WEBVTT - How In Vitro Fertlization Works 0:00:00.640 --> 0:00:10.639 Welcome to Stuff You Should Know Fromhouse Stuff Works dot com. Hey, 0:00:10.680 --> 0:00:13.720 and welcome to the podcast. I'm Josh Clark with Charles W. 0:00:13.920 --> 0:00:18.840 Chuck Bryant y. Yeah, and this is Stuff you should Know. 0:00:19.160 --> 0:00:26.840 It sounded uh sardonic, yery yi j a silent yawking, yawking. 0:00:27.640 --> 0:00:30.040 I'd never get sick of that movie. No, it's a 0:00:30.080 --> 0:00:32.200 good one. I haven't seen the second one. Don't really 0:00:32.200 --> 0:00:35.720 intend to, but I'm afraid too, Yeah, because it might 0:00:35.760 --> 0:00:39.040 tarnish my love of that character, because I've heard it's 0:00:39.040 --> 0:00:40.879 not very funny to just keep it keep it with 0:00:40.960 --> 0:00:43.840 the first one. I'm totally gonna watch him just waiting 0:00:43.840 --> 0:00:47.160 for cable. Oh yeah, yeah, Yeah, TBS knows what they're 0:00:47.200 --> 0:00:51.120 doing with movies that were for the big screen. Yeah, 0:00:51.920 --> 0:00:58.280 size them down, best start ever. Uh. So you're doing good. 0:00:58.560 --> 0:01:03.480 I'm great, Okay, good. Um. So we're talking today about 0:01:03.960 --> 0:01:11.960 IVF in vitro fertilization. Um. And I have to say, Chuckers, 0:01:12.080 --> 0:01:13.560 I don't really have by the way, I don't have 0:01:13.600 --> 0:01:18.080 an intro for this one to um, although I do 0:01:18.200 --> 0:01:20.679 have a bit of one. All right, let's see uh 0:01:20.760 --> 0:01:26.319 in nineteen In two thousand thirteen, a lady named Louise 0:01:26.400 --> 0:01:33.320 Brown celebrated her thirty fifth birthday, and with her birthday 0:01:33.319 --> 0:01:36.240 coming and going, she announced that she was pregnant with 0:01:36.240 --> 0:01:40.400 her second child. This is like mind blowing crazy stuff 0:01:40.440 --> 0:01:44.000 all over the place, because Louise Brown was the first 0:01:44.959 --> 0:01:50.400 human being ever conceived using in vitro fertilization. Yes, they 0:01:50.400 --> 0:01:52.680 called them test two babies back then. Remember that. Yeah, 0:01:52.840 --> 0:01:55.600 totally test two babies. You don't call it that anymore. No, 0:01:55.720 --> 0:01:58.680 we've gotten a little more scientific as a society since 0:01:58.720 --> 0:02:02.800 the seventies. Plus. I don't think they use test tubes. Yeah, 0:02:02.880 --> 0:02:06.360 if they ever did, I think maybe petri dishes, culture dishes, 0:02:07.680 --> 0:02:10.360 not test twos, but you know culture dish baby. It's right, 0:02:10.520 --> 0:02:12.680 that's weird. Test tube baby. It kind of rolls off 0:02:12.680 --> 0:02:14.919 the tongue. It's got the two T sounds, which makes 0:02:14.919 --> 0:02:19.320 it a little funny ish and um intriguing. But that's 0:02:19.360 --> 0:02:21.200 what she was. She was the first test two baby. 0:02:21.280 --> 0:02:25.959 It was eight in England, um, and she was born July. 0:02:26.840 --> 0:02:30.800 I think, um, like just a few days later. I 0:02:30.840 --> 0:02:35.399 think the second IVF baby was born in India very 0:02:35.480 --> 0:02:38.639 in very short order. For two. I'm sure that their 0:02:38.760 --> 0:02:41.520 doctors were like come on, will you give birth already? 0:02:41.560 --> 0:02:43.839 I want to be the first. Nobody remembers number two. 0:02:43.919 --> 0:02:46.600 And then the following year, in nineteen seventy nine, the 0:02:46.600 --> 0:02:51.040 first American IVF baby was born. And that's the history 0:02:51.240 --> 0:02:55.160 of IVF, like it just goes back that far. Since then, 0:02:56.000 --> 0:03:00.000 I think thirty five more than thirty five million uh 0:03:00.200 --> 0:03:03.880 IVF babies have been born a couple of hundred thousand 0:03:03.919 --> 0:03:07.520 each year in the US alone. Now, yeah, it was 0:03:07.560 --> 0:03:09.760 like in the sixties eighties. Now it's up to like 0:03:09.800 --> 0:03:12.680 a hundred and something a hundred and change. I think 0:03:13.520 --> 0:03:17.600 I got over two thousands. Do you really really? I 0:03:17.680 --> 0:03:24.200 saw two thousand twelve or maybe maybe two d thousand worldwide. 