assisted reproduction
Last reviewed 02/2022
Assisted reproduction embraces all techniques involving the direct retrieval of oocytes from the ovary. The concept was first pioneered in the 1970's by Steptoe and Edward.
In outline, all assisted reproduction involves initially:
- ovulation induction - by clomiphene, hMG or pure FSH
- egg recovery - hCG added once the leading follicle has reached 16 mm to to complete maturation; oocytes collected 35 hours later
In the technique of gamete intrafallopian transfer or GIFT, the oocytes and partner's sperm are then placed immediately in the fallopian tubes.
In the techniques of in vitro fertilisation, IVF, and zygote intrafallopian transfer, ZIFT, egg recovery is followed by:
- in vitro fertilisation of the oocytes
- culture to the four cell stage
- implantation of the fertilised embryo's in the uterine cavity - IVF - or in the fallopian tubes - ZIFT
The main complications are those of:
- hyperstimulation
- multiple pregnancy
referral criteria for IVF (fertility treatment)
embryo transfer strategies in IVF
anti Mullerian hormone and ovarian reserve (OR)
NICE - measures of ovarian reserve and IVF
IVF success in terms of live births per 100 embryo transfers