Assisted Reproductive Technology (ART)
ART includes multiple methods of assisting fertilization: In-vitro fertilization-embryo transfer (IVF-ET), Gamete intrafallopian transfer (GIFT), and embryo cryopreservation
IVF-ET
IVF-ET is the process of fertilization by manually combining an egg and sperm in a laboratory dish. When the IVF procedure is successful, the process is combined with a procedure known as embryo transfer, which involves physically placing the embryo in the uterus.
The Process of IVF
Step 1: Fertility medications are prescribed to increase the change of collecting multiple eggs during one of the woman's cycles. This process is referred to as ovulation induction. Multiple eggs are desired because of the eggs will not develop or fertilize after they are retrieved. Egg development is monitored using ultrasound to examine the ovaries, and often urine and blood test samples are taken to check the women's hormone levels.
Step 2: Eggs are retrieved through the use of ultrasound imaging to guide a hollow needle through the pelvic cavity. The eggs are removed from the ovaries using the hollow needle - a procedure called follicular aspiration.
Step 3: Sperm is obtained and is prepared to be combined with the eggs.
Step 4: Through a process called insemination, the sperm and eggs are placed in incubators located in a laboratory. The incubators enable fertilization to occur. The eggs are monitored to confirm that fertilization and cell division are taking place. Once this occurs, the fertilized eggs are considered embryos.
Step 5: The embryos are then transferred into the woman's uterus from one to six days later. The fertilized egg at this stage has developed into a two-to-four cell embryo. The predetermined number of embryos are suspended in fluid and placed through a catheter into the womb. This process is often guided by ultrasound.
GIFT
Gamete intrafallopian transfer is a procedure used for women who have at least one healthy fallopian tube. Fertile eggs are removed from the ovaries, mixed with sperm and immediately re-injected back into one or both fallopian tubes. Fertilization can then occur naturally in the fallopian tubes.
Embryo Cryopreservation
Cryopreservation is a process that is used to maintain the viability of extra embryos that are produced during an IVF-ET or GIFT procedure. Embryos are stored in liquid nitrogen at a very low temperature. The embryos can be warmed and transferred to the woman's uterus at a later date.
Sex Selection
The Fertility Institutes of Los Angeles, New York, and Mexico -
"By examining the genetic makeup of embryos, we can virtually guarantee your next child will be the sex of your choice."
Preimplantation Genetic Diagnosis (PGD)
Gender of a pregnancy is determined by the sex chromosome carried by the sperm. Sperm with the "X" chromosome is united with the "X" chromosome from the egg and results in a "XX" pregnancy which produces a female. Sperm with a "Y" chromosome unites with the "X" chromosome from the egg and results in an "XY" pregnancy which produces a male.
Sperm are filtered through a standard sperm preparation process and then allowed to fertilize with the eggs obtained from the female in-vitro. The embryos are then screened for gender and for selected chromosome pairs (aneuploidy screening).
Sperm Sorting
The screening of sperm to determine which carries the "X" or "Y" chromosome and then allowing for only the desired sperm to fertilize the egg.
Chromosomal Screening
Advanced embryo selection with extreme accuracy by detecting and avoiding the use of embryos with chromosomal abnormalities prior to transfer and pregnancy
Preimplantation Genetic Diagnosis (PGD)
The aneuploidy (abnormal chromosome count) screening process which is also carried out during the PGD gender screening allows for the detection of limited genetic count abnormalities or for the screening of a wide variety of additional genetic abnormalities. Genetic abnormalities such as Down's Syndrome, Turner's Syndrome, and Kleinfelter's syndrome can be screened. DNA microarray technology allows for the option of screening embryos for a full 46 chromosome genetic count.
Some genetic diseases that can be screened for include:
- Adrenoleukodystrophy
- Amyotrophic Lateral Sclerosis
- Becker Muscular Dystrophy
- Beta Thalassemia
- BREAST CANCER
- Central Core Disease
- Centronuclear (Myotubular) Myopathy
- Cerebellar Ataxia
- Charcot-Marie-Tooth Disease
- Chondrodysplasia Punctata
- Congenital Aganglionic Megacolon
- Conradi-Hunnerman Syndrome
- Cystic Fibrosis
- Duchenne Muscular Dystrophy
- Factor VIII Deficiency
- Factor IX Deficiency
- Familial Spastic Paraparesis
- Fragile X Syndrome
- Friedrich's Ataxia
- Gardener Syndrome
- Glycogen Storage Disease
- Happle Syndrome
- Hemophilia
- Huntington's Disease
- Retinitis Pigmentosa
- Prostate Cancer
- Sickle Cell Anemia
- Tay-Sachs Disease
- Von Willebrand Disease
