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How In Vitro Fertlization Works · Stuff You Should Know

0:00
Speaker 1: Welcome to Stuff You Should Know Fromhouse Stuff Works dot com. Hey,
0:10
Speaker 1: and welcome to the podcast. I'm Josh Clark with Charles W.
0:13
Speaker 1: Chuck Bryant y. Yeah, and this is Stuff you should Know.
0:19
Speaker 1: It sounded uh sardonic, yery yi j a silent yawking, yawking.
0:27
Speaker 1: I'd never get sick of that movie. No, it's a
0:30
Speaker 1: good one. I haven't seen the second one. Don't really
0:32
Speaker 1: intend to, but I'm afraid too, Yeah, because it might
0:35
Speaker 1: tarnish my love of that character, because I've heard it's
0:39
Speaker 1: not very funny to just keep it keep it with
0:40
Speaker 1: the first one. I'm totally gonna watch him just waiting
0:43
Speaker 1: for cable. Oh yeah, yeah, Yeah, TBS knows what they're
0:47
Speaker 1: doing with movies that were for the big screen. Yeah,
0:51
Speaker 1: size them down, best start ever. Uh. So you're doing good.
0:58
Speaker 1: I'm great, Okay, good. Um. So we're talking today about
1:03
Speaker 1: IVF in vitro fertilization. Um. And I have to say, Chuckers,
1:12
Speaker 1: I don't really have by the way, I don't have
1:13
Speaker 1: an intro for this one to um, although I do
1:18
Speaker 1: have a bit of one. All right, let's see uh
1:20
Speaker 1: in nineteen In two thousand thirteen, a lady named Louise
1:26
Speaker 1: Brown celebrated her thirty fifth birthday, and with her birthday
1:33
Speaker 1: coming and going, she announced that she was pregnant with
1:36
Speaker 1: her second child. This is like mind blowing crazy stuff
1:40
Speaker 1: all over the place, because Louise Brown was the first
1:44
Speaker 1: human being ever conceived using in vitro fertilization. Yes, they
1:50
Speaker 1: called them test two babies back then. Remember that. Yeah,
1:52
Speaker 1: totally test two babies. You don't call it that anymore. No,
1:55
Speaker 1: we've gotten a little more scientific as a society since
1:58
Speaker 1: the seventies. Plus. I don't think they use test tubes. Yeah,
2:02
Speaker 1: if they ever did, I think maybe petri dishes, culture dishes,
2:07
Speaker 1: not test twos, but you know culture dish baby. It's right,
2:10
Speaker 1: that's weird. Test tube baby. It kind of rolls off
2:12
Speaker 1: the tongue. It's got the two T sounds, which makes
2:14
Speaker 1: it a little funny ish and um intriguing. But that's
2:19
Speaker 1: what she was. She was the first test two baby.
2:21
Speaker 1: It was eight in England, um, and she was born July.
2:26
Speaker 1: I think, um, like just a few days later. I
2:30
Speaker 1: think the second IVF baby was born in India very
2:35
Speaker 1: in very short order. For two. I'm sure that their
2:38
Speaker 1: doctors were like come on, will you give birth already?
2:41
Speaker 1: I want to be the first. Nobody remembers number two.
2:43
Speaker 1: And then the following year, in nineteen seventy nine, the
2:46
Speaker 1: first American IVF baby was born. And that's the history
2:51
Speaker 1: of IVF, like it just goes back that far. Since then,
2:56
Speaker 1: I think thirty five more than thirty five million uh
3:00
Speaker 1: IVF babies have been born a couple of hundred thousand
3:03
Speaker 1: each year in the US alone. Now, yeah, it was
3:07
Speaker 1: like in the sixties eighties. Now it's up to like
3:09
Speaker 1: a hundred and something a hundred and change. I think
3:13
Speaker 1: I got over two thousands. Do you really really? I
3:17
Speaker 1: saw two thousand twelve or maybe maybe two d thousand worldwide.
