BSCI1105 9:23 Guest Speaker-Dr. Glenn Weitzman PDF

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Denise Due-Goodwin...

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BSCI1105 9/23 DR. GLENN WEITZMAN—GUESTSPEAKER INFERTILITY AND IN VITRO FERTILIZATION Fertility in the U.S.  Fewer babies being born per woman o Changing roles and aspirations for women o Social reasons, personal reasons, etc. Infertility—after a year of trying and being unsuccessful, this qualifies as infertility  As women get older, fertility declines  Infertility is more common than you might think (1 in 12 couples)  Infertility affects men and women almost equally  Three things to get pregnanta sperm, an egg, and a good place for them to get together The Male Reproductive System  Testes are where sperm in made (seminiferous tubules), collected and stored, and then vaulted out and become part of the ejaculate o Ejected into the tube, tail first, head last o New sperm productionit takes approx. 3 months to get to the “front of the line”  Sperm count (normal fertility)—15M-20M sperm per mL [total motile at least 7.2M-20M moving sperm per ejaculateaverage is around 40M]  What might suppress sperm production? o Varicocele (abnormal dilation and torsion of veins) in scrotum (usually on left side)can effect sperm production (and most common diagnosis)  You can have a varicocele and get someone pregnant  Fertile population (average 15% have varicocele)  Infertile population (average 33% have varicocele) o Work out medications and steroids can suppress sperm and testosterone production (smaller testes) The Female Reproductive System  Normal Egg Development o Born with all the eggs you will ever have o Each month the ovaries release one egg, or ovumatresia  The Menstrual Cycle  Pregnant women in a state of elevated progesteronetemperature goes up (rise in temperature chart following ovulation BUT this is a backwards way of determining when ovulation occurs)  How to predict ovulation o Urine test kitovulation predictor kit o Ovulation predictor kit—tests for LH in urine  Polycystic ovarian Syndromewomen don’t ovulate (most common endocrine problem among women)  Woman’s pelvic anatomy o Mucus leading to uterus is thick (barrier) except for during ovulation (so sperm can go in) and menstruation (so lining can go out) o Fertilization takes place at the end of the Fallopian tube

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Abnormalities of the uterine cavity Laparoscopy Fibroids (benign tumors) Endometriosiscan lead to ovarian Cyst

Curing Infertility  Medications  Surgery for anatomic issues  In Vitro Fertilization (test tube babies) o First test tube babyLouise Brown in 1978 (Steptoe and Edwards) o 1980—first U.S. IVF program opens in Norfolk o indications for IVF  tubal disease  male factor  tubule factor  etc. o Basic steps for IVF  Ovarian stimulation  Find egg  Mix with sperm  Embryonic development  Implant embryos (usually day 3-5) o Embryo Cryopreservation  Tanks of liquid nitrogen (tanks thought to last 15-20 years) o ICSI—Intracytoplasmic Sperm Injection  To treat male factor  Sperm source  Ejaculate  Electro ejaculation  Epididymal sperm aspiration  Testicular biopsy Fertility Preservation Options  Sperm banking  Embryo freezing and egg freezing (VITRIFICATION)  Ovarian tube freezing  Donor sperm, eggs, or embryos (egg donation especially for older women)  Adoption Gestational Surrogacy  For women unable to carry a baby Preimplantation Genetic Diagnosis  5-7% of babies have something wrong with them (minor or major)  chromosomal analysis before implantation in IVF (GENETIC ANALYSIS)also to implant the babies that have a likely chance of survival  Aneuploidy o Downs Syndrome, Turners, etc. o As women get older, more embryos are abnormal in terms of chromosome numbermore likely to have a miscarriage Gene Chips  How chromosome count is analyzed  Single gene disorders amenable to PGD (Preimplantation Genetic Diagnostics)  BVVL

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