IDEAL INSTITUTE OF MANGEMENT AND

TECHNOLOGY & SCHOOL OF LAW

FAMILY LAW

2 ND
YEAR SECTION A

SUBMITTED BY
SUBMITTED TO
ANUSHKA SEHGAL 02713403819
APOORV SALAR 03613403819 MS. KANIKA ARORA
DIVYANSHI RAI 03913403819 ASSISTANT PROFESSOR
ANIRUDH ANAND 04413403819 SCHOOL OF LAW IIMT
RUKSANA 05113403819
What is Assisted Reproductive Technology

• ASSISTED REPRODUCTIVE TECHNOLOGY

IS USED TO TREAT INFERTILITY. IT
INCLUDES FERTILITY TREATMENTS THAT
HANDLE BOTH AWOMAN’S EGG AND A
MAN’S SPERM . IT WORKS BY REMOVING
EGGS FROM A WOMAN’S BODY . THE
EGG ARE THEN MIXED WITH SPERM TO
MAKE EMBRYOS . THE EMBRYOS ARE
THEN PUT BACK IN THE WOMAN’S BODY.
• ASSISTED REPRODUCTIVE
TECHNOLOGY PROCEDURES
SOMETIMES USE DONOR EGGS . A
SUROGATE IS A WOMAN WHO
BECOMES PREGNANT WITH SPERM
FROM THE MALE PARTNER OF THE
COUPLE . A GESTATIONAL CARRIER
BECOMES PREGNANT WITH AN EGG
FROM THE FEMALE PARNER AND
THE SPERM FROM THE MALE
PARTNER.
 IN VITRO FERTILISATION
• IN VITRO FERTILISATION IS A COMPLEX SERIES
OF PROCEDURES USED TO HELP WITH FERTILITY
TO PREVENT GENETIC PROBLEMS AND ASSIST
WITH THE CONCEPTION OF A CHID.
• DURING IVF , MATURE EGGS ARE COLLECTED
FROM OVARIES AND FERTILIZED BY SPERM IN
LAB. THEN THE FERTILIZED EGG ARE
TRANSFERRED TO A UTERUS .ONE FULL CYCLE
OF IVF TAKES ABOUT 3 WEEKS. SOMETIMES
THESE STEPS ARE SPLIT INTO DIFFERENT PARTS
AND THE PROCESS CAN TAKE LONGER.
• IVF IS THE MOST EFFECTIVE FORM OF ASSISTED REPRODUCTIVE
TECHNOLOGY . THE PROCEDURE CAN BE DONE USING YOUR
OWN EGGS AND YOUR PARTNER’S SPERM . IVF MAY INVOLVE
EGGS, SPEM OR EMBRYO’S FROM A KNOWN OR ANONYMOUS
DONOR. IN SOME CASES , A GESTATIONAL CARRIER – AWOMAN
WHO HAS AN EMBRYO IMPLANTED IN HER UTERUS MIGHT BE
USED.
• IN VIRO FERTILIZATION IS A TREATMENT FOR INFERTILITY OR
GENETIC PROBLEMS . IF IVF IS PERFORMED TO TREAT INFERTILITY ,
YOU AND YOUR PARTNER MIGHT BE ABLE TO TRY LESS INVASIVE
TREATMENT BEFORE ATTEMPTING IVF, INCLUDING FERTILITY
DRUGS TO INCREASE PRODUCTION OF EGGS. A PROCEDURE IN
WHICH SPERM ARE PLACED DIRECTLY IN YOUR UTERUS NEAR THE
TIME OF OVULATION.
• SOMETIMES , IVF IS OFFERED AS A PRIMARY TREATMENT FOR
INFERTILITY IN WOMEN OVER AGE 40 IVF CAN ALSO BE DONE IF
YOU HAVE CERTAIN HEALTH CONDITIONS.
• FALLOPIAN TUBE DAMAGE MAKES IT
DIFFICULT FOR AN EGG TO BE FERTILISED
OR FOR AN EMBRYO TO TRAVEL TO THE
UTERUS.
• OVULATION DISORDERS IF OVULATION
IS INFREQUENT , FEWER EGGS ARE
AVAILABLE FOR FERTILISATION.
• ENDOMETRIOSIS OCCURS WHEN THE
UTERINE TISSUE IMPLANTS AND GROWS
OUTSIDE OF THE UTERUS OFTEN
AFFECTING THE FUNCTION OF THE
OVARIES , UTERUS AND FALLOPIAN
TUBES.
• UTERINE FIBRODS ARE BENGIN TUMORS IN
THE WALL OF THE UTERUS AND ARE
COMMON IN WOMEN IN THEIR 30s AND
40s . FIBRODS CAN INTERFARE WITH
IMPLANTATION OF THE FERTILIZED EGG.
• PREVIOUS TUBAL STERLIZATION IF YOU
HAD TUBAL LIGATION ATYPE OF
STERLIZATION IN WHICH YOUR
FALLOPIAN TUBES ARE CUT OR BLOCKED
TO PERMANENTLY PREVENT PREGNANCY
AND WANT TO CONCEIVE , IVF MAY BE AN
ALTERNATIVE TO TUBAL LIGATIO REVERSAL.
HISTORY OF IN VITRO FERTILISATION

