In vitro maturation ( IVM ) is the technique of letting the contents of ovarian follicles and the oocytes inside mature in vitro . It can be offered to women with infertility problems, combined with In Vitro Fertilization (IVF), offering women pregnancy without ovarian stimulation.
78-750: Topics referred to by the same term [REDACTED] This disambiguation page lists articles associated with the title IVM . If an internal link led you here, you may wish to change the link to point directly to the intended article. In vitro maturation Protein Data Bank (PDB) ligand code for ivermectin Innoson Vehicle Manufacturing , in Nigeria Incremental view maintenance in database theory and database systems See also [ edit ] IVM Podcasts ,
156-424: A probe . The ultrasound pulses echo off tissues with different reflection properties and are returned to the probe which records and displays them as an image. A general-purpose ultrasonic transducer may be used for most imaging purposes but some situations may require the use of a specialized transducer. Most ultrasound examination is done using a transducer on the surface of the body, but improved visualization
234-454: A 10% rate of maturation from unilaminar follicles into metaphase II by a multi-step culture system: Once the oocytes have sufficiently matured, they can then be fertilised in vitro , known as in vitro fertilisation (IVF). Techniques such as intracytoplasmic sperm injection (ICSI) can also be utilised to improve the chances of fertilisation being successful, which should be performed at least one hour (and optimally two to four hours) after
312-542: A follicle has reached the early tertiary or antral stage, IVM can be carried out. Firstly, the oocytes need to be obtained from the subject. The timing of this is dependent on the stage of the cycle the subject is in, which is usually monitored using ultrasonography . If without the use of priming, oocytes are obtained when the largest follicles are around 10mm in size. In humans, this can be done with an aspiration needle, using ultrasound to allow accuracy. Depending on whether you are aspirating mature or immature follicles,
390-411: A future resource in case the oocytes will stop functioning by advanced maternal age . Thus, ovarian tissue cryopreservation is an alternative to oocyte cryopreservation which requires a preceding controlled ovarian hyperstimulation . In vitro maturation allows oocytes from the ovarian tissue to be used directly for in vitro fertilization , as an alternative to surgical re-insertion of the tissue into
468-534: A limited potential developmentally. IVM has also been used in domestic animals including mice, cats, dogs, swine, sheep, horse and cattle as well as wild species such as buffalo, bison, fish, lions, tigers and leopards. The ability to recover animals' oocytes initially destined for ovarian follicle atresia , can be utilized by researchers, conservationists and the agriculture industry for academic purposes or for improving breeding systems. In research, IVM can be carried out on animals so as to understand
546-540: A method of signal generation and processing that results in a specific application. Most imaging techniques are operating in B-mode. Therapeutic ultrasound aimed at a specific tumor or calculus is not an imaging mode. However, for positioning a treatment probe to focus on a specific region of interest, A-mode and B-mode are typically used, often during treatment. Compared to other medical imaging modalities, ultrasound has several advantages. It provides images in real-time,
624-502: A personal or family history of an o estrogen associated thrombus , or of severe cardiovascular disease, may also benefit from IVM. This is because conventional IVF, with its hyperstimulation of the ovaries, has the potential to stimulate mass synthesis of oestrogen via the stimulation of granulosa cell oestrogen production. Ovarian tissue cryopreservation can be used as a method of fertility preservation , such as before undergoing chemotherapy that can cause female infertility , or as
702-725: A podcasting company in India. Retrieved from " https://en.wikipedia.org/w/index.php?title=IVM&oldid=1189617754 " Category : Disambiguation pages Hidden categories: Short description is different from Wikidata All article disambiguation pages All disambiguation pages In vitro maturation In 1935, Pincus & Enzmann did the first experiment on immature rabbit oocyte, showing in vitro spontaneous maturation and fertilization. They showed maturation occurs in isolation from normal follicular environment. In 1965 Edwards then continued IVM studies in mouse, sheep, cow, pig, rhesus monkey and human. By 1991,
