In vitro fertilization (IVF) is a procedure where an egg taken from a females body is fertilized by sperm taken from a male

in a laboratory dish. IVF is commonly known as an alternative way for infertile couples to become pregnant. his techni!ue is useful in many other ways as well. IVF can be used to determine if a child possesses a genetic disorder in the earliest stages of development (embryonic stage). It can also be used as a tool for studying se"ual reproduction. Infertility is a condition which prevents a couple from becoming pregnant by normal se"ual intercourse. #ppro"imately $.% million people in the &nited 'tates are affected by infertility. (owever) fewer than *+ of infertile couples choose to use IVF. IVF is usually chosen by women who suffer from blocked) badly damaged) or no fallopian tubes. It may also be used when the woman suffers from endometriosis) or the man suffers from problem with sperm such as low sperm count (,arcia). In vitro fertilization is a procedure where eggs taken from a females body and sperm taken from a males body are combined in a laboratory dish. -nce the eggs are fertilized) they are then implanted in the females uterus through a process called embryo transfer (.In Vitro Fertilization/ IVF0). In this process) the embryos are inserted into the womans uterus using a catheter. If the eggs attach to the uterine wall and grow) the pregnancy test result is positive (,arcia). he success rate of this procedure depends on individual patients as well as treatment methods. 1regnancy rates are not e!uivalent to live birth rates. .In the &nited 'tates) the live birth rate for each IVF cycle started is appro"imately/

23 to 2*+ for women under the age of 2*) 4*+ for women ages 2* to 25) %* to 43+ for women ages 26 to 73) and $ to %3+ for women ages over 73 (.In Vitro Fertilization/ IVF0).0 here are some side effects that may result from in vitro fertilization. -vary stimulation can result in a condition called .-varian hyper stimulation 'yndrome.0 his condition is typically uncommon. It involves some mild side effects such as nausea) vomiting) lack of appetite) or a feeling of being bloated. 8ore serious symptoms include severe abdominal pain) sever nausea9vomiting) decreased urinary fre!uency) dark:colored urine) shortness of breath) and9or ten pound weight gain within three to five days (In Vitro Fertilization/ IVF).0 In addition to helping reproductively challenged couples conceive) in vitro fertilization can also be used to detect genetic disorders. ;mbryos produced through IVF are e"amined for any genetic disorders) and only unaffected embryos are implanted in the uterus. his practice) called preimplantation genetic diagnosis (1,<)) began in the early %==3s. 1,< is a useful procedure for patients who have a high risk of passing on a known genetic defect to their children but do not want to terminate the pregnancy (.<etecting genetic diseases>0). 1reimplantation genetic diagnosis was first used in %==3 to test for an ?: linked genetic disorder (adrenoleukodystrophy). # polymerase chain reaction (1@A) test was used to identify male and female embryos by detection of the B chromosome. -nly female embryos were inserted into the uterus. #nother less complicated method of genetic testing called in situ fluorescent hybridization

(FI'() was produced in early %==2. It allowed chromosomal disorders to be found through the e"amination of single nuclei. 1reimplantation genetic diagnosis is becoming a popular medical alternative in reproductive medicine (.<etecting genetic diseases>0) &ntil 1,< was established) couples had few favorable reproductive options. -ne option was to take their chances of producing a child with a genetic disorder. #nother option was using prenatal diagnosis such as chorionic villus sampling or amniocentesis to check if the baby possessed a genetic defect. In this option a couple should be prepared to abort the pregnancy if a genetic defect is discovered. #bortion of the pregnancy is not an easy alternative) for it can result in psychological and physical pain. .-ther options included the use of donated gametes) with all its ethical and financial difficulties) not to procreate at all) or to adopt (.<etecting genetic diseases>0).0 here are many reasons patients decide to use 1,<. 'ome may have affected children and wish to prevent having more affected children. -thers may be against abortion due to religious or moral values. In some cases) a patient may have dealt with repeated miscarriages or abortions chosen because of genetic defects and want to reduce or get rid of that risk. 1atients with dominant genetic disorders do not want their child to suffer through the same disorder or pass it on to future generations (.<etecting genetic diseases>0). 1reimplantation genetic diagnosis is currently used for three maCor groups of genetic disorders. hese groups include the following/ recessive or dominant 8endelian single gene disorders) gender selection for se" chromosome linked