0:03:24.600 --> 0:03:26.920 All right, let's just settle on that. I'll bite on 0:03:27.000 --> 0:03:30.200 that one. Um. But yeah, that's a lot of babies 0:03:30.200 --> 0:03:34.880 that are born through IVF, and it's a it's crazy 0:03:34.960 --> 0:03:39.520 how the thing that struck me and finally we're getting 0:03:39.560 --> 0:03:43.320 to the end of the intro um is that what 0:03:43.480 --> 0:03:46.320 I v F is? It seems so like whiz bang 0:03:46.480 --> 0:03:51.920 crazy futuristic. No, it's it's figuring out. We figured out 0:03:52.000 --> 0:03:58.120 how a woman becomes pregnant and figured out the ways 0:03:58.160 --> 0:04:02.000 that we could possibly best help that process along, and 0:04:02.640 --> 0:04:05.560 that's what it is. Yeah, it's really there's no like 0:04:05.640 --> 0:04:09.600 crazy new technology. They don't like like buzz her with 0:04:09.680 --> 0:04:14.800 like a prey goo laser, nothing like that. It's strictly 0:04:14.840 --> 0:04:20.400 like catheters and timing and you know, hormones. It's crazy 0:04:20.440 --> 0:04:23.880 how simple it is. But it's also equally crazy that 0:04:23.960 --> 0:04:26.600 you know, it's as successful as it is considering what 0:04:26.640 --> 0:04:32.240 it What in vitro fertilization consists of. Yes, I guess 0:04:32.279 --> 0:04:34.960 we can go ahead and talk about success rates. Um. 0:04:34.960 --> 0:04:37.559 In the US, women under the age of thirty five 0:04:38.040 --> 0:04:40.640 have a thirty to thirty five chance of conceiving with 0:04:40.680 --> 0:04:46.560 ibf uh. It drops between thirty five and forty six 0:04:47.520 --> 0:04:53.839 over forty uh. And that is percentages of live birth cycle, 0:04:53.960 --> 0:04:57.400 which is yeah, per cycle. So like, if you go 0:04:57.480 --> 0:05:00.400 through a cycle of in vitro fertilization, do you have 0:05:00.520 --> 0:05:04.039 the percentage chance typically which is pretty much in lock 0:05:04.160 --> 0:05:09.440 step with natural birth rates according to age it Yeah, well, 0:05:09.440 --> 0:05:12.159 I mean it definitely decreases with age, but I'm not 0:05:12.200 --> 0:05:14.679 saying it's like one for one. Sure, yeah, yeah, it's totally, 0:05:14.839 --> 0:05:21.080 But I'm saying that I think the depreciation of possibility. 0:05:21.400 --> 0:05:25.520 It goes down with age naturally as well with IVF two. Yeah, 0:05:25.560 --> 0:05:29.479 and live birth is the key here because many times, uh, 0:05:29.960 --> 0:05:32.279 there will be conception and there will be a pregnancy, 0:05:32.400 --> 0:05:34.560 but any number of things can go wrong from there. 0:05:34.680 --> 0:05:40.120 Oh yeah sure. Chemical pregnancies UM topic pregnant topic pregnancies. Apparently, 0:05:40.160 --> 0:05:43.040 some Chinese researcher did a survey of a hundred thousand 0:05:43.120 --> 0:05:49.080 plus live IVF births UM and found that there's a correlation. 0:05:50.480 --> 0:05:52.840 You were three times likelier to have a major birth 0:05:52.839 --> 0:05:57.680 effect if you were born via in vitro fertilization than natural. 0:05:57.800 --> 0:06:01.200 And he just found a correlation. Um, not a cause, 0:06:01.360 --> 0:06:06.520 but just the numbers. For some reason spit that out. Yeah. Well, now, 0:06:07.279 --> 0:06:08.880 one of the new things you can do is up 0:06:08.920 --> 0:06:10.960 for at a certain point in the process pg D, 0:06:11.520 --> 0:06:15.839 which is preimplantation genetic diagnosis. And this is a test 0:06:15.960 --> 0:06:20.719 that will cost you several thousand dollars and it basically UM. 0:06:20.760 --> 0:06:23.800 It allows you to root out certain mono genetic disorders, 0:06:23.839 --> 0:06:26.360 like you can get PGD testing and find out if 0:06:27.160 --> 0:06:29.679 the baby might have like sickle cell or Huntington's disease 0:06:29.760 --> 0:06:33.599 or cystic like process or downs and then UM you 0:06:33.600 --> 0:06:35.240 can make a decision at that point whether or not 0:06:35.279 --> 0:06:37.200 you want to continue with the process. Yeah. You know, 0:06:37.279 --> 0:06:41.960 there's a real um concern that there won't be like 0:06:42.040 --> 0:06:46.560 that down syndrome, people will be extinct eventually because the 0:06:47.600 --> 0:06:51.800 should have gotten so accurate. Yeah, yeah, I don't think 0:06:51.839 --> 0:06:54.520 that will happen. Well. And there's also ethical concerns with 0:06:54.600 --> 0:06:57.800 pg D about you know, do you do selective termination 0:06:57.839 --> 0:06:59.240 if you can find out it's a boy and you 0:06:59.279 --> 0:07:01.720 wanted a girl, right or um, oh I didn't want 0:07:01.720 --> 0:07:04.760 to give brown eyes? Yeah, and I know there's a 0:07:04.800 --> 0:07:11.800 lot of ethical yeah, associated with it, and um, it's 0:07:11.800 --> 0:07:14.280 even more basic than that for a lot of people 0:07:14.320 --> 0:07:19.760 to like, if you have a fertilized egg, um, or 0:07:19.800 --> 0:07:22.280 even just an egg with the potential human life. To 0:07:22.320 --> 0:07:26.160 some people, that destroying just the egg that that was 0:07:26.200 --> 0:07:30.920 never fertilized is like a moral problem. Yeah. Or let's 0:07:30.920 --> 0:07:35.720 say you, um, you have a chance of multiples, um 0:07:35.760 --> 0:07:38.960 twins or triplets or quads or more. If you're a 0:07:39.000 --> 0:07:42.720 certain age, that is not good and can be dangerous 0:07:42.960 --> 0:07:46.560 for you as the mother and for the kids too. Yeah. 0:07:46.600 --> 0:07:48.840 So at that point, um, you might have to go 0:07:48.880 --> 0:07:53.160 through what they call selective reduction, which is choosing which 0:07:53.160 --> 0:07:55.440 ones to go with. Well, there's a lot of pitfalls 0:07:55.720 --> 0:07:58.280 this UM, but there's a lot of people who are 0:07:58.320 --> 0:08:00.280 helped by it as well, and at the very least 0:08:00.280 --> 0:08:03.760 there's a lot of people who seek the help from it. 0:08:03.840 --> 0:08:06.520 I saw something like in this article, which I think 0:08:06.640 --> 0:08:08.840 was written in two thousands, six or seven. Yeah, it's 0:08:08.840 --> 0:08:12.200 a little dated. A head they said six point one 0:08:12.240 --> 0:08:17.840 million Americans are faced with infertility, which UM, infertility is 0:08:17.880 --> 0:08:23.800 not like Bam, you're infertile. UM, here's what's wrong with you? 0:08:24.240 --> 0:08:29.280 Infertility be right, but it isn't always technically infertility. The 0:08:29.320 --> 0:08:33.640 definition of infertility is that you have um gotten it 0:08:33.720 --> 0:08:39.000 on for a year unprotected and no baby has been 0:08:39.040 --> 0:08:43.559 produced for six months. If you're overt okay, But it 0:08:43.600 --> 0:08:46.760 depends on the doctor. Like this article talked a lot 0:08:46.800 --> 0:08:48.920 about well, if you've gone this far and you've done 0:08:48.960 --> 0:08:51.520 these procedures, then they'll move you to this. A lot 0:08:51.520 --> 0:08:54.440 of the places are fertility clinics or baby factories and 0:08:54.480 --> 0:08:56.960 they'll you can go right to I D F if 0:08:57.000 --> 0:08:59.760 you want to. And if they say that they believe 0:08:59.800 --> 0:09:03.160 in so's. There's not like any hard and fast law, 0:09:03.840 --> 0:09:06.200 you know, that's the impression. After doing this for how 0:09:06.240 --> 0:09:09.640 many years have we been doing this? Now, after eighty 0:09:09.720 --> 0:09:12.920 years of doing this, um, I've learned that how stuff 0:09:12.920 --> 0:09:16.880 works article is like it deals in ideals. It's not 0:09:17.000 --> 0:09:19.520 necessarily like this is how it works in the real world. 