How in vitro fertilization (IVF) works – Nassim Assefi and Brian A. Levine

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The lesson on in vitro fertilization (IVF) outlines its historical significance, beginning with the birth of Louise Brown in 1978, and explains the natural reproductive process that IVF aims to replicate. It details the IVF procedure, including hormone stimulation, egg retrieval, fertilization, and embryo transfer, while highlighting the increasing demand for this technology among various demographics facing fertility challenges. The lesson concludes by discussing success rates, the potential for future advancements in reproductive technology, and the ongoing hope IVF provides for individuals and couples looking to conceive.

How In Vitro Fertilization (IVF) Works

In 1978, a groundbreaking event in reproductive medicine occurred when Louise Brown became the first baby born through in vitro fertilization (IVF). This innovation has since revolutionized the way we approach fertility challenges. With about one in eight heterosexual couples experiencing difficulties in conceiving, along with many homosexual couples and single parents seeking reproductive assistance, the demand for IVF has grown significantly. To date, over 5 million babies have been born using this technology.

The Natural Reproductive Process

IVF is designed to replicate the natural process of reproduction, which begins in the brain. Approximately fifteen days before fertilization, the anterior pituitary gland releases follicle-stimulating hormone (FSH). This hormone encourages several ovarian follicles to mature and produce estrogen. Typically, only one follicle reaches full maturity. As it grows, it releases more estrogen, which prepares the uterus and signals the brain about the follicle’s progress. When estrogen levels reach their peak, the anterior pituitary releases a surge of luteinizing hormone (LH), which triggers ovulation and the release of the egg.

Once released, the egg travels into the Fallopian tube. If it is not fertilized within 24 hours, it will disintegrate, and the body will prepare for the next cycle. The egg, which is the largest cell in the body, is encased in a protective layer called the zona pellucida. This layer prevents multiple sperm from entering. A man produces sperm continuously, and each ejaculation contains over 100 million sperm. However, only a few will reach the egg, and just one will penetrate the zona pellucida.

After fertilization, the zygote begins its transformation into an embryo. It takes about three days to reach the uterus, where it will implant into the endometrium after another three days. Once implantation occurs, the cells destined to become the placenta release hormones to signal the ovulated follicle, now known as the corpus luteum, to produce progesterone. This hormone supports the pregnancy until the placenta takes over around six to seven weeks into gestation.

The IVF Process

In IVF, higher levels of FSH are administered to stimulate the ovaries to produce multiple eggs. These eggs are retrieved just before ovulation while the woman is under anesthesia, using a needle guided by ultrasound. Sperm samples are typically collected through masturbation. In the laboratory, the eggs are prepared for fertilization in a petri dish. Fertilization can occur naturally with many sperm or through a technique called intracytoplasmic sperm injection (ICSI), where a single sperm is injected directly into an egg. This method is particularly useful in cases of poor sperm quality.

After fertilization, embryos can be screened for genetic suitability, frozen for future use, or transferred into the woman’s uterus via a catheter. Embryos are usually transferred three days after fertilization or on day five when they reach the blastocyst stage. If the woman’s eggs are of poor quality or have been removed for medical reasons, donor eggs may be used. If the intended mother cannot carry the pregnancy, a gestational carrier or surrogate may be utilized.

Success Rates and Future Prospects

To enhance success rates, which can be as high as 40% for women under 35, doctors may transfer multiple embryos, which can increase the likelihood of twins or triplets. However, many clinics aim to minimize the risks associated with multiple pregnancies. Millions of babies, like Louise Brown, have been born through IVF and have led healthy lives. Although the long-term health effects of ovarian stimulation with IVF medications are still under study, IVF appears to be safe for women.

With advancements in genetic testing, delayed childbearing, increased accessibility, and decreasing costs, IVF and related techniques may eventually surpass natural reproduction in popularity. This evolution in reproductive technology continues to offer hope and possibilities for many individuals and couples seeking to start or expand their families.

  1. Reflect on the historical significance of Louise Brown’s birth in 1978. How do you think this event has shaped societal views on reproductive technology?
  2. Considering the natural reproductive process described in the article, what aspects of it do you find most fascinating or surprising, and why?
  3. Discuss the ethical considerations that might arise from the use of IVF and related technologies. How do you think these considerations should be addressed?
  4. How do you perceive the role of IVF in addressing fertility challenges for different types of families, including heterosexual couples, homosexual couples, and single parents?
  5. What are your thoughts on the potential long-term health effects of ovarian stimulation with IVF medications? How should these concerns be balanced with the benefits of IVF?
  6. In what ways do you think advancements in genetic testing and IVF could impact future generations and societal norms around reproduction?
  7. Reflect on the emotional and psychological aspects of undergoing IVF treatment. How might these experiences differ from natural conception, and what support systems could be beneficial?
  8. Considering the potential for IVF to surpass natural reproduction in popularity, how do you envision the future of family planning and reproductive choices evolving?
  1. Interactive Timeline Creation

    Create a timeline that outlines the key steps in both the natural reproductive process and the IVF process. Use digital tools like Prezi or Canva to make your timeline visually engaging. This activity will help you understand the sequence and timing of events in both processes.