780-489: A price of deeper tissue penetration. In anesthesiology , ultrasound is commonly used to guide the placement of needles when injecting local anesthetic solutions in the proximity of nerves identified within the ultrasound image (nerve block). It is also used for vascular access such as cannulation of large central veins and for difficult arterial cannulation . Transcranial Doppler is frequently used by neuro-anesthesiologists for obtaining information about flow-velocity in
858-405: A useful hint to treat patients with symptoms related to pelvic prolapse, double incontinence and obstructed defecation. It is also used to diagnose and, at higher frequencies, to treat (break up) kidney stones or kidney crystals ( nephrolithiasis ). Scrotal ultrasonography is used in the evaluation of testicular pain , and can help identify solid masses. Ultrasound is an excellent method for
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#1732797474407936-421: Is portable , and can consequently be brought to the bedside. It is substantially lower in cost than other imaging strategies. Drawbacks include various limits on its field of view, the need for patient cooperation, dependence on patient physique, difficulty imaging structures obscured by bone , air or gases, and the necessity of a skilled operator, usually with professional training. Sonography (ultrasonography)
1014-693: Is a common disorder involving dysfunction of the endocrine system associated with female reproduction. PCOS involves discrepancies in the Hyphophyseal-pituitary-gonadal endocrine axis which can result in hormonal dysfunction, excess androgens (e.g. testosterone) and frequent anovulatory menstrual cycles. Therefore, it is common for women suffering from PCOS to require assistance in order to conceive. In these patients IVM can be used to mature oocytes and aid conception. Few studies shows that substituting IVM in PCOS patients eliminates
1092-463: Is a common medical procedure. The need for intravenous access occurs in the outpatient laboratory, in the inpatient hospital units, and most critically in the Emergency Room and Intensive Care Unit. In many situations, intravenous access may be required repeatedly or over a significant time period. In these latter circumstances, a needle with an overlying catheter is introduced into the vein and
1170-535: Is a variant of classical in vitro maturation that involves attempting to mature immature oocytes that have been removed from a patient secondary to ovarian hyperstimulation in standard IVF practice. Therefore, allowing for more oocytes to mature to the developmental stage where they can be developmentally viable. However, rescue IVM has been considered a controversial field: If oocytes have not matured sufficiently in vivo – despite exposure to significant levels of gonadotrophins – it may be indicative of dysmaturity and of
1248-470: Is an assistive reproductive technique ( ART ) typically used in patients with fertility issues including polycystic ovary syndrome (PCOS), high antral follicle counts and ovarian hyper-responsiveness. However, more recently IVM has also become widely utilised in areas such as fertility preservation in cancer patient who have undergone treatment involving gonadotoxic therapies. There have been over 1000 live births recorded from mothers using IVM. PCOS
1326-421: Is an essential tool in cardiology , assisting in evaluation of heart valve function, such as stenosis or insufficiency , strength of cardiac muscle contraction, and hypertrophy or dilatation of the main chambers. ( ventricle and atrium ) Point of care ultrasound has many applications in emergency medicine . These include differentiating cardiac from pulmonary causes of acute breathlessness , and
1404-545: Is called obstetric ultrasonography , and was an early development of clinical ultrasonography. The machine used is called an ultrasound machine , a sonograph or an echograph . The visual image formed using this technique is called an ultrasonogram , a sonogram or an echogram . Ultrasound is composed of sound waves with frequencies greater than 20,000 Hz, which is the approximate upper threshold of human hearing. Ultrasonic images, also known as sonograms, are created by sending pulses of ultrasound into tissue using
1482-440: Is curable but must be treated to preserve health and fertility. There are two methods of performing pelvic sonography – externally or internally. The internal pelvic sonogram is performed either trans vaginally (in a woman) or transrectally (in a man). Sonographic imaging of the pelvic floor can produce important diagnostic information regarding the precise relationship of abnormal structures with other pelvic organs and it represents