0:09:19.520 --> 0:09:22.079 It's like, this is how it works according to the law. 0:09:22.200 --> 0:09:25.320 That's true. We do our best. Yeah. Um. So, apparently 0:09:25.360 --> 0:09:28.200 about seven point three million people UM are faced with 0:09:28.280 --> 0:09:31.920 infertility and they turned to IVF, and IVF is far 0:09:31.960 --> 0:09:35.720 and away the most popular form of what's called UH 0:09:36.160 --> 0:09:41.120 assisted reproductive technology, which, as we said, sounds whiz bang 0:09:41.160 --> 0:09:45.960 and futuristic but not necessarily Yeah, about fifty of a 0:09:46.160 --> 0:09:49.240 r t UM methods are what they call low tech, 0:09:49.400 --> 0:09:53.600 which is maybe we'll put you on some hormones. UM 0:09:53.880 --> 0:09:57.319 Antibiotics apparently are a huge one, a huge stream of 0:09:57.320 --> 0:10:02.080 for infertility. Yeah. They supposedly especial the unexplained infertility, which 0:10:02.120 --> 0:10:05.840 affects something between ten to thirty percent of infertility cases 0:10:05.840 --> 0:10:09.480 are just unexplained. Yeah, they're like, we there's nothing structurally 0:10:09.480 --> 0:10:13.199 wrong with you. Your husband's sperm is fine, Like there's 0:10:13.400 --> 0:10:16.480 we can't figure it out. Well, it made getting pregnant 0:10:16.559 --> 0:10:18.800 isn't the easiest thing in the world. It seems that 0:10:18.840 --> 0:10:21.520 way in the movies, but there's an explanation for things 0:10:21.559 --> 0:10:26.920 even when it's unexplained. And because there's this whole unexplained thing, Chuck, 0:10:27.080 --> 0:10:30.360 there's like a lot of suggestions as to you know, 0:10:30.400 --> 0:10:33.120 what's at play. Yeah, but you're but you're right. It 0:10:33.200 --> 0:10:38.120 is kind of like, uh, man, woman, get together, have child, 0:10:38.400 --> 0:10:42.000 have another child, maybe a third, and like it's no problem, 0:10:42.600 --> 0:10:44.880 like you said in the movies. Well, and especially when 0:10:44.920 --> 0:10:47.000 age comes and you know people are getting married later. 0:10:47.840 --> 0:10:50.760 Uh you see, you know, sixteen year will have a 0:10:50.760 --> 0:10:54.040 baby without any problem. It's sort of weird that we've 0:10:55.720 --> 0:11:00.760 we haven't. Things haven't changed reproductively speaking, Like people are 0:11:00.760 --> 0:11:03.200 getting married in their mid thirties, but you can still 0:11:03.200 --> 0:11:08.000 get pregnant when you're thirteen, And it's like has shifted. 0:11:08.000 --> 0:11:11.079 It's not going to shift within cultural attitudes. No, no, 0:11:11.280 --> 0:11:15.600 which is why we're like, okay, well we need technology then, right, right, 0:11:15.720 --> 0:11:18.640 But like I said, um, about half the assisted reproductive 0:11:18.640 --> 0:11:22.920 technology methods are low tech. Um. Klomad is a big 0:11:23.720 --> 0:11:26.800 probably the most popular fertility drug treatment. They've been using 0:11:26.800 --> 0:11:29.240 that since like the fifties, right, I don't know, they 0:11:29.320 --> 0:11:32.720 say fifties, either fifty years or since the fifties. Okay, 0:11:32.880 --> 0:11:35.280 Well it's um. It's an oral medication and it is 0:11:35.520 --> 0:11:39.640 used to induce ovulation. And actually now men have seen 0:11:39.720 --> 0:11:44.360 have used it to increase testosterone. Um. Because an NFL player, 0:11:44.960 --> 0:11:52.560 UH just got banned for using chlomad for fertility because 0:11:52.600 --> 0:11:55.120 they said it increases testosterone. So it was a performance 0:11:55.200 --> 0:11:58.360 enhancing drug, but he was using it to try to 0:11:58.400 --> 0:12:01.840 get pregnant. That's what he said. Oh that's not fair. Um. Yeah, 0:12:02.000 --> 0:12:05.040 Robert mathis of the cult, so he was suspended. Um. 0:12:05.080 --> 0:12:08.240 But clomad, with clumbad alone, you have a chance of 0:12:08.280 --> 0:12:12.360 ovulation success and about a forty three percent chance of 0:12:12.440 --> 0:12:17.000 pregnancy success over three cycles. And after three cycles that 0:12:17.120 --> 0:12:20.880 number goes way down. UM. So really like it becomes 0:12:20.960 --> 0:12:25.160 less and less probable that you'll conceive after three cycles. Yeah, 0:12:25.160 --> 0:12:27.160 it's the same through three and then and that's just 0:12:27.200 --> 0:12:30.920 with clomad and then after that, like what people generally 0:12:31.000 --> 0:12:33.000 do is try a few different methods before moving on 0:12:33.040 --> 0:12:37.880 to IVF, like just the hormones UM or what we'll 0:12:37.920 --> 0:12:41.800 talk about now, which is uh artificial insemination, right, and 0:12:41.840 --> 0:12:46.720 that that like um assisted reproductive technology with an umbrella term. 0:12:46.800 --> 0:12:50.520 Artificial insemination is an umbrella term underneath the a R 0:12:50.600 --> 0:12:54.439 t umbrella. Yeah, and it's basically any time you UM 0:12:54.440 --> 0:12:56.800 try to give the sperm a leg up and its 0:12:56.920 --> 0:13:01.760 race toward the egg. Yeah, it's it's inseminated artificially. In 0:13:01.800 --> 0:13:05.040 other words, it doesn't come directly from the penis into 0:13:05.040 --> 0:13:08.160 the vagina. Right. Why does that make you laugh? Still? 