Dr. SHYJUS

MBBS, MS (JIPMER), FMAS, DMAS, Cert. in daVinci Robotic Surgical System

Asst. ProfessorDept. of Obstetrics and Gynaecology

MES Medical College, Perinthalmanna, Kerala

3/6/2014

Conventional IVF

ICSI

IMSI

ICSI sperm is an Embryologist’s selection…..…not natural!

Physical manipulation of Oocyte membrane and Cytoplasm with a needle

Candidates of ICSI are carriers of ‘Y’ chromosome abnormalities

Genetic disorders

Congenital anomalies

Preterm delivery and perinatal health issues

Developmental delays and disabilities

and

Behavioral and mental health difficulties

Low birth weight babies

Premature babies

3 times more risk to be born as a LBW baby

Geyter, Steimann etal.Comparative birth weights of singletons born after assisted reproduction and natural conception in previously infertile women. Hum Reprod. 2006 Mar;21(3):705-12

2 times more risk to be born premature

Jackson, Gibson etal. Perinatal outcomes in singletons following in vitro fertilization: a meta-analysis.Obstet Gynecol. 2004 Mar;103(3):551-63.

Small increased risk for birth defects

including heart malformations limb abnormalities and metabolic disorders

Klemetti / Olson (2005)

300 singleton children born after ICSI in Belgium,

Sweden and United States

Compared with matched naturally conceived children at 5 years

No significant differences were found in cognitive development or psychological well-being

(Ponjaert-Kristoffersen et al. 2004)

Pre-implantation genetic diagnosis (PGD)

(1 to 2 cells are removed from 3-day-old embryo for genetic analysis)

It can overcome chromosomal disorders through transfer of only genetically screened embryos

Long term safety of PGD?

Only when an ART offspring

themselves become parents

have normal reproductive experiencesandtheir offspring develop normally