1560-440: Is formed with a few granulosa cell layers, as well as a theca layer. Finally before ovulation, a tertiary follicle is formed containing a follicular-fluid filled antrum. Of these small antral follicles, 1 will become dominant and ovulate (in monoovulatory species). During ovulation, the primary oocyte will resume meiosis in response to signals, arresting in metaphase meiosis II, ready for fertilization. The dominant follicle contains
1638-437: Is important in women with polycystic ovarian syndrome (PCOS). This results in an expanding or dispersed pattern of the cumulus oophorus around the egg cell, facilitating its identification within follicular fluid. This leads to improved maturation and quality of the oocytes. However, the evidence of a clinical effect of hCG priming is still lacking. When IVM was initially introduced, successful pregnancies were low, leading to
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#17327974744071716-640: Is insufficient data regarding this outcome. Improving the culture conditions may increase the maturation rates and the potential of IVM oocytes. Besides that, in mouse oocytes, I-Carnitine (LC) supplementation during vitrification of germinal vesicle (GV) and their subsequent IVM improved nuclear maturation as well as meiotic spindle assembly and mitochondrial distribution in MII oocytes. However, no data to date has proven this benefit in fetal development and birth of healthy offspring after embryo transfer to surrogate females. However, this protocol could potentially improve
1794-459: Is often possible if a transducer can be placed inside the body. For this purpose, special-use transducers, including transvaginal , endorectal, and transesophageal transducers are commonly employed. At the extreme, very small transducers can be mounted on small diameter catheters and placed within blood vessels to image the walls and disease of those vessels. The imaging mode refers to probe and machine settings that result in specific dimensions of
1872-620: Is often used as image guidance for renal interventions. Furthermore, novel applications in renal US have been introduced with contrast-enhanced ultrasound (CEUS), elastography and fusion imaging. However, renal US has certain limitations, and other modalities, such as CT (CECT) and MRI, should be considered for supplementary imaging in assessing renal disease. Intravenous access, for the collection of blood samples to assist in diagnosis or laboratory investigation including blood culture, or for administration of intravenous fluids for fluid maintenance of replacement or blood transfusion in sicker patients,
1950-870: Is performed, which is where supraphysiological levels of gonadotropins are administered to the patient in order to hyperstimulate the antral follicles and hence induce oocyte maturation to metaphase II at a rate that is above normal physiological capabilities. This practice can be disadvantageous in several ways: It is very costly, can become complicated and may also predispose to several undesirable side effects, such as ovarian hyperstimulation syndrome (OHSS) . Ovarian hyperstimulation can cause severe OHSS in up to 2% of cases. OHSS can have serious consequences, including respiratory problems, renal impairment and even stroke. Patients with PCOS and younger women are at an increased risk of OHSS. In these women, it may be even more beneficial to employ IVM rather than conventional IVF treatment. In IVM, immature oocytes are removed from
2028-499: Is routinely used in urology to determine the amount of fluid retained in a patient's bladder. In a pelvic sonogram, images include the uterus and ovaries or urinary bladder in females. In males, a sonogram will provide information about the bladder, prostate , or testicles (for example to urgently distinguish epididymitis from testicular torsion ). In young males, it is used to distinguish more benign testicular masses ( varicocele or hydrocele ) from testicular cancer , which
2106-526: Is still under development. There are a lot of cellular changes in the oocyte and the rest of the cells in the follicle, which makes it very susceptible. Nevertheless, it is possible to let a primordial follicle mature to a secondary follicle outside the body by growing it in a slice of ovarian tissue. The subsequent maturity from secondary to early tertiary stage can then be supported in test-tubes. It has been suggested that photoirradiation of granulosa cells and oocytes may facilitate IVM. In vitro maturation
2184-548: Is the initial imaging choice, avoiding radiation if possible, although it frequently needs to be followed by other imaging methods such as CT . Endoanal ultrasound is used particularly in the investigation of anorectal symptoms such as fecal incontinence or obstructed defecation . It images the immediate perianal anatomy and is able to detect occult defects such as tearing of the anal sphincter . Ultrasonography of liver tumors allows for both detection and characterization. Ultrasound imaging studies are often obtained during
