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How can we protect valuable marine habitats for fisheries? - Science Journal for Kids and Teens

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Researchers determined the habitat value for fisheries in Jersey and France to help develop sustainable management plans in the future. %

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How do some fungi turn insects into zombies? - Science Journal for Kids and Teens

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Scientists wanted to explore the mechanisms behind host behavior manipulation by zombie-making fungi. Scientific article for students.

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How Do Gut Bacteria Control the Brain? - Science Journal

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Scientists tested how the presence of human or normal mouse gut bacteria affected the mice's brain development. Scientific article for high school students.

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Biological software updates to cure disease - Science Journal

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Scientists wanted to develop a way to fix or replace a damaged or missing gene within a person's genome by engineering a protein circuit.

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Scientists wanted to find out about the long-term effect of measles on the immune system. Scientific article for students.

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The power of the placebo effect - Emma Bryce

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RAW: Interview with breast cancer patient Donna Julich

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What Is Cancer? What Causes Cancer & How Is It Treated?

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Human Blood Video | Blood Components | Blood Cells

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The Immune System: How does it adapt? (1/2)

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https://youtu.be/KMkmkpitAH0

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Similarity Between Animal And Plant Cells

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Human Blood Video | Blood Components | Blood Cells

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Breast Cancer -  Spread the Awareness - English

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The Immune System Video  | How to boost your Immunity  | What is immune system and its function?

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Differences between prokaryotes and eukaryotes

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Prokaryotic vs Eukaryotic Cells | Differences Animated

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"If you have a honeybee colony exposed to one pesticide that kills 10% of the bees and another pesticide that kills another 10%, you would expect, if those effects were additive, for 20% of the bees to be killed," Dr Siviter said.

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Farm pesticides killing more bees - study

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"If you have a honeybee colony exposed to one pesticide that kills 10% of the bees and another pesticide that kills another 10%, you would expect, if those effects were additive, for 20% of the bees to be killed," Dr Siviter said.

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The Relationship Between Pesticides and Parkinson's

A discussion of how environmental factors, such as pesticides, may affect your risk of Parkinson's disease

During my recent interview on Wisconsin Public Radio, many of the callers asked questions related to environmental risks of Parkinson's disease (PD), specifically, exposures related to farming. Those calls prompted me to delve further into this complicated and murky topic.

Before we start discussing specific factors in the environment that may increase risk of PD, let's understand some basic ground rules that will help put this topic in perspective

A person's genetic makeup is likely more important in determining whether he or she develops PD than any environmental risk factor. This is probably the case even in a person without a known family history of PD. However, environmental exposure may be important in triggering the disease in a person genetically susceptible to it.

It is important to note that any particular environmental exposure that we will talk about, typically increases risk of PD by a very small amount. The risk will also depend on dosage and frequency of exposure, which means that a small and/or infrequent exposure may have a very small impact on PD risk.

There are some chemical exposures that appear to decrease the risk of PD, such as coffee or non-steroidal anti-inflammatory medications. A full understanding of someone's PD risk needs to take into account all of the factors that both increase and decrease risk.

It is more than likely that additional chemicals in our environment, ones that haven't yet been studied and which I will therefore not mention here, impact risk of PD too (by increasing or perhaps decreasing it). Living in a modern society means being exposed to a variety of chemicals whose risks we don't completely understand.

With that background, let us begin.

Rural living and an increased risk of PD

In the 1980s, studies were conducted that showed that early-age exposure to a rural environment as well as exposure to well water were associated with development of PD later in life. Subsequently, multiple additional studies looked at these questions. The studies are mixed in their conclusions, but overall the evidence supports associations between increased PD risk with each of the following:

farming as an occupation,

exposure to farm animals,

living on a farm,

exposure to pesticides,

well water drinking, and

living in a rural area.

Of course, all these categories are inter-related, since farmers live on farms in rural areas, are exposed to farm animals, are more likely than urban dwellers to drink well water and use pesticides. The studies were attempting to tease out why rural environments increased the risk of PD. Do only those who actually farm have an increased risk or is it enough to live on a farm? Is pesticide exposure the reason for the increased risk? Well water exposure? Exposure to farm animals? Or is it another element of rural life?

In the end, epidemiologic data supports the assertion that each of these elements increases the risk of PD. Of note, all of the increased risks in these studies are small - on the order of 1.5-2 times the risk of the general population.

Has anything changed over time?

Since most of the studies concerning PD and rural living were done decades ago, a recent study sought to revisit this issue since farming life has changed in recent times. Pesticide use is reduced, there has been a large migration from rural to urban areas, and there is less dependence on well water in rural communities.

