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Dr. SHYJUS
MBBS, MS (JIPMER), FMAS, DMAS, Cert. in daVinci Robotic Surgical System
Asst. ProfessorDept. of Obstetrics and Gynaecology
MES Medical College, Perinthalmanna, Kerala
3/6/2014
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Conventional IVF
ICSI
IMSI
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ICSI sperm is an Embryologist’s selection…..…not natural!
Physical manipulation of Oocyte membrane and Cytoplasm with a needle
Candidates of ICSI are carriers of ‘Y’ chromosome abnormalities
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Genetic disorders
Congenital anomalies
Preterm delivery and perinatal health issues
Developmental delays and disabilities
and
Behavioral and mental health difficulties
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Low birth weight babies
Premature babies
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3 times more risk to be born as a LBW baby
Geyter, Steimann etal.Comparative birth weights of singletons born after assisted reproduction and natural conception in previously infertile women. Hum Reprod. 2006 Mar;21(3):705-12
2 times more risk to be born premature
Jackson, Gibson etal. Perinatal outcomes in singletons following in vitro fertilization: a meta-analysis.Obstet Gynecol. 2004 Mar;103(3):551-63.
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Small increased risk for birth defects
including heart malformations limb abnormalities and metabolic disorders
Klemetti / Olson (2005)
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300 singleton children born after ICSI in Belgium,
Sweden and United States
Compared with matched naturally conceived children at 5 years
No significant differences were found in cognitive development or psychological well-being
(Ponjaert-Kristoffersen et al. 2004)
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Pre-implantation genetic diagnosis (PGD)
(1 to 2 cells are removed from 3-day-old embryo for genetic analysis)
It can overcome chromosomal disorders through transfer of only genetically screened embryos
Long term safety of PGD?
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Only when an ART offspring
themselves become parents
have normal reproductive experiencesandtheir offspring develop normally
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