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Oocyte Retrieval
Transvaginal oocyte retrieval (TVOR), also referred to as oocyte retrieval (OCR), is a technique used in in vitro fertilization (IVF) in order to remove oocytes from an ovary, enabling fertilization outside the body. Transvaginal oocyte retrieval is more properly referred to as transvaginal ovum retrieval when the oocytes have matured into ova, as is normally the case in IVF. It can also be performed for egg donation, oocyte cryopreservation and other assisted reproduction technology such as ICSI. Procedure Under ultrasound guidance, the operator inserts a 16.5 gauge × 11.8″ (1.6 mm × 300 mm outer diameter) needle through the vaginal wall and into an ovarian follicle, taking care not to injure nearby organs and blood vessels. The other end of the needle is attached to a suction device. Once the follicle is entered, suction is carefully applied to aspirate follicular fluid containing cellular material, including the oocyte. The suction device must maintain a pressure of -14 ...
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In Vitro Fertilisation
In vitro fertilisation (IVF) is a process of fertilisation in which an ovum, egg is combined with spermatozoon, sperm in vitro ("in glass"). The process involves monitoring and stimulating the Ovulation cycle, ovulatory process, then removing an ovum or ova (egg or eggs) from the ovary, ovaries and enabling sperm to fertilise them in a culture medium in a laboratory. After a fertilised egg (zygote) undergoes embryo culture for 2–6 days, it is Embryo transfer, transferred by catheter into the uterus, with the intention of establishing a successful pregnancy. IVF is a type of assisted reproductive technology used to treat infertility, enable gestational surrogacy, and, in combination with pre-implantation genetic testing, avoid the transmission of abnormal genetic conditions. When a fertilised egg from egg and sperm donors Implantation (embryology), implants in the uterus of a genetically unrelated surrogate, the resulting child is also genetically unrelated to the surrogate. ...
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Granulosa Cells
A granulosa cell or follicular cell is a somatic cell of the sex cord that is closely associated with the developing female gamete (called an oocyte or egg) in the ovary of mammals. Structure and function In the primordial ovarian follicle, and later in follicle development ( folliculogenesis), granulosa cells advance to form a multilayered cumulus oophorus surrounding the oocyte in the preovulatory or antral (or Graafian) follicle. The major functions of granulosa cells include the production of sex steroids, as well as myriad growth factors thought to interact with the oocyte during its development. The sex steroid production begins with follicle-stimulating hormone (FSH) from the anterior pituitary, stimulating granulosa cells to convert androgens (coming from the thecal cells) to estradiol by aromatase during the follicular phase of the menstrual cycle. However, after ovulation the granulosa cells turn into granulosa lutein cells that produce progesterone. The progester ...
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Cervix
The cervix (: cervices) or cervix uteri is a dynamic fibromuscular sexual organ of the female reproductive system that connects the vagina with the uterine cavity. The human female cervix has been documented anatomically since at least the time of Hippocrates, over 2,000 years ago. The cervix is approximately 4 cm long with a diameter of approximately 3 cm and tends to be described as a cylindrical shape, although the front and back walls of the cervix are contiguous. The size of the cervix changes throughout a woman's life cycle. For example, women in the fertile years of their reproductive cycle tend to have larger cervixes than postmenopausal women; likewise, women who have produced offspring have a larger cervix than those who have not. In relation to the vagina, the part of the cervix that opens to the uterus is called the ''internal os'' and the opening of the cervix in the vagina is called the ''external os''. Between them is a conduit commonly called the cervic ...
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Semen
Semen, also known as seminal fluid, is a bodily fluid that contains spermatozoon, spermatozoa which is secreted by the male gonads (sexual glands) and other sexual organs of male or hermaphrodite, hermaphroditic animals. In humans and placental mammals, seminal fluid is ejaculation, ejaculated through the penis and contains Proteolytic enzyme, proteolytic and other enzymes as well as fructose, which promote the survival of spermatozoa and provide a medium through which they can move or "swim" from the vagina into the uterus to fertilization, fertilize the female ovum and form a zygote. semen collection, Semen is collected from animals for artificial insemination or cryoconservation of genetic material. Cryoconservation of animal genetic resources is a practice that calls for the collection of semen in efforts for conservation of a particular breed. Physiology Fertilization Depending on the species, spermatozoa can fertilize ova externally or internally. In external fertiliz ...
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Pregnancy Rate
Pregnancy rate is the success rate for getting pregnant. It is the percentage of all attempts that leads to pregnancy, with attempts generally referring to menstrual cycles where insemination or any artificial equivalent is used, which may be simple artificial insemination (AI) or AI with additional in vitro fertilization (IVF). Definitions There is no universally accepted definition of the term. Thus in IVF pregnancy rates may be based on initiated treatment cycles, cycles that underwent oocyte retrieval, or cycles where an embryo transfer was performed. In terms of outcome, "pregnancy" may refer to a positive pregnancy test, evidence of a pregnancy with a "viable" fetus or implantation. Furthermore, pregnancy rates can be influenced in IVF by transferring multiple embryos that may result in multiple births. A strict definition in the IVF setting would refer to the singleton pregnancy rate that determines how many live singletons are born in relation to initiated IVF cycles. Rel ...