3:24
Speaker 1: All right, let's just settle on that. I'll bite on
3:27
Speaker 1: that one. Um. But yeah, that's a lot of babies
3:30
Speaker 1: that are born through IVF, and it's a it's crazy
3:34
Speaker 1: how the thing that struck me and finally we're getting
3:39
Speaker 1: to the end of the intro um is that what
3:43
Speaker 1: I v F is? It seems so like whiz bang
3:46
Speaker 1: crazy futuristic. No, it's it's figuring out. We figured out
3:52
Speaker 1: how a woman becomes pregnant and figured out the ways
3:58
Speaker 1: that we could possibly best help that process along, and
4:02
Speaker 1: that's what it is. Yeah, it's really there's no like
4:05
Speaker 1: crazy new technology. They don't like like buzz her with
4:09
Speaker 1: like a prey goo laser, nothing like that. It's strictly
4:14
Speaker 1: like catheters and timing and you know, hormones. It's crazy
4:20
Speaker 1: how simple it is. But it's also equally crazy that
4:23
Speaker 1: you know, it's as successful as it is considering what
4:26
Speaker 1: it What in vitro fertilization consists of. Yes, I guess
4:32
Speaker 1: we can go ahead and talk about success rates. Um.
4:34
Speaker 1: In the US, women under the age of thirty five
4:38
Speaker 1: have a thirty to thirty five chance of conceiving with
4:40
Speaker 1: ibf uh. It drops between thirty five and forty six
4:47
Speaker 1: over forty uh. And that is percentages of live birth cycle,
4:53
Speaker 1: which is yeah, per cycle. So like, if you go
4:57
Speaker 1: through a cycle of in vitro fertilization, do you have
5:00
Speaker 1: the percentage chance typically which is pretty much in lock
5:04
Speaker 1: step with natural birth rates according to age it Yeah, well,
5:09
Speaker 1: I mean it definitely decreases with age, but I'm not
5:12
Speaker 1: saying it's like one for one. Sure, yeah, yeah, it's totally,
5:14
Speaker 1: But I'm saying that I think the depreciation of possibility.
5:21
Speaker 1: It goes down with age naturally as well with IVF two. Yeah,
5:25
Speaker 1: and live birth is the key here because many times, uh,
5:29
Speaker 1: there will be conception and there will be a pregnancy,
5:32
Speaker 1: but any number of things can go wrong from there.
5:34
Speaker 1: Oh yeah sure. Chemical pregnancies UM topic pregnant topic pregnancies. Apparently,
5:40
Speaker 1: some Chinese researcher did a survey of a hundred thousand
5:43
Speaker 1: plus live IVF births UM and found that there's a correlation.
5:50
Speaker 1: You were three times likelier to have a major birth
5:52
Speaker 1: effect if you were born via in vitro fertilization than natural.
5:57
Speaker 1: And he just found a correlation. Um, not a cause,
6:01
Speaker 1: but just the numbers. For some reason spit that out. Yeah. Well, now,
6:07
Speaker 1: one of the new things you can do is up
6:08
Speaker 1: for at a certain point in the process pg D,
6:11
Speaker 1: which is preimplantation genetic diagnosis. And this is a test
6:15
Speaker 1: that will cost you several thousand dollars and it basically UM.