disorders) and chromosomal structural aberrations. 8ore and more diseases are becoming detectable through 1,<. 1reimplantation genetic diagnosis has also been used for to choose genders for .family balancing.0 1,< can also be used for the .selection of embryos according to their (D# (human leukocyte antigen) type so that a child born after 1,< can be a stem:cell donor for his sick sibling.0 his practice) referred to as .designer babies)0 is !uestioned for moral and legal appropriately (.<etecting genetic diseases>0). o carry out preimplantation genetic diagnosis) an embryo is first ac!uired through ovarian hyperstimulation) oocyte collection) IVF or intracytoplasmic sperm inCection) or embryo culture. &sually one cell is taken from an embryo with $ to %3 cells on day three of in vitro culture. &nusually) a genetic sample may be taken on days five of si" during the blastocyst stage. #fter the genetic material is obtained) it is tested for any genetic disorders (.<etecting genetic diseases>0). For the most part) 1,< testing is very dependableE however) a % to * percent risk of misdiagnosis remains. 'ome patients who seek out this procedure are financially aided. hose who are may pay F*)333 per trial. @urrent studies indicate that children born after 1,< are as healthy as those born through IVF or I@'I. 8ore research and evidence is re!uired to guarantee the safety of preimplantation genetic diagnosis (.<etecting genetic diseases>0). 1reimplantation genetic diagnosis technology is growing rapidly to produce favorable outcomes for reproductively challenged patients. Further studies are still needed to assure its efficiency. -ther means for 1,< such as mini:se!uencing and the use of micro:arrays are also being created to give more

accurate and reliable results. hese 1,< techni!ues are making it possible for an increasing amount of genetic disorders to be discovered (.<etecting genetic diseases>0). Fertilization in plants is difficult to study because their gametes are located inside a protected part of the plant. herefore) there is a narrow grasp of what happens in fertilization in particular plants. Fortunately) in vitro fertilization has enabled researchers to study fertilization in plants by eliminating most of the surrounding somatic tissues and nearby maternal gametophytic cells. IVF has made it possible to investigate hypotheses on gamete recognition and zygote activation. It is currently a very important tool concerning plant development and reproduction in higher plants (Gang). #s reported by @ass in %=52) living sperm cells were first isolated using male gametes from barley (Hordeum vulgare). hese gametes were .isolated by bursting anthesis pollen grains in a 43+ sucrose solution (Gang.)0 #fter a mass of sperm cells were isolated in %=6$) the isolation of male gametes was continued with revision in a variety of angiosperms (flowering plants). he first reports regarding isolation of egg and central cells was completed by (u et al. in %=6* and (uang and Aussel in Plumbago in %=6=. # common way to isolate female gametes was .to use a dilute enzyme treatment to loosen surrounding cell walls) followed of accompanied by micromanipulation to separate remaining ovule cells from embryo sacs (Gang).0 @omponents contained within the embryo sacHthe egg cell) two synergids) central cell and three variably present antipodalsHare then available to be isolated without restraint. he first effective

