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Test-tube baby (In vitro fertilization / IVF)

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 In-vivo fertilization: When fertilization of an egg by
sperm takes place in its natural location inside the female
body, it is called in-vivo fertilization.

 In-vitro fertilization: When fertilization of an egg by

sperm takes place outside the female body, it is called in
vitro fertilization.

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What is IVF ?

► IVF commonly known as test tube baby is a technique of

fertilization of ovum by sperm outside the female’s body in
the controlled laboratory conditions and implantation of the
fertilized zygote in the women’s uterus.

► The fertilization of ovum by sperm is allowed to take place in

the laboratory glassware rather than in the body.

► After fertilization, the zygote is allowed to develop up to 16

celled or even 32 celled stage and it is implanted in the uterus of
same female or surrogate mother.

► The embryo then undergoes further development till birth in a

natural way and the born babies are called test tube baby.
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When it is done?
► For infertility treatments

► If there is male infertility due to several reasons like;

o low sperm count
o Abnormal sperm
o Absence of sperm in semen

►If there is female infertility and if female is unable to

conceive naturally due to;
o blockage or damage of fallopian tubes,
o failure in ovulation
o damage to the uterus
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 What causes male What causes female
infertility? infertility

► Azoospermia- Absence of ► Failure to ovulate

sperms in semen
► Damage or blockage of
► Oligospermia- Low sperm fallopian tubes
count
► Damage to the uterus
► Abnormal sperm- Abnormal
in shapes, having two heads, ► Antibiotics to sperms
no tail etc

► Impotence

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History of IVF

► The foundation work of IVF was started by Dr. Petrucci in 1959. but
the fertilized zygote survived only for 29 days. First successful
experiment through IVF was done by Gynecologist Patric
Steptoe and Physiologist Robert Edward.

► Their work lead to the birth of first test tube baby; a baby girl
named Louise Joy Brown on July 25, 1978.

► Thereafter, the technique becomes a boon for infertile couples.

► In Nepal, the first test-tube baby was born on 2005 named Om

Mani Tamang, at Om Hospital and Research Centre in
Kathmandu. 7
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Process / Stages of IVF

Following are the stages in IVF process.

Stage 1: Super ovulation

Firstly a female is treated hormonally by Follicle
stimulating hormone (FSH) to stimulate the ovaries. This
hormones stimulates the ovaries for production of
multiple ova at the same time.
Stage 2: Oocyte/ ova collection
A fine and log needle is inserted into the ovary along with
the inspection by means of ultrasonography(USG). The
needle is connected with suction device which helps to
suck the follicles. Then mature follicles containing ova
are collected. 8
Stage 3: Sperm Collection
Sperms are collected artificially from the father or from the donor
male if in case of male fertility. Also frozen sperms can be used
from sperm bank.

Stage4: Artificial insemination (AI) and fertilization

Sperms and eggs are then placed in an artificial sterile nutrient
solution and allowed to fertilize the ovum by sperm.10,000 to
50,000 motile sperms are used during AI. Multiple ova are
allowed to fertilize. Fertilized ovum are allowed for further
development.

Stage 5: Progesterone treatment

Progesterone hormone is injected to the mother or to surrogate
mother to prepare the uterus for implantation of fertilized ovum.
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Stage 6: Embryo transfer
After fertilization, the zygote starts to divide and when it becomes
a ball of 16 or even 32 celled stage, the embryo are transferred into
the uterus through cervix using a small tube.
Usually 1-3 embryos are transferred to achieve the success.

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Surrogate mother:

The developing embryo can be inserted in the uterus of another

female if the uterus of mother is injured or damaged and not
suitable for pregnancy.

A woman who substitutes or takes the place of real mother to

nurse the embryo is called as surrogate mother and the process is
surrogacy.

A surrogate mother never contributes genetically thus she never

becomes the genetic mother. Surrogate mother is also called as
second mother or substitute mother.

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Drawbacks of IVF

Although it has become a boon in medical science it has raised

some of the ethical and legal problems. They are-

 The problem of what to do with spare pre-embryos alays

arise after the IVF process.

 IVF techniques becomes costly for some couples

 There always occur the high risk of multiple birth due to the
transfer of more embryos.

 A serious issue can arise if a single mother wants a baby. 14

Ethical consideration of IVF/ Ethical problems:
-A serious ethical issue occurs over what to do with the spare pre-
embryos.
- There is no evidence that IVF babies have an increased risk of any
abnormalities.
- The process of IVF is expensive.
- IVF techniques increases the risk of multiple births and also increases
the risk of miscarriage and genetic disorder.

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