The new study was conducted in Finland and looked at the incidence of PD in rural versus urban areas. Interestingly, rural living remained a risk factor for PD. It is possible that current diagnoses of PD continue to reflect the environmental exposures of decades ago, and that risk reduction in rural areas due to decreased pesticide use and other changes in farming life may show more benefits in the future. However, the study suggests that we may not yet fully understand how the rural environment affects Parkinson's risk.

Specific pesticides and their link to PD

The evidence that pesticide use is associated with an increased risk in PD, begs the question - are there specific pesticides that are most concerning? When data is collected on this topic in large populations, often the participants in the study are unaware of which specific pesticide exposures they have had. This makes it difficult to determine which pesticides to avoid.

Some studies however were able to investigate the risks of specific chemicals. A recent review summarized the current state of knowledge on this topic. The chemical with the most data linking it to an increased PD risk is paraquat, with exposure associated with a 2-3 fold increased PD risk over the general population.

One particularly comprehensive study investigated exposure to 31 pesticides and their association with PD risk. From that data emerged paraquat and rotenone as the two most concerning pesticides.

Paraquat's mechanism of action is the production of reactive oxygen species, intracellular molecules that cause oxidative stress and damage cells.

Rotenone's mechanism of action is disruption of the mitochondria, the component of the cell that creates energy for cell survival.

Interestingly, both mitochondrial dysfunction and oxidative stress are common themes in our general understanding of what causes death of nerve cells in PD.

Of note, rotenone is often used by home gardeners and not necessarily on farms. It is extracted from plants and is therefore considered by some to be a "natural" pesticide. Nevertheless, it has been linked to PD in humans, and in fact is used in the laboratory to induce a Parkinson's-like state in animals.

Organochlorine and organophosphate pesticides are also associated with increased risk, although DDT, one specific type of organochlorine pesticide, was not associated with increased risk of PD in more than one study.

Urban pollutants

Although studies suggest that a rural environment increases risk of PD more than an urban environment, those who live in cities have their own pollutants to be concerned about. Numerous epidemiologic studies have investigated the role of air pollution in PD risk. A recent review summarized the current state of knowledge on this topic and analyzed the association between PD and various types of air pollutants including ozone, particulate matter of various sizes, nitrogen dioxide, and the airborne metals copper, mercury, and manganese. Results varied across studies but overall, data exists associating each of these components of air pollution with a small increased risk of PD.

Other pollutants

There are many other chemicals in use today that may increase risk of PD. However, data is hard to come by and variable in conclusion. There is evidence that certain solvents and metals increase the risk of PD and additional studies are needed.

Exposure to pesticides in the military

Agent Orange was an herbicide that US troops sprayed in Vietnam from 1961-1971 to kill trees and crops that provided protection and food to the rival army. It is a mixture of two chemicals: 2,4-Dichlorophenoxyacetic acid and 2,4,5-Trichlorophenoxyacetic acid. Agent Orange was also contaminated with Dioxin, a chemical even more damaging than Agent Orange itself, since it is very long-lasting.

The effects of Agent Orange (and its contaminants) on both the Vietnamese population and on American soldiers has been studied extensively, but with much variability in the results. Birth defects have been attributed to Agent Orange exposure, as well as multiple types of cancer.

With the understanding that the Veteran community served selflessly on behalf of the American people and therefore deserve the protection and support of the American government, the Agent Orange Act was passed in 1991, allowing the Department of Veteran Affairs to declare certain conditions "presumptive" to exposure to Agent Orange, even if the scientific data associating Agent Orange with that condition was not airtight.

The list of conditions has grown over the years, and in 2010, PD was added. Read here about how veterans who may have been exposed to Agent Orange and have subsequently developed PD are eligible for VA healthcare and disability compensation. APDA offers a free booklet specifically for veterans to help them find the care and support they need.

Tips and Takeaways

Rural living, farming and pesticide exposure are linked to a small increased risk of developing PD over the general population. The pesticides with the most convincing data connecting them to increased risk of PD include paraquat and rotenone and one should consider limiting exposure to these chemicals.

Multiple other chemicals have been associated with an increased risk of PD including solvents and many components of air pollution. There are likely additional chemicals that increase the risk of PD that we are not yet aware of. It is therefore impossible, or at least extremely difficult, to avoid all substances that may increase the risk of PD.

Veterans who may have been exposed to Agent Orange and have PD should be aware that they are eligible for disability compensation.