0:13:08.360 --> 0:13:11.200 I just felt like I was in the kindergarten class 0:13:11.240 --> 0:13:14.960 cop class. Uh. Yeah, it's when the sperm is harvested 0:13:15.080 --> 0:13:19.440 in UM for for AI for artificial insemination, it's either 0:13:19.520 --> 0:13:23.320 implanted intravaginal or interest cervical, so in the vagina, in 0:13:23.320 --> 0:13:25.559 the cervics. But if you're going to put it directly 0:13:25.600 --> 0:13:30.839 into this service or the uterus, you have to wash them. Yes, 0:13:32.160 --> 0:13:37.360 you can't put untreated sperm into directly into the uterus 0:13:37.400 --> 0:13:42.920 because you will have what's called uteral contraction, which apparently 0:13:42.960 --> 0:13:48.440 is extraordinarily unpleasant. The sperm have some sort of um 0:13:49.040 --> 0:13:52.960 it's called proto glandings. I think, yeah, that you have 0:13:53.080 --> 0:13:55.600 to wash off the sperm. If you don't, protoglandings will 0:13:55.600 --> 0:13:58.880 set off these contractions in the uterus exactly. So they 0:13:59.080 --> 0:14:01.280 and I said, you or I think of at uterine 0:14:01.360 --> 0:14:04.880 contractions they're pretty violent. Uh so yeah, you wash the 0:14:04.920 --> 0:14:08.360 sperm and um. Not only does it remove those protoglass stuns, 0:14:08.520 --> 0:14:11.839 it's um. It eliminates any substance it will get in 0:14:11.880 --> 0:14:16.000 the way and make the sperm motile. And motile means 0:14:16.040 --> 0:14:20.120 they're good swimmers. Right. That's another another advantage of using 0:14:20.200 --> 0:14:24.480 artificial inscimination, as you can say, uh, you're cut, you're cut. 0:14:24.920 --> 0:14:27.640 You made the team, you're cut, and then you put 0:14:27.680 --> 0:14:30.800 together this dream team of the best firm and you say, 0:14:31.120 --> 0:14:34.600 go get them. That's right. Right, So, if you're using 0:14:34.640 --> 0:14:37.560 the wash sperm and directly onto the uterus, that's called 0:14:37.600 --> 0:14:41.320 I ui intra uterine instimonation. Uh. And that's just kind 0:14:41.320 --> 0:14:44.680 of one step further than Hey, I like artificial instimination. 0:14:44.720 --> 0:14:46.760 You can do the turkey based method at home, sure 0:14:46.880 --> 0:14:50.320 if you want. So that's a thing. Yeah, like they 0:14:50.360 --> 0:14:53.360 have kids. That's a form of artificial insemination. That is 0:14:53.440 --> 0:14:58.720 artificial instamonation. Yeah, but I mean it's an umbrella term. 0:14:58.760 --> 0:15:00.920 Well yeah, if you're using the key based her at home, 0:15:01.000 --> 0:15:04.760 you're you're artificially inseminating but you're probably inserting it directly 0:15:04.800 --> 0:15:08.480 into the vagina. Maybe the cervix. You're not doing intra 0:15:08.600 --> 0:15:13.000 uterine you can't do unless you have a sperm washer, right, 0:15:14.520 --> 0:15:16.720 which you can afford one of those these days, you know, 0:15:16.920 --> 0:15:20.000 that's right. So if those fail, then your next step 0:15:20.080 --> 0:15:22.640 is is probably gonna be IBF. But like I said, 0:15:22.680 --> 0:15:25.760 depending on your age and what's going on, you can 0:15:26.000 --> 0:15:28.560 skip straight to ib F if your doctor says that's okay, 0:15:28.720 --> 0:15:31.640 well we'll skip straight to IVF after a message break. 0:15:31.640 --> 0:15:44.640 How about that? All right, So let's talk about the 0:15:44.640 --> 0:15:50.200 IVF process. Huh yeah, again, pretty low tech, high tech stuff. 