• THE FIRST EXPERIMENT WITH IVF BEGAN

IN 1878, WHEN VIENNESE
EMBRYOLOGIST SAMUEL LEOPOLD
SCHENK COLLECTED OVA FROM
RABBITS AND GUNIEA PIGS. HE
INTRODUCED SPERM TO THE COLLECTED
OVA AND NOTED THAT CELL DIVISION
COULD OCCUR OUTSIDE A MAMMAL’S
BODY.
• IN 1934, GREGORY PINEUS AND ERNST
VINZENZ ENZMANN TOOK THINGS A STEP
FURTHER . THEY ALSO WORKED WITH OVA
COLLECTED FROM RABBITS AND INTRODUCED
SPERM TO THE RABBIT EGGS WHILE THEY
WERE OUTSIDE OF THE BODY. THEY LATER
IMPLANTED THE EGGS BACK INTO RABBIT’S
UTERUS AND THE RABBIT BECAME
PREGNANT .
• HOWEVER THE EGGS WERE IMPLANTED
BEFORE FERTILIZATION HAD ACTUALLY
OCCURRED [ AFTER JUST 12 HOURS ] SO THE
FERTILIZATION ACTUALLY OCCURRED IN THE
RABBIT’S BODY.
• IN 1959, SCIENTIST MIN CHUEH CHANG WAS
ABLE TO DEMONSTRATE THAT SPERM TO
NEEDS TO REACH CERTAIN PHASE OF
MATURITY BEFORE THEY ARE READY TO BE
FERTILIZED .USING THIS INFORMATION AND
THE RESULTS OF THE EXPERIMENTS FROM HIS
PREDECESSORS , CHANG WAS FINALLY ABLE
TO SUCESSFULLY IMPREGNATE A RABBIT VIA
IN VITRO FERTILIZATION . ALTHOUGH THE
IVF PROCEDURE WAS SUCCESSFUL IT WOULD
ONLY STILL BE ANOTHWER 10 YEARS BEFORE
THE TECHNIQUE WAS APPLIED TO PEOPLE.
THE FIRST HUMAN IVF PROCEDURE

• IN 1968 , GYNECOLOGIST PATRICH

STEPTOE TEAMED UP WITH A PROFESSOR
OF HUMAN REPRODUCTION , ROBERT
EDWARD , TO ATTEMPT THE FIRST HUMAN
PREGNANCY VIA IVF . THEY WERE ABLE
TO EXTRACT AND SUCCESSFULLY FERTLIZE
MULTIPLE MATURE EGGS , BUT THEY HAD
TROUBLE IMPLANTING THE EMBRYO INTO
THE FEMLE UTERUS.
• THEN IN 1976, THEY BEGAN WORKING WITH
AN INFERTILE COUPLE, LESLEY AND JOHN
BROWN WITH THIS COUPLE , THEY FINALLY
ACHIEVED THEIR FIRST SUCCESSFUL
IMPLANTATION OF A FERTILISED EGG.
• LESLEY BECAME PREGNANT AND GAVE BIRTH
TO THEIR DAUGHTER , LOUISE BROWN ON
JULY 25, 1978. LESLIE IS KNOWN AS THE FIRST
TEST TUBE BABY . SINCE THE BIRTH OF LOUISE
BROWN , IVF TECHNIQUES HAVE
CONTRIBUTED TO IMPROVE AND MILLIONS
OF CHILDREN HAVE BEEN BORN VIA THIS
REVOLUTIONARY FERTILITY TREATMENT.
 LIST OF STEPS INVOLVED
• TESTING AND OVARIAN
STIMULATION
• EGG RETRIEVAL
• FERTILIZATION
• EMBRYO TRANSFER
• ASSISTED HATCHING
TESTING AND OVARIAN STIMULATION

