In Vitro Fertilization (IVF) Rels 300 / Nurs 330 18 November 2015 300/330 - appleby1.
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Transcript of In Vitro Fertilization (IVF) Rels 300 / Nurs 330 18 November 2015 300/330 - appleby1.
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In Vitro Fertilization (IVF)
Rels 300 / Nurs 330
18 November 2015
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On left: Physiologist Robert Edwards
Middle: baby Louise Joy Brown
(Middle woman, unidentified)
Right: Gynecologist Patrick Steptoe
Parents: Lesley & John Brown – after 9 years of infertilityAfter 80 embryo transfer failures, 1st successful pregnancy and birth
25 July 1978:1st “test tube” Baby
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Robert Edwards received the 2010 Nobel prize for medicine.
the world's first "test tube baby" was born in July 1978.
IVF technology allowed Lesley & John Brown to experience pregnancy & birth, in spite of Lesley’s blocked fallopian tubes
Currently, over 4 million test tube Babies have been born
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In response, the Vatican protested the awarding of the prize, saying that: Conception occurs separate
from the couple’s conjugal union Embryos that are fertilized but
not implanted are destroyed
The President of the Pontifical Academy for Life said that “without Edwards there would not be freezers full of embryos waiting to be transferred to a uterus, or, more likely, used for research or left to die, abandoned and forgotten by all.”
http://catholic.org/hf/family/story.php?id=39343
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“All hell will break loose, politically and morally,all over the world.”The Atlantic, June 2012
James Watson, co-discoverer with Crick of the structure of DNA, and fellow Nobel Laureate from 1953, had this to say about IVF:
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IVF is a process whereby ova and sperm are placed together in a glass dish (in vitro = in glass) in a laboratory setting If fertilization occurs, and the early embryos
successfully begin to grow in the dish, then the embryos are transferred into the woman’s uterus
If one or more embryos are successful in achieving implantation, then a pregnancy has begun
What is IVF?
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5 Steps
1. Ovulation induction: fertility drugs are used to cause production of multiple ova (usually 3 or more, up to 15 or 20) and to control the exact timing of the ovulation
2. Follicular aspiration: ripe ova within their follicles are surgically removed from the woman’s ovaries using a hollow catheter
3. Ova and sperm are combined in a glass dish in a nutrient-rich medium (ratio of 50,000 to 1)
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5. Healthy fertilized zygotes are transferred to the woman’s uterus through the cervix using a catheter; generally 1 to 3 embryos per transfer
4. Dish containing ova and sperm is placed in an incubator to provide a temperature-controlled environment; eggs are monitored for fertilization and cell division
(“Spare” embryos may be discarded, frozen, or donated)
After 17 days, a pregnancy test will be done, followed by an ultrasound if pregnancy has been confirmed
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Risks associated with anesthesia
Risks of bleeding, infection
Risks of damage to the bowel, bladder or blood vessels
Potential for a multiple pregnancy with risk of premature delivery
Potential risks from donor sperm or ova
Hormonal stimulation of woman’s ovaries to produce multiple ova
→ risk of ovarian hyperstimulation
Severe abdominal pain
Nausea or vomiting Decreased urination Shortness of breath Up to 10 lb. weight
gain within 3 to 5 days
Medical Risks associated with IVF
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ICSI – intracytoplasmic sperm injection – if sperm are few or inactive – a single sperm is inserted into the ovum with a catheter
GIFT – gamete intrafallopian transfer – ova and sperm are collected and then transferred to the fallopian tubes so that fertilization takes place within the woman’s body
Variations of IVF
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SPERM Donation of
sperm no longer needed for AI or IVF
Purchase of sperm from a “donor” catalogue
Altruistic donation from a family member or friend
Purchase online; http://www.mountsinai.on.ca/care/fertility/services/donor-insemination
OVA Donation of
healthy ova no longer needed by another IVF woman
Purchase of ova from a “donor” catalogue