6:20
Speaker 1: It allows you to root out certain mono genetic disorders,
6:23
Speaker 1: like you can get PGD testing and find out if
6:27
Speaker 1: the baby might have like sickle cell or Huntington's disease
6:29
Speaker 1: or cystic like process or downs and then UM you
6:33
Speaker 1: can make a decision at that point whether or not
6:35
Speaker 1: you want to continue with the process. Yeah. You know,
6:37
Speaker 1: there's a real um concern that there won't be like
6:42
Speaker 1: that down syndrome, people will be extinct eventually because the
6:47
Speaker 1: should have gotten so accurate. Yeah, yeah, I don't think
6:51
Speaker 1: that will happen. Well. And there's also ethical concerns with
6:54
Speaker 1: pg D about you know, do you do selective termination
6:57
Speaker 1: if you can find out it's a boy and you
6:59
Speaker 1: wanted a girl, right or um, oh I didn't want
7:01
Speaker 1: to give brown eyes? Yeah, and I know there's a
7:04
Speaker 1: lot of ethical yeah, associated with it, and um, it's
7:11
Speaker 1: even more basic than that for a lot of people
7:14
Speaker 1: to like, if you have a fertilized egg, um, or
7:19
Speaker 1: even just an egg with the potential human life. To
7:22
Speaker 1: some people, that destroying just the egg that that was
7:26
Speaker 1: never fertilized is like a moral problem. Yeah. Or let's
7:30
Speaker 1: say you, um, you have a chance of multiples, um
7:35
Speaker 1: twins or triplets or quads or more. If you're a
7:39
Speaker 1: certain age, that is not good and can be dangerous
7:42
Speaker 1: for you as the mother and for the kids too. Yeah.
7:46
Speaker 1: So at that point, um, you might have to go
7:48
Speaker 1: through what they call selective reduction, which is choosing which
7:53
Speaker 1: ones to go with. Well, there's a lot of pitfalls
7:55
Speaker 1: this UM, but there's a lot of people who are
7:58
Speaker 1: helped by it as well, and at the very least
8:00
Speaker 1: there's a lot of people who seek the help from it.
8:03
Speaker 1: I saw something like in this article, which I think
8:06
Speaker 1: was written in two thousands, six or seven. Yeah, it's
8:08
Speaker 1: a little dated. A head they said six point one
8:12
Speaker 1: million Americans are faced with infertility, which UM, infertility is
8:17
Speaker 1: not like Bam, you're infertile. UM, here's what's wrong with you?
8:24
Speaker 1: Infertility be right, but it isn't always technically infertility. The
8:29
Speaker 1: definition of infertility is that you have um gotten it
8:33
Speaker 1: on for a year unprotected and no baby has been
8:39
Speaker 1: produced for six months. If you're overt okay, But it
8:43
Speaker 1: depends on the doctor. Like this article talked a lot
8:46
Speaker 1: about well, if you've gone this far and you've done
8:48
Speaker 1: these procedures, then they'll move you to this. A lot
8:51
Speaker 1: of the places are fertility clinics or baby factories and
8:54
Speaker 1: they'll you can go right to I D F if
8:57
Speaker 1: you want to. And if they say that they believe
8:59
Speaker 1: in so's. There's not like any hard and fast law,
9:03
Speaker 1: you know, that's the impression. After doing this for how
9:06
Speaker 1: many years have we been doing this? Now, after eighty
9:09
Speaker 1: years of doing this, um, I've learned that how stuff
9:12
Speaker 1: works article is like it deals in ideals. It's not
9:17
Speaker 1: necessarily like this is how it works in the real world.
9:19
Speaker 1: It's like, this is how it works according to the law.
9:22
Speaker 1: That's true. We do our best. Yeah. Um. So, apparently
9:25
Speaker 1: about seven point three million people UM are faced with
9:28
Speaker 1: infertility and they turned to IVF, and IVF is far
9:31
Speaker 1: and away the most popular form of what's called UH
9:36
Speaker 1: assisted reproductive technology, which, as we said, sounds whiz bang
9:41
Speaker 1: and futuristic but not necessarily Yeah, about fifty of a
9:46
Speaker 1: r t UM methods are what they call low tech,
9:49
Speaker 1: which is maybe we'll put you on some hormones. UM
9:53
Speaker 1: Antibiotics apparently are a huge one, a huge stream of
9:57
Speaker 1: for infertility. Yeah. They supposedly especial the unexplained infertility, which
10:02
Speaker 1: affects something between ten to thirty percent of infertility cases
10:05
Speaker 1: are just unexplained. Yeah, they're like, we there's nothing structurally
10:09
Speaker 1: wrong with you. Your husband's sperm is fine, Like there's
10:13
Speaker 1: we can't figure it out. Well, it made getting pregnant
10:16
Speaker 1: isn't the easiest thing in the world. It seems that
10:18
Speaker 1: way in the movies, but there's an explanation for things
10:21
Speaker 1: even when it's unexplained. And because there's this whole unexplained thing, Chuck,
10:27
Speaker 1: there's like a lot of suggestions as to you know,
10:30
Speaker 1: what's at play. Yeah, but you're but you're right. It
10:33
Speaker 1: is kind of like, uh, man, woman, get together, have child,
10:38
Speaker 1: have another child, maybe a third, and like it's no problem,
10:42
Speaker 1: like you said in the movies. Well, and especially when
10:44
Speaker 1: age comes and you know people are getting married later.