• MOST WOMEN WILL TAKE FERTILITY DRUGS FOR

OVARIAN STIMULATION FOR 8 - 14 DAYS THE
AVERAGE IS 10 - 11 DAYS OVARIAN STIMULATION
ISUSED TO MATURE MULTIPLE EGGS FOR EGG
RETIEVAL. EVEN IF OVULATION IS NORMAL , FERTLITY
DRUGS ARE USED TO PRODUCE MORE THAN ASINGLE
EGG BECAUSE PREGNANCY RATES ARE HIGHER WITH
MORE EGGS. AN AVERAGE OF 10 - 20 EGGS USUALLY
RETRIEVED FOR IVF . HOWEVER , NOT ALL OF THEM
ARE VIABLE TO USE AS ON AVERAGE ONLY ABOUT
TWO- THIRDS HAVE THE APPROPRIATE MATURITY.
• THE PHYSICIAN WILL CAREFULLY DESIGN A
PROTOCOL TO TRY TO OBATIN THE MAXIMUM
NUMBER OF EGGS WHILEPROTECTING AGAINST
DEVELOPMENT OF OVARIAN HYPER- STIMULATION
SYNDROME. FERTLITY DRUGS FOR IVF ARE USUALLY
INJECTED AND YOU WILL BE FREQUENTLY
MONITORED USING HORMNAL TESTING AND
VAGINAL ULTRASOUNDS DETERMINES YOU HAVE A
SUFFICIENT NUMBER OF LARGE ENOUGH FOLLICLES
AND YOUR ESTROGEN LEVEL IS AT THE RIGHT
LEVEL , YOU WILL RECEIVE A TRIGGER SHOT OF HCG
OR OTHER MEDICATION . THIS REPLACES THE
NATURAL LUTEINIZING HORMONE SURGE , SO
EGGS ARE CAPABLE OF BEING FERTILIZED.
 EGG RETRIEVAL
• THIRTY FOUR TO THIRTY SIX HOURS AFTER RECEIVING
THE TRIGGER SHOT BEFORE THE EGG OVULATE YOU
WILL HAVE A SURGICAL PROCEDURE TO REMOVE THE
EGGS FROM THE FOLLICLES IN YOUR OVARIES. FOR
THIS EGG RETRIEVAL PROCEDURE AN ULTRASOUND IS
USED TO VISUALLY GUIDE A SMALL NEEDLE THROUGH
THE TOP OF THE VAGINA INTO ONE OVARY AND
THEN THE OTHER . YOU SHOULDN’T EXPERIENCE ANY
PAIN OR DISCOMFORT DURING THE PROCESS AS YOU
WILL BE UNDER SEDATION THROUGH AN IV WHILE
CLOSELY MONITERED BY AN ANESTHESIOLOGIST.
• FOLLICLES ARE ENTERED WITH THE NEEDLE AND THE
FOLLICULAR FLUID CONTENTS ARE REMOVED USING GENTLE
SUCTION THAT BRINGS THE EGG ALONG IN THE FLUID IN THE
ENTIRE PROCESS USUALLY TAKES LESS THAN 30 MINUTES.
YOU MAY FEEL SOME MINOR CRAMING THE DAY OF THE
PROCEDURE WHICH IS USUALLY GONE THE NEXT DAY . THERE
MAY BE A FEELING OF FULLNESS AND PRESSURE DUE TO
EXPAND OF OVARIES FROM THE OVARIAN STIMULATION .
THIS AMY LAST FOR FEW WEEKS.
• THE FLUID FROM THE FOLLICLES THAT CONTAIN THE EGG IS
SUCTIONEDBY THE IVF PHYSICIAN THROUGH SMALL TUBING
AND INTO A TEST TUBE . THE TEST TUBE IS THEN HANDED TO
AN EMBRYO LOGIST WHO USES A MICROSCOPE TO FIND THE
EGG IN EACH TUBE OF FOLLICULARFLUID.ALL OF THE DATAILS
OF THE EGGS ARE CAREFULLY RECORDED .THE NYMBER OF