Do you have a question or issue that you would like Dr. Gilbert to explore? Suggest a Topic

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Dr. Rebecca Gilbert

APDA Chief Scientific Officer

Dr. Gilbert received her MD degree at Weill Medical College of Cornell University in New York and her PhD in Cell Biology and Genetics at the Weill Graduate School of Medical Sciences. She then pursued Neurology Residency training as well as Movement Disorders Fellowship training at Columbia Presbyterian Medical Center. Prior to coming to APDA, she was an Associate Professor of Neurology at NYU Langone Medical Center. In this role, she saw movement disorder patients, initiated and directed the NYU Movement Disorders Fellowship, participated in clinical trials and other research initiatives for PD and lectured widely on the disease.
View all posts by Dr. Rebecca Gilbert

A Closer Look Article Risk Factors for Parkinson's
DISCLAIMER: Any medical information disseminated via this blog is solely for the purpose of providing information to the audience, and is not intended as medical advice. Our healthcare professionals cannot recommend treatment or make diagnoses, but can respond to general questions. We encourage you to direct any specific questions to your personal healthcare providers.

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The Relationship Between Pesticides and Parkinson's - APDA

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During my recent interview on Wisconsin Public Radio, many of the callers asked questions related to environmental risks of Parkinson's disease (PD), specifically, exposures related to farming. Those calls prompted me to delve further into this complicated and murky topic.

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Assessment of human exposure to pesticides by hair analysis: The case of vegetable-producing areas in Burkina Faso - PubMed

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The present work assesses human exposure to pesticides in vegetable-producing areas in Burkina Faso, using hair as an indicator. The study design includes a comparison between operators who are occupationally exposed while working in the fields and a reference population (i.e. not occupationally exp…

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As technology continues to get closer to merge with our bodies, from the smartphones in our hands to the smartwatches on our wrists to earbuds. Now, it's getting under our skin literally with a tiny microchip. A human microchip implant is typically an identifying integrated circuit device or RFID (Radio-Frequency IDentification) transponder encased in silicate glass and implanted in the body of a human being. This type of subdermal implant usually contains a unique ID number that can be linked to information contained in an external database, such as personal identification, law enforcement, medical history, medications, allergies, and contact information.

In Sweden, thousands have had microchips inserted into their hands. The chips are designed to speed up users' daily routines and make their lives more convenient - accessing their homes, offices and gyms is as easy as swiping their hands against digital readers. Chips also can be used to store emergency contact details, social media profiles or e-tickets for events and rail journeys.

Advocates of the tiny chips say they're safe and largely protected from hacking, but scientists are raising privacy concerns around the kind of personal health data that might be stored on the devices. Around the size of a grain of rice, the chips typically are inserted into the skin just above each user's thumb, using a syringe similar to that used for giving vaccinations. Implanting chips in humans has privacy and security implications that go well beyond cameras in public places, facial recognition, tracking of our locations, our driving habits, our spending histories, and even beyond ownership of your data, which poses great challenges for the acceptance of this technology.

To understand the big picture about this technology, you need to know that the use of the chips is an extension of the concept of Internet of Things (IoT), which is a universe of connected things that keep growing by the minute with over 30 billion connected devices at the end of 2020, and 75 billion devices by 2025. Just as the world begins to understand the many benefits of the Internet of Things, but also learns about the 'dark side' from 'smart everything,' including our connected cities, we are now looking at small chips causing major new privacy challenges.

Like any new trend, in order for that trend to be accepted and become mainstream, it needs to overcome three challenges: Technology, Business, and Society (regulations and laws).

The first challenge is Technology: which is advancing every day and the chips are getting smaller and smarter, in the world of IoT the chips are considered as the first element of a typical IoT system which consists of: Sensors, Networks, Cloud, and Applications. As a sensor, the chip touches upon your hand, your heart, your brain and the rest of your body -literally. This new development is set to give a quite different meaning to 'hacking the body' or biohacking. While cyber experts continue to worry about protecting critical infrastructure and mitigating security risks that could harm the economy or cause a loss of life, implanted chips also affect health but add in new dimensions to the risks and threats of hacking of sensors as they considered as the weakest link in IoT systems.

The second challenge is Business: there are many companies in this field and the opportunities are huge with all aspects of replacing ID in stores, offices, airports, hospitals just to mention few. Also, chips will provide key physical data and further processing of that data in the cloud to deliver business insights, new treatments, and better services - presents a huge opportunity for many players in all types of businesses and industries in private and public sectors.

The third challenge is Society: As individuals try to grapple with the privacy and security implications that come with technologies like IoT, big data, public- and private-sector data breaches, social media sharing, GDPR, a new California privacy law CCPA, along with data ownership and "right to be forgotten" provisions, along comes a set of technologies that will become much more personal than your smartphone or cloud storage history, and the tiny chip under your skin is sitting at the top of the list of these technologies, posing new risks and threats.

This challenge can be divided into two tracks: Government regulations like GDPR in EU and recent regulations in the US to ban forced usage of the chip for example, and consumer trust which is built on three pillars; SSP (Security, Safety and Privacy):

Safety is a major concern in using tiny chips inside your body including infection risks, MRI's use with chips, and corrosion of the chip's parts.

