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ART (Assisted Reproductive Technology) - Coggle Diagram
ART (Assisted Reproductive Technology)
Understanding DNA tests and twin zygosity
Definition:
Identify individuals via unique genetic profiles
Why?
Identity confirmation
Paternity/relationship
Forensic investigation
Medical/ancestry insights
Process
Sample collection (cheek swab, blood, saliva)
DNA extraction
DNA amplification (PCR)
Analysis (STRs, SNPs, Y-DNA, mtDNA, sequencing)
Interpretation (compare with references/databases)
Ethical considerations
Informed consent
Psychological impact of results
Privacy & data ownership
Inheritance patterns
Humans
23 chromosome pairs
1 set from each parent
Fertilization -> recombination -> unique zygote
Mendel's Laws
(segregation, independent assortment, dominance)
Twin Zygosity
Dizygotic (Fraternal) --> 2 eggs, 2 sperm --> 50% DNA like siblings
Monozygotic (Identical) --> 1 egg, 1 sperm --> 100% DNA
Special types
Genetic differences
De Novo mutations
Epigenetics
Copy number variations
Testing Zygosity Methods
Chorionicity/placenta (85%-95% accuracy)
Blood typing (70% - 80% accuracy)
Physical Exam (70%-80% accuracy)
DNA testing STRs (99.9% accuracy GOLD standard)
Why test?
Research (genetics vs environment)
Psychological (identity development)
Medical (shared genetic risks)
Personal knowledge (curiosity, certainty)
Embryo cryopreservation
Frozen embryo implementation
Prepare uterus
Thaw embryo
Embryo transfer
Process
Old Method
Dehydrate by using low conc of 2 types of cryoprotectant
Slow cooling
Seeding (ice crystal formation)
Storage in liquid nitrogen tank
Purpose
Avoid forming ice crystal
inside embryo only
New Method
Dehydrate using high conc of cryoprotectant
Rapid cooling
Storage
Purpose
Avoid formation of ice crystal completely
High conc effect
Cause of unsuccessful freezing
Ice crystal formation
Cryoprotectant toxicity
Somatic stress
When?
Stages of embryogenesis
zygote
cleavage
morula
blastocyst
Definition
Freezing & storing fertilized eggs
in safe cryopreservation facilities
Why?
back up plan before starting medical treatment
another round of IVF without egg retrieval
ART considerations
Legal (parental rights, embryo own)
Positive (entitlement to support)
Negative (no interference right to procreate.
Intended parents those who consent
Types of parenthood
Biological (genetic)
Social (foster etc)
Gestational (pregnancy)
Medical
(smooth transition to new tech)
Ethical (equity + funding)
Long term considerations
Cost/equity
Ongoing consent
Social impact
Designer babies
Child health outcomes
Responsibility during medical error
transparency
accountability
protect patient rights/trust
minimise harm
root cause analysis + action plan
inform early
continued care
Principles of informed consent
Strong interpersonal skills
Simplify medical info
Voluntariness
Consider culture/background
mental capacity
Free from coercion
Lab safegaurds
Extra care during transport of gametes/embryo
Minimise cross-contamination
Label material, barcode it
Train new staff
Double check every IVF step
Keep medical record copies
IVF
Definiton
Fertilising oocytes in the laboratory
Steps
Ovarian stimulation (1)
Pituitary suppression (prevents internal FSH/LH)
Multiple follicular growth (artificial gonadotropins & medication protocoles)
Final follicular maturation (drug with hCG)
Egg retrieval (2)
Sedation (surgical procedure)
Transvaginal ultrasound guidance
Collection via aspiration with special needle
Fertilization & embryo culture (3)
Conventional IVF
Female-factor infertility
Mixing of sperm & eggs
Intracytoplasmic sperm injection (ICSI)
Male factor infertility
Embryo culture
Cryopreservation of extra embryo(s) blastocyst stage
Genetic screening
5-6 days
Embryo transfer (4)
Best quality embryo(s) chosen
Painless (no sedation)
Cryopreserved embryo(s)
Estrogen/progesterone preparation
Post-transfer care & pregnancy test (5)
Hormonal support for 2 weeks
Progesterone support
until 10-12 weeks gestation
Placenta takes over
Blood test for hCG (pregnancy test)
Reason behind IVF mix up
Mislabeling of samples
Poor record-keeping
Paper based
Electronic failure
Staff
No standardised protocols
Not well trained
Factors affecting success
Sperm quality/quantity
Smoking
Ovarian reserve
Costs
May need more than 1 cycle
Age
Most important
BMI
Stress
Amenorrhea
Absent periods
Psychological & emotional impact
Psychological issues
Families
Rogers: anger,grief,fear of losing child,
mistrust of clinic.
Fasanos: guilt, anxiety, fear of custody loss
Children
Identity confusion (who are my parents?)
Emotional burden of being result of medical error
Racial identity challenges
Medical institution regulations
Error prevention
Double verification of embryo label & transfer
Electronic tracking/barcoding
Quality control
Staff training
Regular audits & protocols
Transparency & trust
Clear communication with patients
Cultural & racial dynamics
Visible racial difference
One baby is black
while the other is white
Parental disputes
Custody considerations
Societal perceptions of race
Media/public attention
Amplifies racial/cultural issues