IVF e"periments) as conveyed by Iranz and others (%==%)) Coined sperm and egg cells from maize to produce an in vitro zygote by using electrofusion. hese researchers adapted this process and) by using in vitro:created zygotes) were able to accomplish restoration of fertile plants (Gang). In vitro fertilization of angiosperms has e"perienced only limited success so far. #lthough tobacco would appear to be an ideal prototype for in vitro fertilization) its gametes did not merge easily to create embryos. Ghen gametes were e"posed to a polyethylene glycol solution) fusion occurredE however) there was no further development. #lthough limited) grasses remain the best group for in vitro fertilization. IovJcs et al. (%==*) succeeded in combining wheat gametes with the same IVF process. Kecause the in vitro zygotes ceased to grow) a multicellular structure was generated (Gang). #side from using plants with superior living gametes) the cell cycle is another important factor in effectively fusing gametes. For most eukaryotes) fertilization takes place during the ,% phase of the cell cycle) but for many angiosperms) fertilization takes place during the , 4 phase. here are numerous ways fertilization may occur in angiosperms. For e"ample) pollen could be e"pelled before the development of sperm in bicellular pollen species. In tricelluar pollen species) the stage of the cell cycle that sperm formation occurs can vary from ,%) ') or ,4. #lso) sperm cells do not always occur in harmony with the female gametes. he phase of the cell cycle that fertilization takes place has only been reported for a small amount of plants) which show significant diversity. hese studies have indicated that grasses are the most proficient species for in

vitro fertilization since their gametes are usually released in the , % phase) which is the same phase that they combine in naturally (Gang). -n the other hand) tobacco has been shown to be an ineffective e"ample for in vitro fertilization. his is likely because its sperm cells form during the , % phase but do not fuse until the ,4 phase naturally. It is very difficult) if not impossible) to obtain a sperm cell at the right time in tobacco plants. his is because the sperm cells finish the ' phase within the synergid (cell near the egg inside a mature embryo sac) and instantly fuse after entering the , 4 phase. Aesponsive egg cells are probably Cust as challenging to ac!uire because egg cells develop in synchrony with sperm cells. .8atching the cell cycle of gametes with their normal fusion condition thus represents a potentially grace pitfall in meeting IVF congruity re!uirements (Friedman %===) (Gang).0 Fortunately) all that has been achieved with in vitro fertilization of grasses is a positive sign that IVF may be effective on some essential crop plants and offer a helpful understanding of zygote activation. 'uccessful IVF into new fertile plants may prove to be a useful approach for investigating epigenetic effects nucleocytoplasmic interactions typical to gametes (Gang). In vitro fertilization can also allow gametes from different species of plants to be fused) creating hybrids. he production of hybrid plants has encountered many problems because of differences in chromosome number. 'ometimes fusion of the gametes of two different species is successful) but the product plant is infertile. #n interesting occurrence in some hybrid cells is the total removal of one parents chromosomes. here are several other problems involved in IVF of

different species including the failure of cells to divide properly and genetic instability. 'till) there has been some success in creating hybrid plants such as the making of potato:tomato hybrids (Gang). #ll in all) there have been numerous setbacks involved with in vitro fertilization in plants. -ne of the most maCor complications has been the isolation of gametes. In vitro fertilization has been very successful in grasses) but unsuccessful in tobacco. #lthough creating hybrid plants has e"perienced a variety of problems) the production of potato:tomato hybrids was accomplished. oday) many more tools are offered to allow e"amination of plant gametes. hese advances will hopefully allow many !uestions concerning reproduction in angiosperms to be answered (Gang). In vitro fertilization has caused some side effects such as ovarian hyperstimulation syndrome and multiple pregnancies. -ther concerns involving the risks of taking ovulation:stimulating drugs have risen within the past few years. he possible connection between these drugs and ovarian cancer was discussed in a collection of articles) regenerating concern among the public (Derner:geva). here has actually only been a few cases of ovarian cancer among women that underwent IVF treatments. # fast:developing tumor was detected soon after IVF treatment in the maCority of these cases. #lthough these cases do not confirm a link between IVF treatment and the occurrence of ovarian cancer) they do suggest the ovarian stimulation or oocyte e"traction may !uicken the development of a present tumor. 'tudies that analyzed the occurrence of cancer

