the frozen embryo transfer (FET) process using vitrified/thawed embryos now yields the same IVF success rate as when fresh embryos are transferred!These innovations (CGH and Vitrification) have not only made embryo banking/stockpiling feasible, but have rendered the approach a most appealing option for older women and women with DOR who seek to undergo IVF using their own eggs.This having been said, CGH is not an indispensable part of embryo banking. The process can be done without it. But, given the inevitability of an age-related increase in the incidence of chromosomal abnormalities in the egg/embryo, it would be impossible for patients to know whether they have stored “competent” embryos and which ones to transfer to the uterus for the best chance of success when the time comes.I want to emphasize that CGH does not improve embryo quality. It is an efficiency tool that allows us toselect “competent” embryos for transfer and thereby dramatically improve the baby rate per embryo transferred. It is also well to bear in mind that aneuploidy not only reduces the chance of a successful pregnancy but it is also the cause of miscarriages and many birth defects (e.g. Down’s syndrome). Thus CGH embryo selection not only improves IVF success (per embryo transferred), but it also reduces the incentive to transfer multiple embryos at a time, thereby virtually eliminating the occurrence of high-order multiple pregnancies (triplets or greater).Proudly, we at SIRM were the first to introduce CGH embryo selection into the clinical IVF arena. Since then, we have reported hundreds of successes using this approach, which is finally starting to gain wide acceptance in the IVF field. We were also among the first in the United States to supplant conventional egg/embryo freezing with “vitrification.” It is against this background that we now provide selective embryo banking/stockpiling to an ever increasing number of older women and women with DOR. We have already witnessed the profound benefits of such an approach.Finally, embryo banking/stockpiling would also have appeal to younger women who plan on deferring having children until later in life – or who want to at least have the option available, should their life/career path so dictate. Even some fertile women for whom IVF would otherwise not be necessary could fall into this category.Through our technology and package pricing, we at SIRM have attempted to make this approach relatively accessible to those that need or desire access to this advantage.
Embryo Banking in IVF: An Approach That Arrests the Adverse Effects of the Biological Clock29JUNASK DR. SHER A QUESTION An ever increasing number of American women first seek IVF treatment in their late 30’s or early 40’s.This trend is in large part due to the fact that more and more women are choosing to defer childbearing until they have fulfilled their career aspirations. While such deliberate deferment is understandable, it nevertheless poses significant problems, because women in their late 30’s and early 40’s have about one half the chance of having a baby following IVF than do women in their early to mid 30’s. There are two primary reasons for this:First is the fact that advancing age beyond 35 years is accompanied by an inevitable and progressive increase in chromosomal egg abnormalities (aneuploidy) which lead to “incompetent” embryos that cannot propagate viable pregnancies. That is why we see a profound and steady decline in IVF success rates as well as an increase in chromosomal miscarriages and birth defects such as Down’s syndrome with advancing maternal age.Second, as women get older, there occurs a progressive decline in their ovarian egg supply. This so-called “diminished ovarian reserve” (DOR) results in less eggs being accessible via egg retrieval and consequentially, fewer “competent” embryos available for transfer to the uterus.Most women/couples would like to have more than one child. This desire is no less prevalent in older women. However, by the time the older woman decides to do IVF, goes through the process successfully, has a baby, completes breastfeeding, and thereupon re-establishes regular menstruation in order to try for another IVF baby, a period of 2-3 years will have elapsed. While such a hiatus would usually be of little consequence to a young