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Local Anesthetic
A local anesthetic (LA) is a medication that causes absence of all sensation (including pain) in a specific body part without loss of consciousness, providing local anesthesia, as opposed to a general anesthetic, which eliminates all sensation in the entire body and causes unconsciousness. Local anesthetics are most commonly used to eliminate pain during or after surgery. When it is used on specific nerve pathways ( local anesthetic nerve block), paralysis (loss of muscle function) also can be induced. Classification LAs are of 2 types: *Clinical LAs: ** amino amide LAs ** amino ester LAs *Synthetic LAs **Cocaine derivatives Synthetic cocaine-derived LAs differ from cocaine because they have a much lower abuse potential and do not cause hypertension vasoconstriction (with few exceptions). The suffix "-caine" at the ends of these medication names is derived from the word "cocaine", because cocaine was formerly used as a local anesthetic. Examples Short Duration of Act ...
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Local Anesthesia
Local anesthesia is any technique to induce the absence of sense, sensation in a specific part of the body, generally for the aim of inducing local analgesia, i.e. local insensitivity to pain, although other local senses may be affected as well. It allows patients to undergo surgical and dentistry, dental procedures with reduced pain and distress. In many situations, such as caesarean section, cesarean section, it is safer and therefore superior to general anesthesia. The following terms are often used interchangeably: * ''Local anesthesia'', in a strict sense, is anesthesia of a small part of the body such as a tooth or an area of skin. * ''Regional anesthesia'' is aimed at anesthetizing a larger part of the body such as a leg or arm. * ''Conduction anesthesia'' encompasses a great variety of local and regional anesthetic techniques. Medical A local anesthetic is a medication, drug that causes reversible local anesthesia and a loss of nociception. When it is used on specific ne ...
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Spinal Anaesthesia
Spinal anaesthesia (or spinal anesthesia), also called spinal block, subarachnoid block, intradural block and intrathecal block, is a form of neuraxial regional anaesthesia involving the injection of a local anaesthetic with or without an opioid into the subarachnoid space. Usually a single-shot dose is administrered through a fine needle, alternatively continuous spinal anaesthesia through a intrathecal catheter can be performed. It is a safe and effective form of anesthesia usually performed by anesthesiologists and CRNAs that can be used as an alternative to general anesthesia commonly in surgeries involving the lower extremities and surgeries below the umbilicus. The local anesthetic with or without an opioid injected into the cerebrospinal fluid provides locoregional anaesthesia: true anaesthesia, motor, sensory and autonomic (sympathetic) blockade. Administering analgesics (opioid, alpha2-adrenoreceptor agonist) in the cerebrospinal fluid without a local anaestheti ...
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Paracervical Block
A paracervical block is an anesthetic procedure used in obstetrics and gynecology, in which a local anesthetic is injected into between two and six sites at a depth of 3–7 mm alongside the vaginal portion of the cervix in the vaginal fornices. In the United States, the paracervical block is underutilized during insertion of intrauterine devices (IUDs). There is speculation that this is related to the disproportionate under-researching of women's health. It is used for various obstetric and gynecologic procedures, such as hysteroscopy and vacuum aspiration. It is as efficient as intracervical block, according to a study on women undergoing vacuum aspiration with lidocaine as anesthetic agent. The majority of surgical abortions in the United States are performed with a paracervical block with or without the addition of other pain medications. The best specific technique has yet to be defined and there is still a lot of procedure related pain. The choice of the best anesthe ...
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General Anaesthesia
General anaesthesia (UK) or general anesthesia (US) is medically induced loss of consciousness that renders a patient unarousable even by painful stimuli. It is achieved through medications, which can be injected or inhaled, often with an analgesic and neuromuscular blocking agent. General anaesthesia is usually performed in an operating theatre to allow surgical procedures that would otherwise be intolerably painful for a patient, or in an intensive care unit or emergency department to facilitate endotracheal intubation and mechanical ventilation in critically ill patients. Depending on the procedure, general anaesthesia may be optional or required. No matter whether the patient prefers to be unconscious or not, certain pain stimuli can lead to involuntary responses from the patient, such as movement or muscle contractions, that make the operation extremely difficult. Thus, for many procedures, general anaesthesia is necessary from a practical point of view. The patient's n ...
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Procedural Sedation And Analgesia
Procedural sedation and analgesia (PSA) is a technique in which a sedating/dissociative medication is given, usually along with an analgesic medication, in order to perform non-surgical procedures on a patient. The overall goal is to induce a decreased level of consciousness while maintaining the patient's ability to breathe on their own. PSA is commonly used in the emergency department, in addition to the operating room. While PSA is considered safe and has low rates of complication, it is important to conduct a pre-procedural assessment, determine any contraindications to PSA, choose the most appropriate sedative agent, and monitor the patient for potential complications both during and after the procedure. Medical uses This technique is often used in the emergency department for the performance of painful or uncomfortable procedures. Common purposes include: * laceration repair * setting fractures * draining abscesses * reducing dislocations * performing endoscopy * for cardio ...
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Lithotomy Position
The lithotomy position is a common position for surgical procedures and medical examinations involving the pelvis and lower abdomen, as well as a common position for childbirth in Western nations. The lithotomy position involves the positioning of an individual's feet above or at the same level as the hips (often in stirrups), with the perineum positioned at the edge of an examination table. References to the position have been found in some of the oldest known medical documents including versions of the Hippocratic oath (see lithotomy); the position is named after the ancient surgical procedure for removing kidney stones and bladder stones via the perineum. The position is perhaps most recognizable as the 'often used' position for childbirth: the patient is laid on the back with knees bent, positioned above the hips, and spread apart through the use of stirrups. The position is frequently used and has many obvious benefits from the doctor's perspective. Most notably the position p ...
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