2262-514: Is unfeasible. In norma-ovulatory women, the success rate of IVM is lower than conventional ovarian stimulation regimens with poorer implantation and pregnancy rates. IVM is suboptimal and influenced by several factors. However, IVM is a milder approach to assisted reproduction treatment and an alternative procedure for specific conditions. Accurate patient selection can improve IVM clinical outcome. IVM of oocytes cryopreserved may assist urgent fertility preservation in cancer patients. However, there
2340-448: Is used at the bedside or examination table to evaluate a number of different lung abnormalities as well as to guide procedures such as thoracentesis , (drainage of pleural fluid (effusion)), needle aspiration biopsy, and catheter placement. Although air present in the lungs does not allow good penetration of ultrasound waves, interpretation of specific artifacts created on the lung surface can be used to detect abnormalities. Ultrasound
2418-488: Is used for imaging flow in the intracerebral arteries. Intravascular ultrasound ( IVUS ) uses a specially designed catheter with a miniaturized ultrasound probe attached to its distal end, which is then threaded inside a blood vessel. The proximal end of the catheter is attached to computerized ultrasound equipment and allows the application of ultrasound technology, such as a piezoelectric transducer or capacitive micromachined ultrasonic transducer , to visualize
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2496-437: Is used to create an image of internal body structures such as tendons , muscles , joints, blood vessels, and internal organs, to measure some characteristics (e.g., distances and velocities) or to generate an informative audible sound. The usage of ultrasound to produce visual images for medicine is called medical ultrasonography or simply sonography , or echography . The practice of examining pregnant women using ultrasound
2574-485: Is widely used in medicine . It is possible to perform both diagnosis and therapeutic procedures , using ultrasound to guide interventional procedures such as biopsies or to drain collections of fluid, which can be both diagnostic and therapeutic. Sonographers are medical professionals who perform scans which are traditionally interpreted by radiologists, physicians who specialize in the application and interpretation of medical imaging modalities, or by cardiologists in
2652-640: The Focused Assessment with Sonography for Trauma (FAST) exam , extended to include assessment for significant hemoperitoneum or pericardial tamponade after trauma ( EFAST ). Other uses include assisting with differentiating causes of abdominal pain such as gallstones and kidney stones . Emergency Medicine Residency Programs have a substantial history of promoting the use of bedside ultrasound during physician training. Both abdominal and endoanal ultrasound are frequently used in gastroenterology and colorectal surgery . In abdominal sonography,
2730-425: The endothelium of blood vessels in living individuals. In the case of the common and potentially, serious problem of blood clots in the deep veins of the leg, ultrasound plays a key diagnostic role, while ultrasonography of chronic venous insufficiency of the legs focuses on more superficial veins to assist with planning of suitable interventions to relieve symptoms or improve cosmetics. Echocardiography
2808-440: The transducer at the desired frequency. The frequencies can vary between 1 and 18 MHz , though frequencies up to 50–100 megahertz have been used experimentally in a technique known as biomicroscopy in special regions, such as the anterior chamber of the eye. Older technology transducers focused their beam with physical lenses. Contemporary technology transducers use digital antenna array techniques (piezoelectric elements in
2886-777: The absence of sonography. It is currently believed that the risk of delayed diagnosis is greater than the small risk, if any, associated with undergoing an ultrasound scan. However, its use for non-medical purposes such as fetal "keepsake" videos and photos is discouraged. Obstetric ultrasound is primarily used to: According to the European Committee of Medical Ultrasound Safety (ECMUS) Ultrasonic examinations should only be performed by competent personnel who are trained and updated in safety matters. Ultrasound produces heating, pressure changes and mechanical disturbances in tissue. Diagnostic levels of ultrasound can produce temperature rises that are hazardous to sensitive organs and