Security and Privacy concerns deal with stolen identity, risk to human freedom and autonomy to mention few.

This technology is promising and another step towards more convenience and simplifying many of the daily tasks of billions of people around the world, but without solid security, safety and privacy measures applied when using this tiny chip, we will be facing a cybersecurity nightmare with far reaching consequences, in addition to an ethical dilemma in dealing with population who refused to use it is, they will be marginalized when it comes to jobs for instance. According to a recent survey of employees in the United States and Europe, two-thirds of employees believe that in 2035, humans with chips implanted in their bodies will have an unfair advantage in the labor market. One big concern raised by many privacy advocates is the creation of surveillance state tracking individuals using this technology.

Too many moving parts to deal with, in this technology, until we answer all questions related to this technology, many people will look at it as another attempt of both governments and businesses to gain access to another piece of data about us and add it to many channels used now in gathering info. using our electronic devices, knowing that by 2030, there will be an average of 15 IoT devices for each person in the US.

Ahmed Banafa, Author the Books:

References

[1] https://www.govtech.com/blogs/lohrmann-on-cybersecurity/chip-implants-the-next-big-privacy-debate.html

[2] https://www.npr.org/2018/10/22/658808705/thousands-of-swedes-are-inserting-microchips-under-their-skin

[3] https://www.cnn.com/2020/09/18/business/jobs-robots-microchips-cyborg/index.html

[4] https://www.thomasnet.com/insights/the-future-of-microchip-implants-in-humans/

[5] https://www.linkedin.com/pulse/three-major-challenges-facing-iot-ahmed-banafa/

[6] https://en.wikipedia.org/wiki/Microchip_implant_(human)

[7] https://www.linkedin.com/pulse/8-key-tech-trends-post-covid-19-world-ahmed-banafa/

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Technology Under Your Skin: Challenges of Microchip Implants | OpenMind

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As technology continues to get closer to merge with our bodies, now it's getting under our skin literally with a tiny microchip.

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Facing COVID passport mandate, more Swedes get microchip implants

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Rise comes after Sweden required vaccination passport at all events with over 100 participants as of Dec. 1, local media reports - Anadolu Agency

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Why human microchipping is so popular in Sweden | ITV News

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Everything you need to know about gestational surrogacy

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France to legalise IVF for lesbians, single women after two-year debate

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France to legalise fertility treatment for lesbians after two-year debate

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Countries that Accept Single Women for IVF

If you have a partner, the egg donor IVF program is open to you in any country. But if you are single, your choices will narrow to:

Countries that Accept Lesbian Couples for IVF

If you want to start undergoing IVF with donor eggs for same-sex couples, the available destinations are:

Spain(ROPA)

Portugal

Finland

Uk

Barbados

North Cyprus

Greece(Yes, only if they are treated as a single woman - a notary statement is needed)

Latvia(only if they are treated as a single woman - a notary statement is needed)

Age Limit by the Country for IVF

Spain - 50 (some clinics may support patients up to 52)

The Czech Republic - 49

Greece - 50

North Cyprus - 58 (over the age of 55, will need the approval of the ethics committee, over 45 - the Ministry Of Health approval is mandatory)

Ukraine - No legal limit (not specified by legislation, decided by each clinic)

Poland - No legal limit (not specified by legislation, decided by each clinic)

Russia - 51 (some clinics may treat older women at their own risk)

Latvia - No legal limit (not specified by legislation, decided by each clinic)

Thailand - No legal limit (not specified by legislation, decided by each clinic)

Malaysia - Not specified by legislation, decided by each clinic)

Singapore - The 45 y.o. age limit was removed on 1 Jan 2020

Choosing an Egg Donor for IVF Abroad

In the majority of countries (e.g. Greece, Poland, the Czech Republic, or Spain) they select the egg donors based on a phenotype matching with the recipient. This meaning the donor should resemble the recipient in terms of hair, eye, and skin color as much as possible. These rules are because of legal requirements. This also means that in these countries patients cant select "any donor". In other countries (e.g. in Ukraine), a patient can choose a donor who looks similar to them.

According to international medical associations (ESHRE, ASRM), selecting an egg donor who has some common characteristics with a recipient is recommended. This resemblance should at least cover the color of the eyes, hair, and skin, height, and a blood type.

What Information is shared with the recipient about the egg donor?

In Russia, Ukraine, and the United States, additionally, to the donor's basic physical features (height, weight, and hair color), patients will have information about the donor's adult/childhood, photos, and others. The shared information may vary from clinic to clinic and countries.

The Egg Donor's Race in IVF Procedure

In Ukraine, Russia and Poland IVF clinic databases are mainly dominated by egg donors of Caucasian origin. If you are interested in a donor with darker skin, your choice would be IVF centers from Spain, Cyprus, or Greece. African-American or Afro-Caribbean donors are most often found in the USA or Barbados.