10:47
Speaker 1: Uh you see, you know, sixteen year will have a
10:50
Speaker 1: baby without any problem. It's sort of weird that we've
10:55
Speaker 1: we haven't. Things haven't changed reproductively speaking, Like people are
11:00
Speaker 1: getting married in their mid thirties, but you can still
11:03
Speaker 1: get pregnant when you're thirteen, And it's like has shifted.
11:08
Speaker 1: It's not going to shift within cultural attitudes. No, no,
11:11
Speaker 1: which is why we're like, okay, well we need technology then, right, right,
11:15
Speaker 1: But like I said, um, about half the assisted reproductive
11:18
Speaker 1: technology methods are low tech. Um. Klomad is a big
11:23
Speaker 1: probably the most popular fertility drug treatment. They've been using
11:26
Speaker 1: that since like the fifties, right, I don't know, they
11:29
Speaker 1: say fifties, either fifty years or since the fifties. Okay,
11:32
Speaker 1: Well it's um. It's an oral medication and it is
11:35
Speaker 1: used to induce ovulation. And actually now men have seen
11:39
Speaker 1: have used it to increase testosterone. Um. Because an NFL player,
11:44
Speaker 1: UH just got banned for using chlomad for fertility because
11:52
Speaker 1: they said it increases testosterone. So it was a performance
11:55
Speaker 1: enhancing drug, but he was using it to try to
11:58
Speaker 1: get pregnant. That's what he said. Oh that's not fair. Um. Yeah,
12:02
Speaker 1: Robert mathis of the cult, so he was suspended. Um.
12:05
Speaker 1: But clomad, with clumbad alone, you have a chance of
12:08
Speaker 1: ovulation success and about a forty three percent chance of
12:12
Speaker 1: pregnancy success over three cycles. And after three cycles that
12:17
Speaker 1: number goes way down. UM. So really like it becomes
12:20
Speaker 1: less and less probable that you'll conceive after three cycles. Yeah,
12:25
Speaker 1: it's the same through three and then and that's just
12:27
Speaker 1: with clomad and then after that, like what people generally
12:31
Speaker 1: do is try a few different methods before moving on
12:33
Speaker 1: to IVF, like just the hormones UM or what we'll
12:37
Speaker 1: talk about now, which is uh artificial insemination, right, and
12:41
Speaker 1: that that like um assisted reproductive technology with an umbrella term.
12:46
Speaker 1: Artificial insemination is an umbrella term underneath the a R
12:50
Speaker 1: t umbrella. Yeah, and it's basically any time you UM
12:54
Speaker 1: try to give the sperm a leg up and its
12:56
Speaker 1: race toward the egg. Yeah, it's it's inseminated artificially. In
13:01
Speaker 1: other words, it doesn't come directly from the penis into
13:05
Speaker 1: the vagina. Right. Why does that make you laugh? Still?