2964-517: The antral follicle of a woman and then are matured in vitro in a culture rich in gonadotrophins. This hence negates (or significantly reduces) the need for gonadotrophin stimulation. IVM is not an entirely perfected technique. Pregnancy rates are lower in IVM than in standard IVF. There is also research required into whether or not babies born to mothers who have undergone IVM have any health concerns (e.g. developmental issues) later in life. Women with
3042-424: The basal cerebral vessels . In angiology or vascular medicine, duplex ultrasound (B Mode imaging combined with Doppler flow measurement) is used to diagnose arterial and venous disease. This is particularly important in potential neurologic problems , where carotid ultrasound is commonly used for assessing blood flow and potential or suspected stenosis in the carotid arteries , while transcranial Doppler
3120-409: The body. IVM may also be an important consideration for female patients diagnosed with empty follicle syndrome ( EFS ). In EFS, no oocytes are retrieved from mature ovarian follicles despite the application of supraphysiological levels of gonadotrophins. A woman can be diagnosed with EFS after she has undergone multiple rounds of IVF with total (or near total) failure in each round. Rescue IVM
3198-510: The case of cardiac ultrasonography ( echocardiography ). Sonography is effective for imaging soft tissues of the body. Superficial structures such as muscle , tendon , testis , breast , thyroid and parathyroid glands, and the neonatal brain are imaged at higher frequencies (7–18 MHz), which provide better linear (axial) and horizontal (lateral) resolution . Deeper structures such as liver and kidney are imaged at lower frequencies (1–6 MHz) with lower axial and lateral resolution as
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3276-578: The catheter is then inserted securely into the vein while the needle is withdrawn. The chosen veins are most frequently selected from the arm, but in challenging situations, a deeper vein from the neck ( external jugular vein ) or upper arm ( subclavian vein ) may need to be used. There are many reasons why the selection of a suitable vein may be problematic. These include, but are not limited to, obesity, previous injury to veins from inflammatory reaction to previous 'blood draws', previous injury to veins from recreational drug use. In these challenging situations,
3354-415: The chosen vein. Ultrasound training for intravenous cannulation is offered in most ultrasound training programs. The creation of an image from sound has three steps – transmitting a sound wave , receiving echoes , and interpreting those echoes. A sound wave is typically produced by a piezoelectric transducer encased in a plastic housing. Strong, short electrical pulses from the ultrasound machine drive
3432-411: The competence to be fertilised and undergo embryogenesis'. Folliculogenesis is the mechanism by which the ovarian follicles mature. This can take many months in vivo and involves primordial follicle growth and differentiation. Primordial follicles containing the primary oocyte, arrested at prophase of meiosis I, develop into primary follicle containing cuboidal granulosa cells. A secondary follicle
3510-514: The developmental capacities of oocytes under certain conditions, or to understand the specific reproductive biology during that developmental period. IVM in other species is also carried out as some animals are used as models to study human-related reproductive biology. This research is often carried out with the aim of improving success rates of in vitro systems and/or aim to improve fertility in vivo. Animal IVM models can be used to study how different exposures to harmful and toxic substances affect
3588-399: The embryo/fetus. Biological effects of non-thermal origin have been reported in animals but, to date, no such effects have been demonstrated in humans, except when a micro-bubble contrast agent is present. Nonetheless, care should be taken to use low power settings and avoid pulsed wave scanning of the fetal brain unless specifically indicated in high risk pregnancies. Figures released for
3666-464: The evaluation process of Fatty liver disease . Ultrasonography reveals a "bright" liver with increased echogenicity. Pocket-sized ultrasound devices might be used as point-of-care screening tools to diagnose liver steatosis. Gynecologic ultrasonography examines female pelvic organs (specifically the uterus , ovaries , and fallopian tubes ) as well as the bladder , adnexa , and pouch of Douglas . It uses transducers designed for approaches through
3744-402: The first polar body extrusion. Out of in vitro matured oocytes, those fertilised with ICSI have a success rates of 60-80%, compared to IVF with success rates of 25-40%. A few live births have already been made by taking small early tertiary follicles, letting them mature in vitro and subsequently fertilizing them. However, for follicles that haven't reached the early tertiary stage, IVM