How many eggs you will receive from the donor

The exact number of oocytes received from a donor depends on the clinic's policy. Generally, they should provide a minimum of 6 eggs, which can result in 2 embryos, on condition that your partner's sperm quality is high enough. Some foreign IVF clinics don have a limit on offered eggs, no matter how many eggs have been retrieved (so-called exclusive donor).

However, it's important to know that receiving limitless oocytes doesn't promise a successful result, it depends mainly on their quality when determining how successful the egg donation program would be.

Egg Donation Abroad with Frozen Eggs

Before you visit a clinic abroad, confirm with the IVF center if they use frozen or fresh eggs. With frozen eggs, most abroad IVF clinics will offer 6-10 oocytes. This number usually refers to frozen eggs - such oocytes need to be thawed first, and this means that the number of eggs intended for fertilization will be smaller, due to the fact that around 50-70% of oocytes are successfully thawed.

IVF Abroad Cost

Ukraine- Egg donation can be as low as 4600 EUR, but some clinics will offer full packages that will be a one-time payment for the entire process 35,000EUR-50000EUR(all included, even the birth).

Spain- from 5500 EUR with own eggs, from 7500EUR with egg donation, for a cycle.

The USA - an average of 12,000EUR for a cycle without medication that cand be around 1,200 to 2,700EUR for a cycle.

Barbados - an average of 12,000EUR per cycle, without medication.

Malaysia - from 4,200$

Singapore - on average 12,000$ per cycle

How Many IVF Cycles are Needed for a Successful Pregnancy?

When considering your budget and IVF destination you should consider the fact that you may need a couple of IVF cycles to conceive, this meaning you will have to make the trip to your chosen destination a couple of times for the treatment. It is stated that you may have to do at least 3 IVF cycles to have a successful pregnancy. The number of needed cycles may be bigger if you are older, have certain health issues, etc.
Read about IVF Treatments During COVID-19. Read about IVF prices in different countries.

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If you have a partner, the egg donor IVF program is open to you in any country. But if you are single, your choices will narrow to: Spain, Portugal...If you want to start undergoing IVF with donor eggs for same-sex couples, the available destinations are: Finland, Barbados...

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How in vitro fertilization (IVF) works - Nassim Assefi and Brian A. Levine

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Overview

In vitro fertilization, also called IVF, is a complex series of procedures that can lead to a pregnancy. It's a treatment for infertility, a condition in which you can't get pregnant after at least a year of trying for most couples. IVF also can be used to prevent passing on genetic problems to a child.

During in vitro fertilization, mature eggs are collected from ovaries and fertilized by sperm in a lab. Then a procedure is done to place one or more of the fertilized eggs, called embryos, in a uterus, which is where babies develop. One full cycle of IVF takes about 2 to 3 weeks. Sometimes these steps are split into different parts and the process can take longer.

In vitro fertilization is the most effective type of fertility treatment that involves the handling of eggs or embryos and sperm. Together, this group of treatments is called assisted reproductive technology.

IVF can be done using a couple's own eggs and sperm. Or it may involve eggs, sperm or embryos from a known or unknown donor. In some cases, a gestational carrier - someone who has an embryo implanted in the uterus - might be used.

Your chances of having a healthy baby using IVF depend on many factors, such as your age and the cause of infertility. What's more, IVF involves getting procedures that can be time-consuming, expensive and invasive. If more than one embryo is placed in the uterus, it can result in a pregnancy with more than one baby. This is called a multiple pregnancy.

Your health care team can help you understand how IVF works, what the risks are and whether it's right for you.

Why it's done

In vitro fertilization is a treatment for infertility or genetic problems. Before you have IVF to treat infertility, you and your partner might be able to try other treatment options that involve fewer or no procedures that enter the body. For example, fertility drugs can help the ovaries make more eggs. And a procedure called intrauterine insemination places sperm directly in the uterus near the time when an ovary releases an egg, called ovulation.

Sometimes, IVF is offered as a main treatment for infertility in people over the age of 40. It also can be done if you have certain health conditions. For example, IVF may be an option if you or your partner has:

Fallopian tube damage or blockage. Eggs move from the ovaries to the uterus through the fallopian tubes. If both tubes get damaged or blocked, that makes it hard for an egg to be fertilized or for an embryo to travel to the uterus.

Ovulation disorders. If ovulation doesn't happen or doesn't occur often, fewer eggs are available to be fertilized by sperm.

Endometriosis. This condition happens when tissue that's like the lining of the uterus grows outside of the uterus. Endometriosis often affects the ovaries, uterus and fallopian tubes.

