UNDERSTANDING INFERTILITY
CONCEPTION UNDER THE MICROSCOPE: IN VITRO
FERTILIZATION
AUTHOR Robert K. Hunter II, MD, MSc, MBA, FACOG
I
n June 2018, Louise Brown, the world’s
first baby born from in vitro fertilization
(IVF) treatment, celebrated her 40 th birth-
day. In the decades that have passed since
her historic birth, we have seen remark-
able advances in the clinical and labo-
ratory sciences of assisted reproduction
that have now led to the births of over 7
million children worldwide. In 2017, over 78,000 infants were born
from IVF treatment in the United States, representing just over 2%
of all births in the country. As IVF has continuously evolved, it now
represents one of the safest and most successful treatment options
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LOUISVILLE MEDICINE
for patients coping with a variety of infertility diagnoses.
In a typical IVF protocol, injectable gonadotropins are used to
induce the growth and development of a number of oocytes over the
course of about 10 days. The process is closely monitored, and med-
ication doses are adjusted as needed to optimize a patient’s response.
Once a number of peri-ovulatory ovarian follicles are present, final
maturation of the oocytes and their surrounding granulosa cells is
induced with a trigger shot, which simulates the natural mid-cycle
Luteinizing Hormone surge. An ultrasound-guided transvaginal
oocyte aspiration procedure is performed about 36 hours later.
Oocytes that are recovered in the metaphase II stage of meiosis