3822-418: The first human pregnancy was recorded using IVM followed by IVF, and in 1994 the first birth using IVM oocytes from polycystic ovarian syndrome patients was recorded highlighting that PCOS patient's oocytes are capable of maturation. Oogenesis takes place during fetal life, in which primordial germ cells undergo mitosis until a few weeks prior to birth, forming oogonia . These then begin meiosis to form
3900-415: The head and neck can be differentiated, evaluated, and managed with the help of diagnostic ultrasound and ultrasound-guided procedures. In neonatology , transcranial Doppler can be used for basic assessment of intracerebral structural abnormalities, suspected hemorrhage, ventriculomegaly or hydrocephalus and anoxic insults ( periventricular leukomalacia ). It can be performed through the soft spots in
3978-407: The insertion of a catheter into a vein has been greatly assisted by the use of ultrasound. The ultrasound unit may be 'cart-based' or 'handheld' using a linear transducer with a frequency of 10 to 15 megahertz . In most circumstances, choice of vein will be limited by the requirement that the vein is within 1.5 cms. from the skin surface. The transducer may be placed longitudinally or transversely over
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#17327974744074056-423: The kidneys is essential in the diagnosis and management of kidney-related diseases. The kidneys are easily examined, and most pathological changes are distinguishable with ultrasound. It is an accessible, versatile, relatively economic, and fast aid for decision-making in patients with renal symptoms and for guidance in renal intervention. Using B-mode imaging , assessment of renal anatomy is easily performed, and US
4134-466: The lateral resolution decreases. Therefore, the wider the transducer width and the higher the frequency of ultrasound, the longer the Fresnel zone, and the lateral resolution can be maintained at a greater depth from the transducer. Ultrasound waves travel in pulses. Therefore, a shorter pulse length requires higher bandwidth (greater number of frequencies) to constitute the ultrasound pulse. As stated,
4212-443: The layers between different tissues or scattered from smaller structures. Specifically, sound is reflected anywhere where there are acoustic impedance changes in the body: e.g. blood cells in blood plasma , small structures in organs, etc. Some of the reflections return to the transducer. The return of the sound wave to the transducer results in the same process as sending the sound wave, in reverse. The returned sound wave vibrates
4290-474: The lower abdominal wall, curvilinear and sector, and specialty transducers such as transvaginal ultrasound . Obstetrical sonography was originally developed in the late 1950s and 1960s by Sir Ian Donald and is commonly used during pregnancy to check the development and presentation of the fetus . It can be used to identify many conditions that could be potentially harmful to the mother and/or baby possibly remaining undiagnosed or with delayed diagnosis in
4368-399: The major organs of the abdomen such as the pancreas , aorta , inferior vena cava , liver , gall bladder , bile ducts , kidneys , and spleen may be imaged. However, sound waves may be blocked by gas in the bowel and attenuated to differing degrees by fat, sometimes limiting diagnostic capabilities. The appendix can sometimes be seen when inflamed (e.g.: appendicitis ) and ultrasound
4446-409: The mature oocyte. Follicular development is directly under gonadotropins control, LH and FSH. These use cAMP as an intracellular second messenger, with growth factors and cytokines also influencing their development in vivo. Through in vitro maturation, folliculogenesis and latter parts of oogenesis are being mimicked outside of the ovaries- trying to recreate the conditions for these processes. If
4524-411: The maturing oocytes and their ability to become fertilized and develop into an embryo. It can also be used for subsequent biotechnology applications such as for the creation of transgenic animals using innovative gene-editing techniques such as CRISPR/Cas9 , TALENs and ZFNs for biomedical research. An example includes genetically engineered pigs with CD163 and CD1D genes knocked out . One of
4602-437: The neck, including the thyroid and parathyroid glands , lymph nodes , and salivary glands , are well-visualized by high-frequency ultrasound with exceptional anatomic detail. Ultrasound is the preferred imaging modality for thyroid tumors and lesions, and its use is important in the evaluation, preoperative planning, and postoperative surveillance of patients with thyroid cancer . Many other benign and malignant conditions in
