Module 3: ART Techniques
➢ Fertilization and embryogenesis
The fusion of a sperm cell with an egg leads to fertilization which ultimately forms a zygote that normally happens in oviducts. Consequently, the blastocyst, a product of repeated mitotic cell divisions, is what lands into the uterus after only a few days. At the same time it attaches onto endometrium, thus beginning of implantation marking the onset of development. During embryogenesis, the blastocyst breaks into a variety of structures and cell types. The result is the establishment of the embryo and the formation of tissues and organs that are important for the growth of the baby.
➢ Intrauterine Insemination (IUI) and its indications
In the reproductive phase of a woman’s life, sperm are washed and deposited into her uterus through Intrauterine Insemination (IUI). The procedure is often carried out during ovulation. This is helpful in cases of low sperm numbers, low motility, inexplicable infertility, cervix-related infertility, donor sperm. IUI increases the odds that the sperm will reach the fallopian tubes and fertilize an egg by getting around obstacles like cervical mucus, so it is less invasive and cost-effective than IVF which is why it is usually recommended first for less difficult cases of infertility than other advanced methods.
➢ In vitro fertilization (IVF) stimulation protocols
Ovarian Stimulation using gonadotropin injections is part of stimulation protocols in In Vitro Fertilization (IVF) which is aimed at promotion of growth of several follicles simultaneously. Monitoring will assure you of appropriate retrieval time of eggs while Preventing Premature Ovulation would be done through the use of GnRH agonists or antagonists. hCG treatment is what leads to eventual maturity of the ovum before undergoing transvaginal retrieval. Eggs get fertilized with sperms in the lab and then once the embryos have been produced, they are grown before being transferred into a woman’s womb. Each patient has got their own individualized method of stimulation that tries to create as many viable embryos for implanting thus enhancing chances of having a child through successful pregnancy.
➢ Oocyte and embryo grading techniques
The determination of their suitability for successful IVF outcomes is based on the oocytes and embryos grading techniques. Shape, cytoplasm appearance and maturity are the oocytes grading criteria. The other variables considered in grading the embryos are fragments, cell number as well as symmetry. Advanced methods like time-lapse imaging enable continuous observation coming with enhanced selection accuracy thanks to monitoring over time. This grading procedure enables embryologists to choose the most suitable embryos for transfer or cryopreservation improving implantation and pregnancy rates.
➢ IVF-ICSI embryologist and clinician perspectives
It’s important for experts in human conception science including embryologists and obstetricians to work together when carrying out an in vitro fertilization-intracytoplasmic sperm injection procedure because those involved specialize in diverse aspects of the procedure. While embryologists focus on improving techniques for culturing embryos, grading them and selecting those that meet specific criteria, physicians oversee ovarian stimulation, oocyte pick-up, and transfer of an embryo into a woman’s womb. A productive relationship between a scientist and a physician results in such things as a match between patient requirements and laboratory findings, thus affecting pregnancy rates beneficially.
➢ Semen preparation and infection control in ART
Sperm preparation in assisted reproductive technology includes steps such as density gradient centrifugation or swim up for obtaining motile gametes from the seminal plasma and debris; leading to good quality male germ cells that can be used for fertilization. In order to prevent infection transmission during assisted reproduction operations, we must carefully screen donors and patients for possible infections, maintain aseptic laboratory conditions and adhere to specific handling and disposal guidelines.
➢ Third-party reproduction: donor eggs and sperm, surrogacy, etc.
In third-party reproduction, people use donor eggs or sperms for infertility cases. Evaluation of donors involves their medical history and genetic defects while a pregnancy is not carried by a woman but by someone else who may or may not be related to it genetically in surrogacy. Legal agreements are used to determine the rights and duties of parents. These possibilities are open to individuals and couples who are experiencing infertility or genetic issues and want to become mothers and fathers.
Module 4: Endometrial Function and Implantation
➢ Role of the endometrium in implantation
Implantation is a process that depends on the kind of nutrients available to it from the woman’s body. The uterus endometrium is a tissue that accepts embryos by so to say providing a home for them where they can burrow in it and hence ensuring childbearing by women. In response to estrogen levels in the body though, its thickness increases before being shed off together with blood cells from menstruation thus forming what we usually know as periods. Oestrogens together with progesterone also ensure that there are enough blood vessels grow that ahead when the fetus comes for implantation. Ensuring that the endometrium is prepared for pregnancy is vital for an embryo’s implantation and the subsequent establishment of pregnancy. This can be affected by hormone levels as well as other factors such as the overall condition of the uterus.
➢ Endometrial assessment and preparation for embryo transfer
Before you transfer an embryo, evaluate endometrial thickness and morphology by ultrasound. To ensure that there is sufficient sensitivity to both oestrogen as well as progesterone hormonal tests should be carried out. Employ hysteroscopy along with saline infusion sonography for structural diagnosis. Hormone therapy works in the improvement of preparing the endometrium for the implantation of the embryo hence this process enhances successful embryo transfer and pregnancy rates in Assisted Reproductive Technology which are inclusive of In-Vitro Fertilization (IVF).
➢ Luteal phase defects and support
Inadequate progesterone causes luteal phase abnormalities, which can lead to either implant failure or miscarriage. Progesterone supplementation is administered as injections, oral pills or vaginal suppositories. The level of hormones in the body should be monitored and controlled so that the endometrial lining is properly maintained, thereby enhancing the chances of successful implantation and getting pregnant.
In this article, we have covered some of the more advanced topics covered in the curriculum of Fellowship in Reproductive Medicine in India.
If you are looking for advancing your career in Reproductive Medicine, Fellowship in Reproductive Medicine is the right choice for you! Medline Academics, located in Bangalore offers hybrid mode of training in reproductive medicine. In addition, to the fellowship programs, Medline Academics also offers short term infertility courses in India and IVF course training.
Courses offered List: Basic Infertility Course, Andrology Certificate Course, Fellowship in Embryology and many more.
