Describe steps involved in the process of in vitro fertilization. Discuss two moral or ethical concerns about in vitro fertilization.

It may also be helpful to understand the process of
natural conception. Think about your IVF cycle as natural conception process aided by
our fertility specialists. Human conception is a relatively simple and yet amazingly
complex process.

The process begins on the first day of
your menstrual cycle. We also call this day Cycle Day 1. During the next 12 to 14 days
occurs what fertility specialists call follicular phase, the event that results in the
ovulation of a mature egg. It’s called "follicular phase," because the eggs develop in a
fluid-filled sacs called the follicles. On Cycle Day 1, your body starts developing
follicles. Many eggs begin to develop during each monthly cycle. Naturally, however,
usually just one of the eggs will reach maturity while the rest undergo a process known
as atresia, or degeneration, and are lost forever. When that one egg is mature, it is
released from the ovary. With IVF medications, fertility doctors help your body to
develop more than one egg during the first 10 days of the cycle. The egg will be capable
of being fertilized for only the next 12 to 24 hours. If not fertilized within that
time, it is simply reabsorbed by the body.

On
day 14 of the typical 28-day cycle, woman’s egg is mature and ovulation occurs. As the
egg begins it descend through the fallopian tubes, it meets with sperm and gets
fertilized. Ovulation triggers many other changes in the body. The cervical mucus
becomes penetrable, and the lining of the uterus is getting ready to accept an
implantation. In contract to the natural process, our IVF doctors will retrieve the
mature eggs on Cycle Day 12. Normally IVF medications are taken for 10 days. However, if
patient’s ovaries don’t respond well, you may be instructed to take medication up to
five days longer.

Typically, IVF clinics perform egg
retrieval on Cycle Day 12. The very same day, the eggs are fertilized with sperm either
by conventional insemination or by Intracytoplasmic Sperm Injection (ICSI). The eggs
will be checked the following day to document fertilization and again the next day to
evaluate for early cell division. Until recently, embryos were cultured for three days
and then transferred to the uterus and/or cryogenically frozen for later use. As
mentioned in the previous comment, IVF clinics now have the ability to grow the embryos
for five or six days until they reach the blastocyst stage. Blastocysts are believed to
have a greater chance of implantation. This, in turn, allows our IVF doctors to transfer
fewer embryos and lower the risk of multiple births while increasing the chance of
pregnancy.  Recently, however, I have been hearing about the trend of transferring
embryos three days after fertilization.

The final step in
the IVF cycle is the embryo transfer. As it is the case with the natural fertilization,
not all embryos will grow in the laboratory dish. The embryo(s) that continue to divide
and grow is transferred into recipient’s uterus about the time it would arrive there in
a natural conception. Unused embryos can be cryopreserved for later
use.