  2. Case Study Analysis

    Analyze a case study of a couple undergoing IVF treatment. Discuss the challenges they face, the decisions they make, and the outcomes. This will give you insight into the practical and emotional aspects of IVF.

  3. Debate on Ethical Considerations

    Participate in a debate on the ethical considerations of IVF, such as genetic screening and the use of donor eggs or surrogates. This will encourage you to think critically about the implications of reproductive technologies.

  4. Laboratory Simulation

    Engage in a laboratory simulation where you can observe or simulate the fertilization process in vitro. This hands-on experience will deepen your understanding of the technical aspects of IVF.

  5. Research Presentation

    Conduct research on the future prospects of IVF and present your findings to the class. Focus on advancements in technology, success rates, and societal impacts. This will enhance your research and presentation skills while keeping you informed about the latest developments.

In 1978, Louise Brown became the world’s first baby to be born through in vitro fertilization (IVF), a breakthrough that transformed reproductive medicine. With approximately one in eight heterosexual couples facing challenges in conceiving, and many homosexual couples and single parents seeking clinical assistance, the demand for IVF has significantly increased. Today, over 5 million babies have been born using this technology.

IVF mimics the natural process of reproduction, which begins in the brain. About fifteen days before fertilization, the anterior pituitary gland releases follicle-stimulating hormone (FSH), which stimulates several ovarian follicles to mature and produce estrogen. Typically, only one follicle fully matures, and as it grows, it releases more estrogen, which helps prepare the uterus and informs the brain about the follicle’s development. When estrogen levels peak, the anterior pituitary releases a surge of luteinizing hormone (LH), triggering ovulation and the release of the egg.

Once released, the egg is guided into the Fallopian tube. If not fertilized within 24 hours, it will perish, and the body will prepare for the next cycle. The egg, the largest cell in the body, is protected by a thick shell called the zona pellucida, which prevents multiple sperm from entering. A man produces sperm continuously, with each ejaculation containing over 100 million sperm, but only a few will reach the egg, and only one will penetrate the zona pellucida.

Upon fertilization, the zygote begins developing into an embryo and takes about three days to reach the uterus, where it will implant into the endometrium after another three days. Once implanted, the cells that will become the placenta release hormones to signal the ovulated follicle, now called the corpus luteum, to produce progesterone, which supports the pregnancy until the placenta takes over around six to seven weeks.

In IVF, FSH is administered at higher levels to stimulate the ovaries to produce multiple eggs. These eggs are retrieved just before ovulation while the woman is under anesthesia, using a needle guided by ultrasound. Most sperm samples are collected through masturbation. In the lab, the eggs are prepared for fertilization in a petri dish, which can occur naturally with many sperm or through a technique where a single sperm is injected directly into an egg, especially useful in cases of poor sperm quality.

After fertilization, embryos can be screened for genetic suitability, frozen for future use, or transferred into the woman’s uterus via catheter. Typically, embryos are transferred three days after fertilization or on day five when they reach the blastocyst stage. If the woman’s eggs are of poor quality or have been removed due to medical reasons, donor eggs may be used. If the intended mother cannot carry the pregnancy, a gestational carrier or surrogate may be utilized.

To improve success rates, which can be as high as 40% for women under 35, doctors may transfer multiple embryos, leading to a higher incidence of twins and triplets. However, many clinics aim to minimize the risks associated with multiple pregnancies.

Millions of babies, like Louise Brown, have been born through IVF and have led healthy lives. While the long-term health effects of ovarian stimulation with IVF medications are still being studied, IVF appears to be safe for women. With advancements in genetic testing, delayed childbearing, increased accessibility, and decreasing costs, it’s possible that IVF and related techniques could surpass natural reproduction in the future.

FertilizationThe process by which a sperm cell and an egg cell combine to form a zygote, initiating the development of a new organism. – During fertilization, the genetic material from both parents is combined to form a unique genetic blueprint for the embryo.

HormoneA chemical substance produced in the body that regulates and controls the activity of certain cells or organs. – Insulin is a hormone that plays a crucial role in regulating blood glucose levels.

EmbryoAn early stage of development in multicellular organisms, following fertilization and before fetal development. – The embryo undergoes rapid cell division and differentiation during the first few weeks of pregnancy.

OvariesFemale reproductive organs that produce eggs and secrete hormones such as estrogen and progesterone. – The ovaries release an egg during each menstrual cycle, a process known as ovulation.

SpermMale reproductive cells that are capable of fertilizing an egg to form a zygote. – Sperm are produced in the testes and are essential for sexual reproduction in humans.

ImplantationThe process by which a fertilized egg attaches to the lining of the uterus to begin pregnancy. – Successful implantation is crucial for the continuation of pregnancy and the development of the embryo.

ProgesteroneA hormone produced by the ovaries that prepares the uterus for pregnancy and maintains the early stages of pregnancy. – Progesterone levels increase after ovulation to prepare the uterine lining for potential implantation.

GeneticsThe study of heredity and the variation of inherited characteristics in living organisms. – Genetics plays a significant role in determining an individual’s susceptibility to certain diseases.

ReproductionThe biological process by which new individual organisms are produced from their parents. – Sexual reproduction involves the combination of genetic material from two parents, resulting in offspring with genetic variation.

HealthThe state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity. – Maintaining a balanced diet and regular exercise are essential components of good health.

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