Uterine fibroids. Fibroids are tumors in the uterus. Most often, they're not cancer. They're common in people in their 30s and 40s. Fibroids can cause a fertilized egg to have trouble attaching to the lining of the uterus.

Previous surgery to prevent pregnancy. An operation called tubal ligation involves having the fallopian tubes cut or blocked to prevent pregnancy for good. If you wish to conceive after tubal ligation, IVF may help. It might be an option if you don't want or can't get surgery to reverse tubal ligation.

Issues with sperm. A low number of sperm or unusual changes in their movement, size or shape can make it hard for sperm to fertilize an egg. If medical tests find issues with sperm, a visit to an infertility specialist might be needed to see if there are treatable problems or other health concerns.

Unexplained infertility. This is when tests can't find the reason for someone's infertility.

A genetic disorder. If you or your partner is at risk of passing on a genetic disorder to your child, your health care team might recommend getting a procedure that involves IVF. It's called preimplantation genetic testing. After the eggs are harvested and fertilized, they're checked for certain genetic problems. Still, not all of these disorders can be found. Embryos that don't appear to contain a genetic problem can be placed in the uterus.

A desire to preserve fertility due to cancer or other health conditions. Cancer treatments such as radiation or chemotherapy can harm fertility. If you're about to start treatment for cancer, IVF could be a way to still have a baby in the future. Eggs can be harvested from their ovaries and frozen for later use. Or the eggs can be fertilized and frozen as embryos for future use.

People who don't have a working uterus or for whom pregnancy poses a serious health risk might choose IVF using another person to carry the pregnancy. The person is called a gestational carrier. In this case, your eggs are fertilized with sperm, but the embryos that result are placed in the gestational carrier's uterus.

Risks

IVF raises the chances of certain health problems. From short term to longer term, these risks include:

Stress. IVF can be draining for the body, mind and finances. Support from counselors, family and friends can help you and your partner through the ups and downs of infertility treatment.

Complications from the procedure to retrieve eggs. After you take medicines to spur the growth of sacs in the ovaries that each contain an egg, a procedure is done to collect the eggs. This is called egg retrieval. Ultrasound images are used to guide a long, thin needle through the vagina and into the sacs, also called follicles, to harvest the eggs. The needle could cause bleeding, infection or damage to the bowel, bladder or a blood vessel. Risks are also linked with medicines that can help you sleep and prevent pain during the procedure, called anesthesia.

Ovarian hyperstimulation syndrome. This is a condition in which the ovaries become swollen and painful. It can be caused by receiving shots of fertility medicines, such as human chorionic gonadotropin (HCG), to trigger ovulation.

Symptoms often last up to a week. They include mild belly pain, bloating, upset stomach, vomiting and diarrhea. If you become pregnant, your symptoms might last a few weeks. Rarely, some people get a worse form of ovarian hyperstimulation syndrome that also can cause rapid weight gain and shortness of breath.

Miscarriage. The rate of miscarriage for people who conceive using IVF with fresh embryos is similar to that of people who conceive naturally - about 15% for pregnant people in their 20s to over 50% for those in their 40s. The rate rises with the pregnant person's age.

Ectopic pregnancy. This is a condition in which a fertilized egg attaches to tissue outside the uterus, often in a fallopian tube. The embryo can't survive outside the uterus, and there's no way to continue the pregnancy. A small percentage of people who use IVF will have an ectopic pregnancy.

Multiple pregnancy. IVF raises the risk of having more than one baby. Becoming pregnant with multiple babies carries higher risks of pregnancy-related high blood pressure and diabetes, early labor and delivery, low birth weight, and birth defects than does pregnancy with a single baby.

Premature delivery and low birth weight. Research suggests that IVF slightly raises the risk that the baby will be born early or with a low birth weight.

Cancer. Some early studies suggested that certain medicines used to stimulate egg growth might be linked with getting a specific type of ovarian tumor. But more-recent studies do not support these findings. There doesn't seem to be a significantly higher risk of breast, endometrial, cervical or ovarian cancer after IVF.

How you prepare

To get started, you'll want to find a reputable fertility clinic. If you live in the United States, the Centers for Disease Control and Prevention and the Society for Assisted Reproductive Technology provide information online about clinics' individual pregnancy and live birth rates.

A fertility clinic's success rate depends on many things. These include the ages and medical issues of people they treat, as well as the clinic's treatment approaches. When you talk with a representative at a clinic, also ask for detailed information about the costs of each step of the procedure.

Before you start a cycle of IVF using your own eggs and sperm, you and your partner will likely need various screening tests. These include:

Ovarian reserve testing. This involves getting blood tests to find out how many eggs are available in the body. This is also called egg supply. The results of the blood tests, often used together with an ultrasound of the ovaries, can help predict how your ovaries will respond to fertility medicines.