EGGS PRODUCED AND REMOVED ARE INFLUENCED BY A
PATIENT’S AGE, OVARIAN RESRVE , RESPONSE TO OVARIAN
STIMULATION AND OCCASSIONALLY , THE ABILITY TO ACCESS
THE OVARIES WITH THE NEEDLE.
 FERTILIZATION
• ONCE EGGS REACH THE LAB , EXPERTS EXAMINE
THEM TO DETERMINE MATURITY AND QUALITY .
MATURE EGGS ARE TRANSFEREED INTO A SPECIAL
CULTURE MEDIUM , PLACED IN AN INCUBATOR AND
WITHIN A FEW HOURS OF EGG RETRIEVAL ARE
FERTILIZED WITH SPERM. THERE ARE TWO WAYS TO
FERTILIZE AN EGG : CONVENTIONAL INSEMINATION
OR INTRA CYTOPLASMICINFECTION WHICH PROCESS
IS USED WILL BE DETERMINED BY YOUR IVF TEAM
AND DEPENDS ON MULTIPLE FACTORS RELATED TO
THE COUPLE GOING THROUGH IVF. BOTHMETHODS
HAVE APPROXIMATELY THE SAME SUCESSRATE .ICSI
IS USED APPROXIMATELY 70%OF THE TIME WHEN
FACTORS MAKE FERTILIZATION LESS LIKELY DUE
TOMPOOR SEMEN QUALITY OR PREVIOUS IVF
FAILURE.
• FOR THE CONVENTIONAL METHOD,
SPERM IS PLACED IN THE CULTURE
MEDIUM INCUBATED TOGETHER IN THE
DISH IN THE LAB, ALLOWING THE SPERM
TO ENTER THE EGG ON ITS OWN.FOR
ICSI , ONE SPERM IS INJECTED INTO THE
CYTOPLASM OF THE EGG USING A
NEEDLE AND A SOPHAISTICATED
OPERTAIVE MICROSCOPE . NO MATTER
WHICH PROCESS IS USED , FERTILIZATION
IS CHECKED THE NEXT MORNING.
 EMBRYO TRANSFER
• FOLLOWING FERTILIZATION , THE IVF TEAM AND THE
COUPLE DETERMINE EXACTLY WHEN THE EMBRYO
TRANSFER WILL TAKE PLACE ANYWHERE BETWEEN 1
AND 6 DAYS BUT USUALLY 3 – 5 DAYS AFTER EGG
RETRIEVAL . HOWEVER , IF THE DECISION IS MADE TO
DO THE GENTIC TESTING , FIRST A BIOPSY IS TAKEN
FROM THE EMBRYO , ALMOST ALWAYS ON CULTURE
DAY 5 OR 6 . USUALLY 3 TO8 CELLS ARE SENT FOR
TESTING PERFORMED AT AN OUTSIDE LAB , WHILE
THE EMBRYO ARE FROZEN AND REMAIN IN THE IVF
LABORATORY. AFTER RECEIVING THE GENETIC TEST
TUBES, THE SELECTED EMBRO IS CHOSEN THAWED
AND TRANSFERRED INTO THE UTERUS, USUALLY
WITHIN 1 TO 2 MONTHS AFTER THE EGG RETRIEVAL
• THE NUMBER OF EMBRYO PRODUCED DEPENDS ON
SEVERAL FACTORS INCLUDING THE AGE OF THE
COUPLE . IN THE PAST, MULTIPLE EMBRYO WERE
TRANSFERRED IN THE HOPE OF MAXIMIZING
SUCCESS BUT THIS OFTEN RESULTED IN TWINS OR
RARELY TRIPLETS , BOTH OF WHICH ARE ASSOCIATED
WITH PRE TEM BIRTH AND OTHER SERIOUS
COMPLICATIONTO BOTH BABIES AND MOTHER.
• THE SAFEST APPROACH IS TO LIMIT TRANSFER TO
ASINGLE EMBRYO . TO MAXIMIZE THE CHANCE FOR