0:15:50.240 --> 0:15:53.080 It's neat. Yeah, it will cost you about twelve grand 0:15:53.560 --> 0:15:57.120 I saw. Yeah. I mean that's a I hate the 0:15:57.200 --> 0:16:01.480 ranges for these procedures because it really it depends on 0:16:01.520 --> 0:16:03.600 where you are and if you have insurance. I think 0:16:03.640 --> 0:16:07.320 fifteen states require insurance to cover it. Um. You know. 0:16:07.880 --> 0:16:12.600 Let me interject here. There's an argument that the lack 0:16:12.760 --> 0:16:18.800 of standards in pricing for medical procedures is the single 0:16:19.600 --> 0:16:23.280 problem for why the health care system in the US 0:16:23.400 --> 0:16:27.120 is broken. Yeah, that it's not necessarily insurance, that it's 0:16:27.120 --> 0:16:31.120 not necessarily chronic disease that it is. If you came 0:16:31.200 --> 0:16:34.760 up with standard pricing, yeah, you could solve quite a 0:16:34.760 --> 0:16:37.920 bit of the car mechanics. Yeah, that's supposed to be 0:16:38.000 --> 0:16:40.480 a standard. Yes, I always I never knew that with 0:16:40.520 --> 0:16:43.760 car mechanics. If you um, when they say how much 0:16:43.800 --> 0:16:46.200 time it takes, it's really not how they don't time 0:16:46.280 --> 0:16:49.120 how long it takes. There's a manual that says, you know, 0:16:49.680 --> 0:16:52.520 changing a carburetor is one point five hours. I didn't 0:16:52.520 --> 0:16:55.800 know that. Yeah, I just know that Mr Goodbrand's posts 0:16:55.920 --> 0:17:01.800 is on the board him like McDonald's what like oh 0:17:01.840 --> 0:17:05.879 a menu. Yeah. Anyway, I agree with you about the 0:17:06.160 --> 0:17:08.160 medical standards, and it makes a lot of sense. I mean, 0:17:09.119 --> 0:17:12.479 chronic disease is a huge problem, especially preventable chronic disease. 0:17:12.920 --> 0:17:16.160 But that's not the only issue here. It's the fact 0:17:16.200 --> 0:17:19.159 that you can be charged almost literally in arm and 0:17:19.200 --> 0:17:23.760 a leg depending on where you go. That's rights. It 0:17:23.760 --> 0:17:25.320 will cost you some money, but if you have good 0:17:25.359 --> 0:17:28.160 insurance then that will help out. Uh. So here are 0:17:28.160 --> 0:17:33.000 there are basically five steps. The first is ovarian stimulation. Um, 0:17:33.000 --> 0:17:36.199 this is when you're gonna be taking fertility drugs. Uh. 0:17:36.280 --> 0:17:38.960 It's could be a couple of weeks of that um. 0:17:39.040 --> 0:17:41.600 Some are oral. Sometimes you're gonna be given shots to 0:17:41.640 --> 0:17:43.680 your wife, or if the ladies on our own should 0:17:43.680 --> 0:17:46.840 be given shots to herself. Because the good thing about 0:17:46.840 --> 0:17:50.960 ib F is you don't need a live man necessarily. No, 0:17:51.119 --> 0:17:53.280 you just need the sperma. So a lot of the 0:17:53.520 --> 0:17:57.280 could come from anywhere. Yeah, single ladies are all the 0:17:57.320 --> 0:18:04.840 single ladies or ladies in the l g BT community. 0:18:04.880 --> 0:18:08.440 I always want to mix up those letters. Oh yeah, 0:18:08.640 --> 0:18:10.840 like they doesn't need to be a man involved. No, 0:18:11.520 --> 0:18:14.000 I mean at some point, I guess if you could 0:18:14.000 --> 0:18:18.520 grow sperm in a lab from stem cells. Not directly 0:18:19.400 --> 0:18:21.159 technically you could do that, but no, it doesn't have 0:18:21.200 --> 0:18:23.440 to be involved in harvest sperm from a sperm bank, 0:18:24.240 --> 0:18:29.560 anonymous donor friend of a friend, transient who's just passing 0:18:29.560 --> 0:18:34.080 through town, whatever your standards are. You could conceivably get 0:18:34.119 --> 0:18:37.120 your hands on some sperm and then bam, you don't 0:18:37.119 --> 0:18:39.760 need a man. I was it from the besket I 0:18:39.760 --> 0:18:42.600 could get you some sperm by three pm. That is 0:18:42.640 --> 0:18:44.720 a great movie. Man. I saw that again for the 0:18:44.760 --> 0:18:47.360 first time in a while recently. Oh man, I think 0:18:47.359 --> 0:18:49.080 he's talking about a big toe. I can get you 0:18:49.080 --> 0:18:52.560 a big toe by three pm. Um. But yes, you 0:18:52.600 --> 0:18:54.960 will need sperm if you're the husband and it's uh, 0:18:55.200 --> 0:18:57.639 just your regular old husband and wife trying to conceive, 0:18:57.800 --> 0:19:00.119 or just a man and woman. Then the hus and 0:19:00.200 --> 0:19:05.080 will deposit that sperm and a little room designed to 0:19:05.920 --> 0:19:09.919 make that happen, and then they will take the sperm 0:19:09.920 --> 0:19:12.000 and wash it and hold it. Uh, and it's all 0:19:12.040 --> 0:19:15.280 timed out, you know appropriately. Of course they can't hold 0:19:15.320 --> 0:19:18.480 them to it forever. And so that's the ovarian stimulation. 