Semen analysis. Semen is the fluid that contains sperm. An analysis of it can check the amount of sperm, their shape and how they move. This testing may be part of an initial fertility evaluation. Or it might be done shortly before the start of an IVF treatment cycle.

Infectious disease screening. You and your partner will both be screened for diseases such as HIV.

Practice embryo transfer. This test doesn't place a real embryo in the uterus. It may be done to figure out the depth of your uterus. It also helps determine the technique that's most likely to work well when one or more actual embryos are inserted.

Uterine exam. The inside lining of the uterus is checked before you start IVF. This might involve getting a test called sonohysterography. Fluid is sent through the cervix into the uterus using a thin plastic tube. The fluid helps make more-detailed ultrasound images of the uterine lining. Or the uterine exam might include a test called hysteroscopy. A thin, flexible, lighted telescope is inserted through the vagina and cervix into the uterus to see inside it.

Before you begin a cycle of IVF, think about some key questions, including:

How many embryos will be transferred? The number of embryos placed in the uterus often is based on age and the number of eggs collected. Since the rate of fertilized eggs attaching to the lining of uterus is lower for older people, usually more embryos are transferred - except for people who use donor eggs from a young person, genetically tested embryos or in certain other cases.

Most health care professionals follow specific guidelines to prevent a multiple pregnancy with triplets or more. In some countries, legislation limits the number of embryos that can be transferred. Make sure you and your care team agree on the number of embryos that will be placed in the uterus before the transfer procedure.

What will you do with any extra embryos? Extra embryos can be frozen and stored for future use for many years. Not all embryos will survive the freezing and thawing process, but most will.

Having frozen embryos can make future cycles of IVF less expensive and less invasive. Or you might be able to donate unused frozen embryos to another couple or a research facility. You also might choose to discard unused embryos. Make sure you feel comfortable making decisions about extra embryos before they are created.

How will you handle a multiple pregnancy? If more than one embryo is placed in your uterus, IVF can cause you to have a multiple pregnancy. This poses health risks for you and your babies. In some cases, a surgery called fetal reduction can be used to help a person deliver fewer babies with lower health risks. Getting fetal reduction is a major decision with ethical, emotional and mental risks.

Have you thought through the risks linked with using donor eggs, sperm or embryos, or a gestational carrier? A trained counselor with expertise in donor issues can help you understand the concerns, such as the legal rights of the donor. You also may need an attorney to file court papers to help you become legal parents of an embryo that's developing in the uterus.

What you can expect

After the preparations are completed, one cycle of IVF can take about 2 to 3 weeks. More than one cycle may be needed. The steps in a cycle go as follows:

Treatment to make mature eggs

The start of an IVF cycle begins by using lab-made hormones to help the ovaries to make eggs - rather than the single egg that usually develops each month. Multiple eggs are needed because some eggs won't fertilize or develop correctly after they're combined with sperm.

Certain medicines may be used to:

Stimulate the ovaries. You might receive shots of hormones that help more than one egg develop at a time. The shot may contain a follicle-stimulating hormone (FSH), a luteinizing hormone (LH) or both.

Help eggs mature. A hormone called human chorionic gonadotropin (HCG), or other medicines, can help the eggs ripen and get ready to be released from their sacs, called follicles, in the ovaries.

Delay ovulation. These medicines prevent the body from releasing the developing eggs too soon.

Prepare the lining of the uterus. You might start to take supplements of the hormone progesterone on the day of the procedure to collect your eggs. Or you might take these supplements around the time an embryo is placed in the uterus. They improve the odds that a fertilized egg attaches to the lining of your uterus.

Your doctor decides which medicines to use and when to use them.

Most often, you'll need 1 to 2 weeks of ovarian stimulation before your eggs are ready to be collected with the egg retrieval procedure. To figure out when the eggs are ready, you may need:

Vaginal ultrasound, an imaging exam of the ovaries to track the developing follicles. Those are the fluid-filled sacs in the ovaries where eggs mature.

Blood tests, to check on how you respond to ovarian stimulation medicines. Estrogen levels often rise as follicles develop. Progesterone levels remain low until after ovulation.

Sometimes, IVF cycles need to be canceled before the eggs are collected. Reasons for this include:

Not enough follicles develop.

Ovulation happens too soon.

Too many follicles develop, raising the risk of ovarian hyperstimulation syndrome.

Other medical issues happen.

If your cycle is canceled, your care team might recommend changing medicines or the amounts you take, called doses. This might lead to a better response during future IVF cycles. Or you may be advised that you need an egg donor.

Egg retrieval

This is the procedure to collect the eggs from one or both ovaries. It takes place in your doctor's office or a clinic. The procedure is done 34 to 36 hours after the final shot of fertility medicine and before ovulation.