in a group of women who went through in vitro fertilization treatments generally showed no increased risks of ovarian or breast cancer. he obCective of the current study was to investigate the development of cancer in a group of infertile women who underwent IVF treatment. Gomen who developed cancer within the first year were focused on especially (Derner:geva). his research was based on a group of women treated for infertility from %=67 to %==4 at an IVF unit in el #viv) Israel. -nly women who underwent at least one IVF treatment were used in this study. # variety of demographic information was collected such as age and continent of birth. <ata concerning infertility type) diagnosis of infertility) and the number of treatment cycles were also collected through a !uestionnaire (Derner:geva). he automated data from this study was connected to the Israel Lational @ancer Aegistry to distinguish cancer cases through <ecember %==$. #ll information on malignant tumors) borderline tumors) and benign tumors was kept by the @ancer Aegistry. . he records were linked by computer matching of patients identification numbers) names) and demographic variables with the @ancer Aegistry data file (Derner:geva).0 he @ancer Aegistry supplied cancer diagnosis) the date of diagnosis) and the place of diagnosis consistent with the International @lassification of <iseases) Linth Aevision. -riginal case reports were evaluated to confirm the diagnoses (Derner:geva). @ases of the women diagnosed within a year of their first IVF treatment were e"plained separate from the other cases. his was done to give a minimal

latency period between IVF treatments and the development of cancer (Derner: geva). he data was analyzed by comparing the observed to e"pected occurrence of cancerHstandardized incidence ratios ('IA). he e"pected values were determined by age) se") continent of birth) and the rate of year:specific national cancer fre!uency. he risk period was calculated from the initial treatment date to either the last follow:up date or malignancy diagnosis date (Derner:geva). # total of %364 women were involved in this study. he average age of initial IVF treatment was 24.5 M 7.6) and the average age of the last follow:up was 26.5 M *.4. he e"pected number of patients who would develop cancer was %%) but 4% cases were actually observed. . hese included five cases of breast cancer) compared to 7.66 that were e"pected) three cases of ovarian cancer as compared to 3.$3 e"pected) and three cases of cervical cancer as compared to 3.$* e"pected (Derner:geva).0 In the cases that cancer was detected within the first year were e"cluded from the evaluation) Cust %$ cancer cases were detected opposed to 4% cases. he occurrence of ovarian cancer was eliminated. he occurrence of cervical cancer was still higher than e"pected but not significantly. -verall) the ratio between the observed and e"pected number of cancer cases displayed not significantly greater risk for cancer development (Derner:geva). his study) which included determining whether or not IVF treatments were related to the development of cancer) found no significantly increased risk

of cancer. In fact) infertility alone has been considered to be responsible for a higher possibility of cancer. 'imilar studies have shown that the incidence of breast and ovarian cancer was no higher than predicted. he greater than e"pected rate of cancer development was reduced by e"cluding the women who were diagnosed with cancer within the first year receiving IVF treatment. hese numbers may possibly be due to pre:e"isting cancer that was simply triggered by the hormonal drugs involved with IVF treatment. IVF treatments may actually help to diagnose cancer earlier by activating pre:e"isting malignancies (Derner: geva). In vitro fertilization) or the fertilization of egg and sperm outside of the reproductive organs) has proved to be a very useful tool in science. #side from allowing infertile couples to produce a biologically related baby) it also allows preimplantation genetic diagnosis (1,<). 1,< makes it possible to detect genetic diseases before birth. In vitro fertilization has also been used to study reproductive processes in angiosperms. his has led to the creation of hybrid plants such as the potato:tomato hybrid. -n the negative side) in vitro fertilization was suspected to increase the risk of cancer development. (owever) this hypothesis has been proven false according to a study involving IVF treated women. #ctually) it has been suggested that IVF treatments may allow malignant tumors to be detected earlier because of the hormonal stimulation. -verall) the use of in vitro fertilization has resulted in numerous positive outcomes and will likely continue to do so.