4680-524: The newborn, respiratory distress syndrome, congenital pneumonia, meconium aspiration syndrome, and pneumothorax. A neonatal lung ultrasound score, first described by Brat et al., has been found to highly correlate with oxygenation in the newborn. In ophthalmology and optometry , there are two major forms of eye exam using ultrasound: Ultrasound is used to assess the lungs in a variety of settings including critical care, emergency medicine, trauma surgery, as well as general medicine. This imaging modality
4758-434: The oocyte within the primordial follicle. This follicle consists of the oocyte surrounded by flattened pregranulosa cells. Babies are born with 1-2 million primordial follicles, and by puberty have around 300,000. Of these primordial follicles, only around 400 mature oocytes are released and could be potentially fertilised, with the rest undergoing atresia. 'Maturation' of an oocyte is the process by which an 'oocyte attains
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#17327974744074836-484: The ovaries of live female animals can be repeatedly carried out prior to the in vitro production of embryos. In non-domesticated animals, IVM can also be used for the conservation of endangered species whilst maintaining genetic diversity. However, due to limited resources and the species-specific nature of assisted reproductive technologies, the application of techniques such as IVM is still rare for non-domesticated animals. In an experiment by Segers I et al. (2015),
4914-410: The overall maturation rate after IVM of oocytes recovered from ovariectomy specimens in laboratory was 36%. The maturation rate correlated with the age of patient and duration of IVM. With the 8 couples with embryo cryopreservation , there was a 65% fertilisation rate. At least one good quality day 3 embryo was cryopreserved in 7/8 couples. This experiment shows that IVM of oocytes obtained ex vivo during
4992-682: The period 2005–2006 by the UK Government (Department of Health) show that non-obstetric ultrasound examinations constituted more than 65% of the total number of ultrasound scans conducted. Blood velocity can be measured in various blood vessels, such as middle cerebral artery or descending aorta , by relatively inexpensive and low risk ultrasound Doppler probes attached to portable monitors. These provide non-invasive or transcutaneous (non-piercing) minimal invasive blood flow assessment. Common examples are transcranial Doppler , esophageal Doppler and suprasternal Doppler . Most structures of
5070-436: The processing of ovarian cortex prior to cryopreservation is a promising solution for patients at risk for fertility loss. The success of embryo production in vitro depends upon the use of an efficient oocyte retrieval technique and the best results have been obtained by laparoscopic aspiration. The obstetric and perinatal outcomes of births from IVM cycles are similar to those with ICSI treatments. However, IVM involves
5148-449: The protocol differs slightly. In both procedures the aspiration pressure is reduced, but to varying degrees. Additionally, it is more important that the aspirate is filtered when retrieving immature follicles, as the follicles are much smaller and harder to see in the fluid extracted. Priming is the process by which the oocytes are primed with follicle-stimulating hormone (FSH) or human chorionic gonadotrophin (hCG) before retrieval. hCG
5226-682: The quality of vitrified human oocytes and embryos during IVM. In a research by Wang X et al. (2014), gonadotropins affect oocyte maturation, fertilisation and developmental competence in vitro. The responsiveness of bovine oocytes to gonadotropins in vitro depends on the relative concentrations (FSH/LH) for optimal oocyte development developmental competence. Optimal FSH/LH concentrations could improve therapeutic clinical stimulation protocols and IVF success rates. Medical ultrasound Medical ultrasound includes diagnostic techniques (mainly imaging techniques) using ultrasound , as well as therapeutic applications of ultrasound. In diagnosis, it
5304-490: The risk of OHSS and lowers the cost of treatment. The same group conducted a retrospective analysis study to compare the treatment outcome of IVM with IVF in patients with PCOS.They have further concluded there was significant increase pregnancy rates, implantation rates and number of embryos transferred in IVM group. The use of in vitro maturation in assisted reproduction has advantages over standard ART procedures. In typical IVF practice, controlled ovarian hyperstimulation