Altruistic donation from a family member or friend; http://www.mountsinai.on.ca/care/fertility/services/egg-donation
IVF with donors
EMBRYO• Excess frozen
fertilized embryos from previous IVF cycles; http://www.mountsinai.on.ca/care/fertility/services/embryo-freezing
• Purchase from an IVF clinic’s excess inventory
• Prenatal adoption of “spare” embryos
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IVF fee schedule http://
www.mountsinai.on.ca/care/fertility/financing-options/fee-schedule-may-2015.pdf
250 Dundas Street West, Suite 700 · Toronto, ON · M5T 2Z5 · (416)
586-4748
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http://www.eggdonation.com/index.php https://www.eggdonation.com/becoming-an-egg-donor/BecominganEggDonor.php
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MISSION To locate stunning, well motivate candidates…To accept no more than 5% of our 1,200 + monthly egg donor applicationsTo be instrumental in setting & surpassing industry standards…To provide competitive program costsTo provide reliable financial auditing To provide secure and confidential recordsTo provide cycle coordination…To honor the responsibility of creating families
Create a username and password to view ourDatabase of Egg Donors
ONE OF OUR REAL EGG DONOR ANGELS
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https://www.eggdonation.com/becoming-an-egg-donor/Donor-compensation.php
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Frozen Egg Donor Cycle5 mature eggs = $16,500 plus transfer fees
Fresh Egg Donor CycleUnknown quantity of eggs = $38,000 - $60,000
http://www.eggdonation.com/egg-donor-bank.php
Frozen Eggs Available from egg donor 1019 only. We have had a 100% success rate with transfers from
this donor cycle, both fresh and frozen.
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HAYLEY (#73010) https://www.eggdonor.com/donor-profile/?pid=73010
https://www.eggdonor.com/egg-donor-database/
Our on-line egg donor catalog
SHAKIRA (#61803)https
://www.eggdonor.com/donor-profile/?pid=61803
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http://www.ctfertility.com/find-egg-donors
Sample Profile for egg donor #254, http://www.ctfertility.com/sample-egg-donor-profile
What does she think you would want to know about her?
Choose – a – Donor !
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Rotunda Clinic offers comprehensive IVF services:
IUI, IVF, ICSI Donor Egg IVF, Embryo Adoption, Surrogacy Embryo Retrieval through Puncture/ Aspiration, Overseas IVF Patient Program, Gestational Surrogacy & Gestational Carrier ART Program
Rotunda-The Center for Human Reproduction MUMBAI, India
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Why choose Egg and/or Embryo Storage? When fertility is at risk due
to illness or surgery To delay childbearing until a
later date Egg/Embryo storage gives
women who have completed IVF treatment the option to preserve the unused embryos for potential use in the future
Your IVF center has limited storage space
Your IVF center is closing
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Donors Donors Embryo Adoption 101 Terminology Defined Videos Personal Stories Donor FAQs Counselor Support
Network News Articles Where to Donate Webinar Registration Glossary
Adopters Adopters Embryo Adoption 101 Terminology Defined Videos Personal Stories Adopter FAQs News Articles Embryo Adoption
Agencies Home Study Providers Clinics with Donation
http://www.embryoadoption.org/sitemap/index.cfm
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Ranjit Hayer tried for decades to have a child, enduring multiple miscarriages, surgery, even the trauma of being robbed by a fertility doctor. Finally, after a successful IVF treatment, the Calgary woman gave birth to twins — at age 60.
She is believed to be among the oldest Canadian women to give birth.
http://www.cbc.ca/news/canada/calgary/60-year-old-calgary-mother-welcomes-twins-1.844372
CASE STUDY:60-YEAR-OLD CALGARY MOTHER WELCOMES TWINS
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“We can do so much but the question is, should we do it just because we can do it?”
60-year-old MOM
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Whose personal dignity and autonomy are promoted or harmed?
What are the potential benefits of reproductive technologies?
Who are the beneficiaries?What are the potential risks and harms of
reproductive technologies?Who is most likely to be harmed?
Are there justice issues in the provision of reproductive services?
Issues of fairness, equality, equitable access?
Evaluating reproductive technologies