Outline

Research Paper Outline

I. Introduction
A. Topic- In Vitro Fertilization (IVF)
1. IVF is a fertility treatment where female’s eggs are taken, fertilized, and then replaced, many eggs are taken and can be replaced resulting in multiple births
B. Thesis Statement
1. Should doctors be allowed to transplant multiple eggs through IVF even with the risk of harming both mother and children?

II. The process of IVF
A. Medication
1. Ovulation induction
B. Collecting Egg
1. Ultrasound imaging
2. Follicular aspiration
C. Combining sperm and egg
1. Insemination
2. Intracytoplasmic sperm injection
D. Transfer of embryos
1. 2-3 days after egg retrieval
2. Embryos suspended in fluid and transferred to womb through catheter

III. IVF alternatives
A. Gamete Interfallopian Transfer (GIFT)
1. Fertilization in fallopian tubes
B. Zygote Interfallopian Transfer (ZIFT)
1. Fertilized eggs placed in fallopian tubes rather than uterus
C. Tubal Embryo Transfer (TET)
1. Embryos transferred back to woman at later stage of development

IV. IVF risks
A. premature delivery
B. Ovarian Hyperstimulation Syndrome
C. Ectopic/Multiple pregnancies

V. IVF Guidelines
A. Women under 35- no more than 2 embryos
B. Women between 35 and 37- no more than 3 embryos
C. Women between 38 and 39- no more than 3 embryos
D. Women older than 39 no more than 4 embryos

VI. The IVF debate
A. Guidelines are only recommendations
1. Embryos in patient’s hands not doctor’s hands
2. Doctors must report to Centers of Disease Control and Prevention
B. Selective Reduction
1. Aborting fetuses if multiple embryos successfully implant
C. Octo-mom and other examples of higher multiples through fertility treatments

VII. Conclusion

20 Notes/Quotes

Research Paper Notes

1. First “test-tube” baby succeeded in 1978 by Dr. Edwards (embryologist) and Dr. Steptoe (gynecologist)
- http://www.ivf.com/ivffaq.html

2. In Vitro Fertilization (IVF) removes eggs from woman’s ovary and fertilizes them with sperm in a laboratory and returns fertilized eggs to uterus
- IVF, Altha Roberts Edgren…GALE

3. IVF costs between $5000-10000 and may not be covered by health insurance
- IVF, Altha Roberts Edgren…GALE

4. Clinics must report to the Centers of Disease Control and Prevention # of embryos transferred in each IVF cycle and # of babies born
- TIME magazine (octuplets fallout…)

5. “Would we write laws limiting the size of someone’s family to 6? Would we write laws mandating selective reduction”- aborting embryos if high number successfully implant
- TIME magazine (octuplets fallout…)

6. 1 million infants have been successfully conceived through IVF
- GALE (study examines live birth rates)

7. Largest study of IVF patients (BIDMC) followed 6000 women, chances of live births- 65- 86% in younger women and 23%-42% in women 40 and older
- GALE (study examines live birth rates)

8. “A singleton birth should be considered a success, triplets a failure”
- TIME magazine (octuplets fallout…)

9. Among 6,164 patients who underwent 14,248 IVF cycles 27% were twins 2% were triplets
- GALE (study examines live birth rates)

10. GIFT- Gamate Interfallopian Transfer, fertilization inside fallopian tube (alternative to IVF)
-http://sharedjourney.com/ivf.html

11. ZIFT- Zygote Intrafallopian Transfer, fertilized eggs placed in fallopian tubes not in uterus (alternative to IVF)
-http://sharedjourney.com/ivf.html

12. TET- Tubal Embryo Transfer, embryos transferred to women at later stage of development (alternative to IVF)
-http://sharedjourney.com/ivf.html

13. Step 1: fertility medications, referred to as ovulation induction
-http://www.americanpregnancy.org

14. Step 2: eggs retrieved (may require minor surgery, follicular aspiration)
-http://www.americanpregnancy.org

15. Step 3: sperm prepared for egg, Step 4: insemination- egg and sperm placed in incubators for fertilization
-http://www.americanpregnancy.org

16. Step 5: embryos transferred into women’s uterus
-http://www.americanpregnancy.org

17. Most complications occur in IVF multiples, 50% twins and 90% triplets are born premature
- Guideline for number of embryos…

18. Women less than 35 no more than 2 embryos, women between 35-37 no more than 3 embryos, women 38-39 no more than 3 embryos, women older than 40 no more than 4 embryos
- Guideline for number of embryos…

19. “Courts have made clear that decisions about what to do with embryos are in the hands of the patients not physicians”
-TIME magazine (octuplets fallout…)

20. Twins most common multiple after IVF, thus the bulk of excess morbidity/mortality occur in twin gestations
- Guideline for number of embryos…

Working Bibliography

Working Bibliography

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Hansen, M.P.H., Michèle, Jennifer J. Kurinczuk, M.D., Carol Bower, M.B., B.S., Ph.D., and Sandra Webb, Ph.D. The Risk of Major Birth Defects after Intracytoplasmic Sperm Injection and in Vitro Fertilization. The Risk of Major Birth Defects after Intracytoplasmic Sperm Injection and in Vitro Fertilization. 7 Mar. 2002. The New England Journal of Medicine. 25 Feb. 2009 .

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1996. 5 vols.

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Rochman, Bonnie. "Octuplets Fallout: Should Fertility Doctors Set Limits?" Time Magazine 2 Feb. 2009.

"Study examines live birth rates following in vitro fertilization. (Clinical report)."
NewsRx Health & Science 1 Feb. 2009: 162.

Templeton, M.D., Allan, and Joan K. Morris, Ph.D. Reducing the Risk of Multiple Births by Transfer of Two Embryos after in Vitro Fertilization. 27 Aug. 1998. The New England Journal of Medicine. 25 Feb. 2009 .