In Vitro Fertilization Blastocyst Single Birth

Many couples have infertility problems for one or more reasons: Blockage in the fallopian tube or endometriosis (problem with the lining of the uterus in women 11) or low sperm count or poor quality of sperm in men. 3 When fertility problems treated unsuccessfully by conventional surgery or treatment, alternatively many couples choose In vitro fertilization (IVF) or test -- tube conception. 1 Before IVF procedure, fertility drugs may be given to the woman to induce several eggs mature in the ovaries at the same time. During In vitro fertilization a woman's eggs from the ovary are removed by one of two possible procedures and then in a laboratory procedure, eggs are fertilized with male sperm. The fertilized eggs (two to four) (embryo) are inserted, about two or five days after fertilization into the uterus of the same or another woman for normal gestation. 2 Any remaining eggs may be cryopreserved (frozen) for future attempts. However IVF will not be feasible if the woman is not capable of ovulating or man is unable to produce at least a few healthy sperm. In the United States, approximately sixty percent of IVF procedures performed on women older than thirty -- five years old. However, women older than thirty-five have a more difficulty time conceiving, may choose more embryos transferred than younger women and consider choosing more viable donor eggs, increase odds of conception. For those women, risk of multiple pregnancies is increased. 4

"Because of the risks of multiple pregnancy to the babies, the American Society for Reproduction Medicine recommends that women under age 35 have no more than two embryos transferred, women age 35 to 37 have no more than three, women 38 to 40 have no more than four transferred, and women have had repeated failed cycles or are over age 40 have no more than five embryos transferred ". Women pregnant with two or more embryos growing in the uterus, may be advised or counseled regarding (controversial to some couples and heart breaking) multifetal pregnancy reduction, reduces the number of fetuses in multiple pregnancies usually to two. Preventing the risk, each additional fetus from stillbirth, miscarriage and life long health concerns or disability. Selective termination 12 determines which fetus has the most severe defect or expected to die later in the pregnancy, unfortunately threatens the life of the survival fetus or fetuses. Also, the procedure increases the outcome for a healthy pregnancy and healthy infant survival of one or more babies. 4

In Vitro Fertilization blastocyst transfer technique eliminates possibility of multiple births common during in vitro fertilization, and not having to consider multifetal pregnancy reduction. Also, IVF blastocyst transfer is an option when conventional IVF transfer failed or few numbers of embryos available for transfer. An embryo reaches the blastocyst stage within five or six days, during this time it is bathed in culture nutrients (replicated nutrients from the fallopian tube environment 9) for development called culturing. 5 The culture dishes containing embryos are carefully kept in an incubator where humidity, atmosphere and temperature are monitored and controlled. Afterwards healthiest embryos are transferred or inserted. 8 Upon advance stage of embryo physiologic development or blastocyst the embryo has an estimated 60 - 100 cells distributed in two areas: Placenta (outer embryo lining) and fetus (inner mass). When blastocyst stage is reached and transfers of embryo accomplished, greater then fifty percent women reach full term pregnancy. Also, advantage the blastocyst embryo is implanted in the uterus sequentially at the same time, normally would be entering the uterus on day five or six (natural pregnancy schedule), compared to IVF procedure when embryos are placed inside the uterus, when normally on day three, still be in the fallopian tubes. 7 Embryos transferred during blastocyst stage considered normal function of the body or physiologic. Also, approximately fifty percent of embryos survive after day three of development reach blastocyst stage, ensuring embryologists a better selection of healthier and viable embryos, inserted into the uterus, usually on day five or six of development (Three or four days longer then conventional IVF transfers). 5 The number of embryos transferred to the uterus, joint decision between patient and physician on the day of transfer. 6 Cryopreservation is not a viable option for any remaining embryos; blastocysts do not survive the freezing process safely, compared to three-day embryos. In North America, blastocyst transfers often performed in fertility clinics. Researchers in Australia developed the technology for IVF blastocyst transfer, thus eliminating the risk of multiple, triple or quadruplet pregnancies. In Vitro Fertilization blastocyst fails to be successful or unachievable if the embryos do not reach blastocyst stage (Some are lost in the culturing process.), insufficient number of embryos available for transfer or fail to develop normally for a small percentage of patients. 5

According to a research study by Stanford University School of Medicine published in the journal of Fertility and Sterility (2007), more than half of women become pregnant undergoing a single In vitro fertilization blastocyst transfer. The study included forty -five patients from 35 - 43 years old. Twenty-eight of those patients conceived and twenty-three had pregnancies beyond the first trimester. Dr. Amin Milki, professor of obstetrics and gynecology and director of Stanford's IVF program at the University said regarding the study: "This offers reassurance that a woman can still expect a good pregnancy rate without gambling with twins." However the Stanford research study cautioned results of the study are not applicable to every woman over the age of thirty-five. 10

References

1.) In vitro fertilization http://www.britannica.com/eb/article-9042232/in-vitro-fertilization

2.) In vitro fertilization http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?requestURI=/healthatoz/Atoz/ency/in_vitro_fertilization.jsp

3.) In vitro fertilization technique enables pregnancy without multiple births - October 2, 2007 http://www.news-medical.net/?id=30639

4.) In vitro fertilization for infertility http://www.webmd.com/infertility-and-reproduction/In-vitro-fertilization-for-infertility

5.) IVF Blastocyst Transfer http://www.sdfertility.com/blastocyst.htm

6.) Blastocyst Stage Transfer http://www.reproductivegenetics.com/blastocyst.html

7.) Blastocyst Transfer http://www.sharedjourney.com/articles/blast.html

8.) IVF Blastocyst Formation and Blastocyst Transfer http://www.ivf1.com/lab-embryo-culture/

9.) In Vitro Fertililization (IVF)) http://ivfpittsburgh.com/treatments_ivf.html

10.) New IVF technique may enable pregnancy without multiple births

http://www.newkerala.com/oct.php?action=fullnews&id=7945

11.) Endometriosis http://familydoctor.org/online/famdocen/home/women/reproductive/gynecologic/476.html12.) FEWER RISKS, NEW HOPE: THE REALITY OF BLASTOCYST TRANSFERS - http://www.ivf.com/blastocyst.html