The Egg, Sperm, and Embryo
The three key players or the stars at fertility clinics are:
1. Egg/Oocyte/Ovum2. Sperm
3. Embryo
- The Egg
The egg is one of the largest cells in the human body; in fact, it is a giant compared to other cells in the body. No other cell in the body is anywhere quite as big. Yet it is not large enough to be seen by the naked eye. It should be remembered that everything examined inside the embryology lab is microscopic.
Women are born with approximately two million eggs which keep diminishing as the age progresses. Naturally, the first day of menstruation, when the bleeding starts, is counted as the first day of the cycle. One of the ovaries will release an egg (ovulation) about 14 days before the start of periods. Eggs are released randomly by any one of the two ovaries.
An egg lives in the fallopian tubes for about 12-24 hours after ovulation. Of the three players, the oocyte or the egg is the most important component. The success of the treatment depends on the quality of the oocyte. The oocyte ages as the maternal age goes up. Oocyte quality matters more than quantity. Remember it just takes one good oocyte to achieve a pregnancy. Your clinician can evaluate the number of eggs present in the ovary through hormonal testing and ultrasound scanning.
- The Sperm
The sperm, the male reproductive cell or gamete is produced in the testis. Male-ejaculate known as semen is a combination of various hormones; fluids which provide sperm with the energy to be motile. A person ejaculating may not necessarily have sperms, as the semen may or may not contain sperms. A healthy adult male can release millions of sperm cells in a single ejaculation. However, for the IVF procedure just a few sperms are needed. Remember, it just takes one egg and one sperm to achieve a pregnancy.
The typical lifespan of sperm in a woman's body while fertile cervical fluid is present is three days, but in the right conditions sperm can even live up to five days. Whilst maternal age does have an effect on the egg, paternal age does not have a major impact on the count, motility, and morphology of the sperm.
- Semen Analysis
A standard semen analysis usually tests sperm count, motility, and morphology. Several tests that are more advanced can be carried out if the sperm count is low for no apparent reason or if several treatment cycles fail without explanation.
One of the first investigations done by a fertility doctor is a semen analysis. This is done after the man has masturbates and collected his semen into a sterile container. You can produce the sample at the clinic in a special room or at home if you live close by. The clinic will supply you with a container
When you get your semen assessment done, your doctor will receive a report from the lab with all the findings. The following table shows the normal ranges for sperm count, motility and morphology.
The most important factors are the sperm count and motility, and this will determine the suggested treatment options for the couple.
After Semen Analysis
Problems with the sperm not diagnosed by standard parameters of a semen analysis are:
· DNA fragmentation
· Aneuploidy (having the wrong number of chromosomes)
An embryo is the result of a mature egg that has been fertilized by a sperm in the woman’s reproductive system, or in a lab-based environment during assisted reproductive treatments. During in-vitro fertilization (IVF), sperms and eggs are collected from couples undergoing the treatment, and the embryo is generated in the lab.
Embryos are grown in the lab in incubators using small dishes knows as petri dishes, not in the test tube as the myth goes, under strictly controlled conditions. They are then transferred to the woman's uterus for implantation and growth at an appropriate stage of embryo development. The decision to do a transfer at the cleavage stage or blastocyst stage is a well-thought-out decision jointly taken by the couple, their clinician, and the embryologist. These stages are explained along with the advantage of blastocyst-stage transfer using the following example.
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