SUCCESS , THE HEALTHIEST EMBRYO IS SELECTED BY
THE EMBRYOLOGIST BASED ON GRADING SYSTEM
USED TO EVALUTE EACH EMBRYO.
 ASSISTED HATCHING
• SOMETIMES AN ADDITIONAL PROCESS IS USED TO PROVIDE
FURTHER HELP OLDER WOMEN , FOR COUPLES WHO HAVE
PREVIOUSLY BEEN UNSUCCESSFUL WITH IVF OR WITH
FROZEN EMBRYO . ASSISTED HATCHING IS A
MICROMANIPULATION PROCEDURE WHERE A HOLE IS MADE
IN THE FLEXIBLE SHELL THAT SURROUNDS THE CELLS OF THE
EARLY EMBRYO . NORMALLY, THIS MEMBRANE DISSOLVES
ON ITS OWN SINCE THIS IS NECESSARY FOR EMBRYO
IMPLANTATION. THIS EXTRA PROCESS HAS NOT BEEN
DEMONSTRATED DEFINITIVELY TO IMPROVE LIVE BIRTH
RATES AND THERE MAY BE VERY MINOR RISKS INVOLVED .
ALSO , THERE IS NO EVIDENCE THAT IMPROVES PREGNANCY
OR LIVE BIRTH RATES FOR OTHER TYPES OF IVF PATIENTS .
 TRIO FERTILITY PROTECTION
• TRIO HAS A DEDICTED AIR HANDLING SYSTEM TO ENSURE AN
OPTIMAL ENVIRONMENT FOR EMBRYO DEVELOPMENT AND WE ARE
ESPECIALLY CAREFUL ABOUT PATIENT IDENTIFICATION . WE TAKE THIS
VERY SERIOUSLY .WE CREATE A UNIQUE IDENTIFIACTION NUMBER OF
EACH PATIENT AS WELL AS A BAR CODING SYSTEM ASSOCIATED
WITH YOUR NAME , UNIQUE IDENTIFICATION NUMBER AND A
DESIGNATED BAR CODE. BAR CODE LABELS WITH YOUR UNIQUE
IDENTIFICATION NUMBER ARE PLACED ON EACH DISH OR TUBE THAT
COMES INTO CONTACT WITH YOUR EGGS ,SPERM AND EMBRYOS.
WHEN WE MOVE SPERM TO EGGS , WE SCAN THE BARCODE LABEL
FROM THE SPREM TUBE AND THE ALBEL FROM YOUR DISH OF EGGS .
THE BARCODING TRACKS ALL PROCEDURES THAT WE PERFORM . WE
ALWAYS KNOW WHICH EGG AND WHICH SPERM IS USED . WHEN
EMBRYO ARE TRANSFERRED , WE SCAN THE BARCODE OF THE CHART
AND THE DISH EMBRYO ARE COMING FROM .DURING CERTAIN
CRUCIAL STEPS,ONE PERSON DOES THE JOB AND ONE PERSON
VERFIES AND BARCODES ARE ALWAYS USED. WE ALSO MAKE SURE
ANOTHER PAIR OF EYES VERFIES CRUCIAL STEPS .WE ACCOUNT FOR
ALL EGGS AND ALL EMBRYO 100% OF THE TIME
 IVF IN INDIA
• DR. SUBHASH MUKHOPADHYAY WAS A
PHYSICIAN FROM KOLKATA , INDIA WHO
CREATED THE WORLD’S SECOND AND INDIA’S
FIRST CHILD USING IN VITRO FERTILISATION.
DURGA WHO WAS BORN 67 DAYS AFTER THE
FIRST IVF BABY IN UNITED KINGDOM .
• UNFORTUNATELY , HE WAS HARASSED BY
THE STATE GOVERNMENT AND NOT ALLOWED
TO SHARE HIS ACHIEVEMENTS WITH THE
INTERNATIONAL SCIENTIFIC COMMUNITY. HE
COMMITTED SUCIDE ON 19 JUNE 1981.
 BIBLOGRAPHY
• SLIDSHARE
• MAYOCLINIC
• MONASHIVF. COM