0:19:18.520 --> 0:19:20.440 Like you're trying to get the eggs to come along, 0:19:20.520 --> 0:19:22.880 and not only are you trying to get that an 0:19:22.920 --> 0:19:24.639 egg to come along, you're trying to get several to 0:19:24.680 --> 0:19:26.280 come along. Yeah, that's the whole point is you want 0:19:26.359 --> 0:19:28.760 multiple eggs, right. So you know, a woman is born 0:19:28.840 --> 0:19:31.800 with all of the approximately four hundred thousand eggs she'll 0:19:31.800 --> 0:19:37.680 ever produce in her life. Um down right, during her 0:19:38.480 --> 0:19:42.720 menstrual cycle, one of those eggs enters a fallopian tube 0:19:42.760 --> 0:19:47.360 and um it becomes mature. Right. So what these hormones 0:19:47.400 --> 0:19:49.720 do is get a bunch of those eggs into their 0:19:49.720 --> 0:19:53.159 fallopian rappers and get them to mature over time. And 0:19:53.200 --> 0:19:57.280 the doctor um, I guess pays attention to how they're maturing, 0:19:57.640 --> 0:19:59.960 and when he decides these eggs are ready to get 0:20:00.480 --> 0:20:02.320 that's when you hit step two, which is the egg 0:20:02.359 --> 0:20:07.960 retrieval step. That's right, and that is not super complicated either. 0:20:08.520 --> 0:20:13.960 It's called the name sounds complicated, transvaginal ultrasound aspiration, but 0:20:14.040 --> 0:20:17.520 what it really is is a mild sedative and a 0:20:17.640 --> 0:20:23.520 suction device that sucks out the eggs and that's really 0:20:23.520 --> 0:20:26.200 all there is. Do it. It's pretty amazing. Um. If 0:20:26.280 --> 0:20:30.520 you cannot use the um TU a method, you will 0:20:30.840 --> 0:20:34.640 have to undergo a more involved procedure called laparoscopic surgery, 0:20:34.680 --> 0:20:39.640 which isn't super involved either. It is also a short process, 0:20:39.680 --> 0:20:42.879 but there's a small incision in the abdomen to locate 0:20:42.920 --> 0:20:45.680 your ovaries. Yeah, they put a little video camera in there. 0:20:46.640 --> 0:20:50.400 So um more involved obviously because it is a surgical procedure, 0:20:50.440 --> 0:20:52.520 but it's not like you're staying in the hospital for 0:20:52.520 --> 0:20:55.040 a week or even right. Yeah, it's just more involved 0:20:55.040 --> 0:20:58.480 because you have to use more anesthesia to which automatically 0:20:58.480 --> 0:21:03.360 increases risks exactly with the other one aspiration. Yeah, uh 0:21:03.440 --> 0:21:06.200 the uh, I guess you just need a mild seditive. 0:21:06.240 --> 0:21:10.840 It sets here. Yeah, it's like like twilight sleep alright. 0:21:10.880 --> 0:21:12.720 So step three, you've got your eggs. You've got your 0:21:12.800 --> 0:21:15.720 multiple eggs. They're all looking good. Then you yeah, because 0:21:15.760 --> 0:21:17.399 they go through and they look at them and ye 0:21:17.600 --> 0:21:20.280 and say this one looks good. This one looks good, man, 0:21:20.359 --> 0:21:23.040 not this one. Yeah, And I'm not sure when pg 0:21:23.200 --> 0:21:29.160 D can take place. I think after would think yeah, yeah, 0:21:29.200 --> 0:21:30.879 I guess it would have to be yeah, okay, that 0:21:30.920 --> 0:21:34.280 makes sense. Um. So then you've got your insemination. And 0:21:34.400 --> 0:21:37.520 like I said, you're you've got your sperm. However you 0:21:37.600 --> 0:21:42.200 got it. We ain't asking whatever it was a transient 0:21:42.240 --> 0:21:45.480 on the street, More power to you. Um. They examine 0:21:45.480 --> 0:21:49.760 the eggs and say these look robust and juicy and full, 0:21:49.800 --> 0:21:52.159 and these are the best ones. So we're going to 0:21:52.320 --> 0:21:54.639 use these. And that's when the sperm is at it 0:21:54.640 --> 0:21:57.840 and the best sperm um is picked and then it's 0:21:58.040 --> 0:22:00.280 in a culture and it's doing its thing right. And 0:22:00.280 --> 0:22:04.800 depending on the sperm um, they might injected directly into 0:22:04.880 --> 0:22:11.400 the egg, which is called um oh intra citoplasmic sperm injection. 