5382-451: The skull of a newborn infant ( Fontanelle ) until these completely close at about 1 year of age by which time they have formed a virtually impenetrable acoustic barrier to ultrasound. The most common site for cranial ultrasound is the anterior fontanelle. The smaller the fontanelle, the more the image is compromised. Lung ultrasound has been found to be useful in diagnosing common neonatal respiratory diseases such as transient tachypnea of
5460-413: The sound is focused either by the shape of the transducer, a lens in front of the transducer, or a complex set of control pulses from the ultrasound scanner, in the beamforming or spatial filtering technique. This focusing produces an arc-shaped sound wave from the face of the transducer. The wave travels into the body and comes into focus at a desired depth. Materials on the face of the transducer enable
5538-408: The sound to be transmitted efficiently into the body (often a rubbery coating, a form of impedance matching ). In addition, a water-based gel is placed between the patient's skin and the probe to facilitate ultrasound transmission into the body. This is because air causes total reflection of ultrasound; impeding the transmission of ultrasound into the body. The sound wave is partially reflected from
5616-409: The study of the penis , such as indicated in trauma, priapism, erectile dysfunction or suspected Peyronie's disease . Musculoskeletal ultrasound is used to examine tendons, muscles, nerves, ligaments, soft tissue masses, and bone surfaces. It is helpful in diagnosing ligament sprains, muscles strains and joint pathology. It is an alternative or supplement to x-ray imaging in detecting fractures of
5694-449: The transducer produce echoes at different times) to enable the ultrasound machine to change the direction and depth of focus. Near the transducer, the width of the ultrasound beam almost equals to the width of the transducer, after reaching a distance from the transducer (near zone length or Fresnel zone ), the beam width narrows to half of the transducer width, and after that the width increases (far zone length or Fraunhofer's zone ), where
5772-532: The ultrasound image. Several modes of ultrasound are used in medical imaging: Most machines convert two-way time to imaging depth using as assumed speed of sound of 1540 m/s. As the actual speed of sound varies greatly in different tissue types, an ultrasound image is therefore not a true tomographic representation of the body. Three-dimensional imaging is done by combining B-mode images, using dedicated rotating or stationary probes. This has also been referred to as C-mode . An imaging technique refers to
5850-635: The use of invasive techniques, this may harm the mother. Furthermore, embryological outcome of IVM is not established. A more comprehensive appraisal of health status of IVM children will demand larger prospective studies. The potential of cryopreserved IVM oocytes from cancer patients remain unknown. The optimal number of IVM oocytes frozen in candidates for fertility preservation (FP) is unknown. FP oocytes of infertile PCOS women have decreased competence compared to oocytes recovered after ovarian stimulation. The FP strategy of cryopreservation of oocytes after IVM should only be considered should ovarian stimulation
5928-584: The use of ovary priming. This technique is also used in sheep, pigs and other animals. See In animals . Oocytes are classified depending on their condition, such as number of cumulus cells. The best oocytes are chosen to be matured in the hope of then being implanted using in vitro fertilisation techniques. The oocytes are then cultured in media containing nutrients important for oocyte survival, such as gonadotrophins, growth factors and steroids. These vary between clinics and research laboratories. McLaughlin et al. biopsied human ovarian tissue and achieved
6006-485: The ways these pigs were created was by injecting the CRISPR/Cas9 system into fertilised oocytes that were matured in vitro . In agriculture, IVM is usually carried out prior to IVF or artificial insemination as a means of conserving desirable traits of particular animals within herds and counteracting lower production as a result of seasonal breeding. In livestock species such cattle, transvaginal oocyte recovery from
6084-487: The wrist, elbow and shoulder for patients up to 12 years ( Fracture sonography ). Quantitative ultrasound is an adjunct musculoskeletal test for myopathic disease in children; estimates of lean body mass in adults; proxy measures of muscle quality (i.e., tissue composition) in older adults with sarcopenia Ultrasound can also be used for needle guidance in muscle or joint injections , as in ultrasound-guided hip joint injection . In nephrology , ultrasonography of
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