Before egg retrieval, you'll be given medicine to help you relax and keep you from feeling pain.

An ultrasound device is placed into the vagina to find follicles. Those are the sacs in the ovaries that each contain an egg. Then a thin needle is inserted into an ultrasound guide to go through the vagina and into the follicles to collect the eggs. This process is called transvaginal ultrasound aspiration.

If your ovaries can't be reached through the vagina this way, an ultrasound of the stomach area may be used to guide the needle through the stomach and into the ovaries.

The eggs are removed from the follicles through a needle connected to a suction device. Multiple eggs can be removed in about 20 minutes.

After the procedure, you may have cramping and feelings of fullness or pressure.

Mature eggs are placed in a liquid that helps them develop. Eggs that appear healthy and mature will be mixed with sperm to attempt to create embryos. But not all eggs are able to be fertilized with success.

Sperm retrieval

If you're using your partner's sperm, a semen sample needs to be collected at your doctor's office or clinic the morning of egg retrieval. Or sperm can be collected ahead of time and frozen.

Most often, the semen sample is collected through masturbation. Other methods can be used if a person can't ejaculate or has no sperm in the semen. For example, a procedure called testicular aspiration uses a needle or surgery to collect sperm directly from the testicle. Sperm from a donor also can be used. Sperm are separated from the semen fluid in the lab.

Fertilization

Two common methods can be used to try to fertilize eggs with sperm:

Conventional insemination. Healthy sperm and mature eggs are mixed and kept in a controlled environment called an incubator.

In certain situations, other procedures may be recommended before embryos are placed in the uterus. These include:

Assisted hatching. About 5 to 6 days after fertilization, an embryo "hatches" from the thin layer that surrounds it, called a membrane. This lets the embryo attach to the lining of the uterus.

If you're older and you want to get pregnant, or if you have had past IVF attempts that didn't work, a technique called assisted hatching might be recommended. With this procedure, a hole is made in the embryo's membrane just before the embryo is placed in the uterus. This helps the embryo hatch and attach to the lining of the uterus. Assisted hatching is also useful for eggs or embryos that were frozen, as that process can harden the membrane.

Preimplantation genetic testing. Embryos are allowed to develop in the incubator until they reach a stage where a small sample can be removed. The sample is tested for certain genetic diseases or the correct number of threadlike structures of DNA, called chromosomes. There are usually 46 chromosomes in each cell. Embryos that don't contain affected genes or chromosomes can be transferred to the uterus.

Preimplantation genetic testing can lower the chances that a parent will pass on a genetic problem. It can't get rid of the risk completely. Prenatal testing may still be recommended during pregnancy.

Embryo transfer

The procedure to place one or more embryos in the uterus is done at your doctor's office or a clinic. It often takes place 2 to 6 days after eggs are collected.

You might be given a mild sedative to help you relax. The procedure is often painless, but you might have mild cramping.

A long, thin, flexible tube called a catheter is placed into the vagina, through the cervix and into the uterus.

A syringe that contains one or more embryos in a small amount of fluid is attached to the end of the catheter.

Using the syringe, the embryo or embryos are placed into the uterus.

If the procedure works, an embryo will attach to the lining of your uterus about 6 to 10 days after egg retrieval.

After the procedure

After the embryo transfer, you can get back to your usual daily routine. Your ovaries may still be enlarged, so vigorous activities or sex might cause discomfort. Ask your care team how long you should stay away from these.

Typical side effects include:

Passing a small amount of clear or bloody fluid shortly after the procedure. This is due to the swabbing of the cervix before the embryo transfer.

Breast tenderness due to high estrogen levels.

Mild bloating.

Mild cramping.

Constipation.

Call your care team if you have moderate or severe pain, or heavy bleeding from the vagina after the embryo transfer. You'll likely to need to get checked for complications such as infection, twisting of an ovary and ovarian hyperstimulation syndrome.

Results

At least 12 days after egg retrieval, you get a blood test to find out whether you're pregnant.

If you're pregnant, you'll likely be referred to an obstetrician or other pregnancy specialist for prenatal care.

If you're not pregnant, you'll stop taking progesterone and likely get your period within a week. Call your care team if you don't get your period or if you have unusual bleeding. If you'd like to try another cycle of IVF, your care team might suggest steps you can take to improve your chances of getting pregnant next time.

The chances of giving birth to a healthy baby after using IVF depend on various factors, including:

Embryo status. Transfer of embryos that are more developed is linked with higher pregnancy rates compared with less-developed embryos. But not all embryos survive the development process. Talk with your care team about your specific situation.

Talk with your care team about any factors that apply to you and how they may affect your chances of a successful pregnancy.

Clinical trials

Explore Mayo Clinic studies of tests and procedures to help prevent, detect, treat or manage conditions.

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