woman, for an older woman such a delay could seriously impact her “biological clock” so as to drastically reduce her chance of having another baby with her own eggs.Egg/embryo banking offers a potential solution for older women and those with DOR who wish to minimize the relentless effect of the biological clock. The process involves undergoing several IVF stimulation/egg retrieval procedures in relatively quick succession, and then freezing/banking all viable embryos for future dispensation, rather than having them transferred to the uterus immediately. Such embryo “stockpiling” would literally stop the biological clock in its tracks, allowing for the subsequent elective thawing of one or two frozen embryos at a time in future frozen embryo transfer (FET) cycles. This process would avert the risk of progressive declining egg/embryo “competency” over time.The concept of embryo banking/stockpiling would not have been feasible even 5 years ago, since it was not until quite recently that we became able to reliably identify chromosomally normal (“competent”) embryos for selective banking. Embryo freezing technology has also evolved dramatically over that time. Just a few years ago, the freezing process took a serious toll on embryos, severely damaging up to 50% of them in the freeze/thaw process. But that was then…Today, through the adaptation of comparative genomic hybridization (CGH) technology to egg and/or embryo selection we are able to much better identify “competent” embryos for banking and stockpiling. In addition, the recent introduction of much improved egg/embryo freezing through ultra-rapid cryopreservation (i.e. vitrification) eliminates most of the potential damage incurred to “competent” embryos during the freezing and thawing process. In fact, in IVF centers of excellence, the frozen embryo transfer (FET) process using vitrified/thawed embryos now yields the same IVF success rate as when fresh embryos are transferred!These innovations (CGH and Vitrification) have not only made embryo banking/stockpiling feasible, but have rendered the approach a most appealing option for older women and women with DOR who seek to undergo IVF using their own eggs.This having been said, CGH is not an indispensable part of embryo banking. The process can be done without it. But, given the inevitability of an age-related increase in the incidence of chromosomal abnormalities in the egg/embryo, it would be impossible for patients to know whether they have stored “competent” embryos and which ones to transfer to the uterus for the best chance of success when the time comes.I want to emphasize that CGH does not improve embryo quality. It is an efficiency tool that allows us toselect “competent” embryos for transfer and thereby dramatically improve the baby rate per embryo transferred. It is also well to bear in mind that aneuploidy not only reduces the chance of a successful pregnancy but it is also the cause of miscarriages and many birth defects (e.g. Down’s syndrome). Thus CGH embryo selection not only improves IVF success (per embryo transferred), but it also reduces the incentive to transfer multiple embryos at a time, thereby virtually eliminating the occurrence of high-order multiple pregnancies (triplets or greater).Proudly, we at SIRM were the first to introduce CGH embryo selection into the clinical IVF arena. Since then, we have reported hundreds of successes using this approach, which is finally starting to gain wide acceptance in the IVF field. We were also among the first in the United States to supplant conventional egg/embryo freezing with “vitrification.” It is against this background that we now provide selective embryo banking/stockpiling to an ever increasing number of older women and women with DOR. We have already witnessed the profound benefits of such an approach.Finally, embryo banking/stockpiling would also have appeal to younger women who plan on deferring having children until later in life – or who want to at least have the option available, should their life/career path so dictate. Even some fertile women for whom IVF would otherwise not be necessary could fall into this category.Through our technology and package pricing, we at SIRM have attempted to make this approach relatively accessible to those that need or desire access to this advantage.