0:22:12.800 --> 0:22:17.080 They could also just right, that's like the sperm doesn't 0:22:17.119 --> 0:22:19.119 have to go into the egg, it gets put into 0:22:19.160 --> 0:22:23.440 the egg um. But more traditional methods are just inserting 0:22:23.480 --> 0:22:26.760 it into the near the egg in the culture, right, 0:22:27.359 --> 0:22:30.520 and the culture can be artificial, but um it's also 0:22:30.600 --> 0:22:34.440 often made of the endometrium from the woman or um 0:22:34.520 --> 0:22:39.440 some in addition to possibly like her um uh cervical fluids. 0:22:40.000 --> 0:22:44.120 So like it's it's basically mimicking what will what would 0:22:44.160 --> 0:22:46.320 be going on in like the fallopian tube or something. 0:22:46.359 --> 0:22:48.720 That's all they're doing is taking the process that normally 0:22:48.760 --> 0:22:52.160 happens inside the woman's body and outside for a little while. 0:22:52.359 --> 0:22:54.280 And so you've got the egg and the sperm in 0:22:54.320 --> 0:22:59.080 the same culture and it's within possibly an hour, fertilization 0:22:59.119 --> 0:23:01.840 might have taken place. There's an open bar, everyone's getting 0:23:01.840 --> 0:23:05.880 to know each other, everyone's getting friendly. Little icebreaker happens, 0:23:06.680 --> 0:23:09.080 and like you said, it can be hours when they 0:23:09.119 --> 0:23:13.919 are doing the fertilization dance. And the next day your 0:23:13.960 --> 0:23:17.440 doctor is gonna confirm visually that there are two pro 0:23:17.560 --> 0:23:22.360 nuclei and that is the basis of your embryo right there. 0:23:23.080 --> 0:23:24.760 You see that, then that means things are ahead in 0:23:24.800 --> 0:23:27.240 the right direction because the pro nuclei from the sperm 0:23:27.280 --> 0:23:29.359 and the pro nuclei from the egg you're gonna fuse 0:23:29.440 --> 0:23:35.200 to make a single nuclei and that becomes the embryo, 0:23:35.840 --> 0:23:39.880 which divides into well, that becomes the zygote I'm sorry, 0:23:40.240 --> 0:23:43.119 which divides into two cells, and then I think by 0:23:43.160 --> 0:23:45.040 the time it's either two or four cells, it becomes 0:23:45.040 --> 0:23:48.960 an embryo, right, yeah, and then that's a couple of 0:23:49.040 --> 0:23:52.640 days after fertilization. Is when you get to that stage. Yeah. Yeah, 0:23:52.640 --> 0:23:55.080 the cell division is very slow at first, but then 0:23:55.119 --> 0:23:57.000 it starts to pick up time. By the time you 0:23:57.119 --> 0:23:59.800 reach day five or six, you've got what's called the 0:24:00.040 --> 0:24:03.960 asked the system. By this time, there's um fetal tissues 0:24:04.000 --> 0:24:08.960 growing in like uh, embryonic fluid cavity, and this thing 0:24:09.080 --> 0:24:14.520 is yeah pretty much. Um this the doctor is not 0:24:14.600 --> 0:24:17.879 normally gonna see this. They're gonna observe the egg, the 0:24:17.920 --> 0:24:21.160 fertilized egg or embryo for maybe a couple of days 0:24:21.200 --> 0:24:23.800 to make sure everything is progressing normally, and then they'll 0:24:23.800 --> 0:24:26.399 put it back into the mom. Yeah. I mean that 0:24:26.480 --> 0:24:30.480 can be done after one day, but um, your your 0:24:30.560 --> 0:24:32.680 doctor that they'll have a plan of when they think 0:24:32.720 --> 0:24:35.960 the best time is. And you're being monitored and all that. 0:24:36.080 --> 0:24:38.160 Not you with the man, but the woman is being 0:24:38.160 --> 0:24:41.400 monitored they don't care about the man. And then depending 0:24:41.840 --> 0:24:46.119 depending on where they put it, that that's the type 0:24:46.200 --> 0:24:51.639 of UM assisted reproductive technology that's being used. Right, So, 0:24:51.680 --> 0:24:55.040