Embryo Banking in IVF: An Approach That Arrests the Adverse Effects of the Biological Clock29JUNASK DR. SHER A QUESTION An ever increasing number of American women first seek IVF treatment in their late 30’s or early 40’s.This trend is in large part due to the fact that more and more women are choosing to defer childbearing until they have fulfilled their career aspirations. While such deliberate deferment is understandable, it nevertheless poses significant problems, because women in their late 30’s and early 40’s have about one half the chance of having a baby following IVF than do women in their early to mid 30’s. There are two primary reasons for this:First is the fact that advancing age beyond 35 years is accompanied by an inevitable and progressive increase in chromosomal egg abnormalities (aneuploidy) which lead to “incompetent” embryos that cannot propagate viable pregnancies. That is why we see a profound and steady decline in IVF success rates as well as an increase in chromosomal miscarriages and birth defects such as Down’s syndrome with advancing maternal age.Second, as women get older, there occurs a progressive decline in their ovarian egg supply. This so-called “diminished ovarian reserve” (DOR) results in less eggs being accessible via egg retrieval and consequentially, fewer “competent” embryos available for transfer to the uterus.Most women/couples would like to have more than one child. This desire is no less prevalent in older women. However, by the time the older woman decides to do IVF, goes through the process successfully, has a baby, completes breastfeeding, and thereupon re-establishes regular menstruation in order to try for another IVF baby, a period of 2-3 years will have elapsed. While such a hiatus would usually be of little consequence to a young woman, for an older woman such a delay could seriously impact her “biological clock” so as to drastically reduce her chance of having another baby with her own eggs.Egg/embryo banking offers a potential solution for older women and those with DOR who wish to minimize the relentless effect of the biological clock. The process involves undergoing several IVF stimulation/egg retrieval procedures in relatively quick succession, and then freezing/banking all viable embryos for future dispensation, rather than having them transferred to the uterus immediately. Such embryo “stockpiling” would literally stop the biological clock in its tracks, allowing for the subsequent elective thawing of one or two frozen embryos at a time in future frozen embryo transfer (FET) cycles. This process would avert the risk of progressive declining egg/embryo “competency” over time.The concept of embryo banking/stockpiling would not have been feasible even 5 years ago, since it was not until quite recently that we became able to reliably identify chromosomally normal (“competent”) embryos for selective banking. Embryo freezing technology has also evolved dramatically over that time. Just a few years ago, the freezing process took a serious toll on embryos, severely damaging up to 50% of them in the freeze/thaw process. But that was then…Today, through the adaptation of comparative genomic hybridization (CGH) technology to egg and/or embryo selection we are able to much better identify “competent” embryos for banking and stockpiling. In addition, the recent introduction of much improved egg/embryo freezing through ultra-rapid cryopreservation (i.e. vitrification) eliminates most of the potential damage incurred to “competent” embryos during the freezing and thawing process. In fact, in IVF centers of excellence, the frozen embryo transfer (FET) process using vitrified/thawed embryos now yields the same IVF success rate as when fresh embryos are transferred!These innovations (CGH and Vitrification) have not only made embryo banking/stockpiling feasible, but have rendered the approach a most appealing option for older women and women with DOR who seek to undergo IVF using their own eggs.This having been said, CGH is not an indispensable part of embryo banking. The process can be done without it. But, given the inevitability of an age-related increase in the incidence of chromosomal abnormalities in the egg/embryo, it would be impossible for patients to know whether they have stored “competent” embryos and which ones to transfer to the uterus for the best chance of success when the time comes.I want to emphasize that CGH does not improve embryo quality. It is an efficiency tool that allows us toselect “competent” embryos for transfer and thereby dramatically improve the baby rate per embryo transferred. It is also well to bear in mind that aneuploidy not only reduces the chance of a successful pregnancy but it is also the cause of miscarriages and many birth defects (e.g. Down’s syndrome). Thus CGH embryo selection not only improves IVF success (per embryo transferred), but it also reduces the incentive to transfer multiple embryos at a time, thereby virtually eliminating the occurrence of high-order multiple pregnancies (triplets or greater).Proudly, we at SIRM were the first to introduce CGH embryo selection into the clinical IVF arena. Since then, we have reported hundreds of successes using this approach, which is finally starting to gain wide acceptance in the IVF field. We were also among the first in the United States to supplant conventional egg/embryo freezing with “vitrification.” It is against this background that we now provide selective embryo banking/stockpiling to an ever increasing number of older women and women with DOR. We have already witnessed the profound benefits of such an approach.Finally, embryo banking/stockpiling would also have appeal to younger women who plan on deferring having children until later in life – or who want to at least have the option available, should their life/career path so dictate. Even some fertile women for whom IVF would otherwise not be necessary could fall into this category.Through our technology and package pricing, we at SIRM have attempted to make this approach relatively accessible to those that need or desire access to this advantage.