13:08
Speaker 1: I just felt like I was in the kindergarten class
13:11
Speaker 1: cop class. Uh. Yeah, it's when the sperm is harvested
13:15
Speaker 1: in UM for for AI for artificial insemination, it's either
13:19
Speaker 1: implanted intravaginal or interest cervical, so in the vagina, in
13:23
Speaker 1: the cervics. But if you're going to put it directly
13:25
Speaker 1: into this service or the uterus, you have to wash them. Yes,
13:32
Speaker 1: you can't put untreated sperm into directly into the uterus
13:37
Speaker 1: because you will have what's called uteral contraction, which apparently
13:42
Speaker 1: is extraordinarily unpleasant. The sperm have some sort of um
13:49
Speaker 1: it's called proto glandings. I think, yeah, that you have
13:53
Speaker 1: to wash off the sperm. If you don't, protoglandings will
13:55
Speaker 1: set off these contractions in the uterus exactly. So they
13:59
Speaker 1: and I said, you or I think of at uterine
14:01
Speaker 1: contractions they're pretty violent. Uh so yeah, you wash the
14:04
Speaker 1: sperm and um. Not only does it remove those protoglass stuns,
14:08
Speaker 1: it's um. It eliminates any substance it will get in
14:11
Speaker 1: the way and make the sperm motile. And motile means
14:16
Speaker 1: they're good swimmers. Right. That's another another advantage of using
14:20
Speaker 1: artificial inscimination, as you can say, uh, you're cut, you're cut.
14:24
Speaker 1: You made the team, you're cut, and then you put
14:27
Speaker 1: together this dream team of the best firm and you say,
14:31
Speaker 1: go get them. That's right. Right, So, if you're using
14:34
Speaker 1: the wash sperm and directly onto the uterus, that's called
14:37
Speaker 1: I ui intra uterine instimonation. Uh. And that's just kind
14:41
Speaker 1: of one step further than Hey, I like artificial instimination.
14:44
Speaker 1: You can do the turkey based method at home, sure
14:46
Speaker 1: if you want. So that's a thing. Yeah, like they
14:50
Speaker 1: have kids. That's a form of artificial insemination. That is
14:53
Speaker 1: artificial instamonation. Yeah, but I mean it's an umbrella term.
14:58
Speaker 1: Well yeah, if you're using the key based her at home,
15:01
Speaker 1: you're you're artificially inseminating but you're probably inserting it directly
15:04
Speaker 1: into the vagina. Maybe the cervix. You're not doing intra
15:08
Speaker 1: uterine you can't do unless you have a sperm washer, right,
15:14
Speaker 1: which you can afford one of those these days, you know,
15:16
Speaker 1: that's right. So if those fail, then your next step
15:20
Speaker 1: is is probably gonna be IBF. But like I said,
15:22
Speaker 1: depending on your age and what's going on, you can
15:26
Speaker 1: skip straight to ib F if your doctor says that's okay,
15:28
Speaker 1: well we'll skip straight to IVF after a message break.
15:31
Speaker 1: How about that? All right, So let's talk about the
15:44
Speaker 1: IVF process. Huh yeah, again, pretty low tech, high tech stuff.
15:50
Speaker 1: It's neat. Yeah, it will cost you about twelve grand
15:53
Speaker 1: I saw. Yeah. I mean that's a I hate the
15:57
Speaker 1: ranges for these procedures because it really it depends on
16:01
Speaker 1: where you are and if you have insurance. I think
16:03
Speaker 1: fifteen states require insurance to cover it. Um. You know.
16:07
Speaker 1: Let me interject here. There's an argument that the lack
16:12
Speaker 1: of standards in pricing for medical procedures is the single
16:19
Speaker 1: problem for why the health care system in the US
16:23
Speaker 1: is broken. Yeah, that it's not necessarily insurance, that it's
16:27
Speaker 1: not necessarily chronic disease that it is. If you came
16:31
Speaker 1: up with standard pricing, yeah, you could solve quite a
16:34
Speaker 1: bit of the car mechanics. Yeah, that's supposed to be
16:38
Speaker 1: a standard. Yes, I always I never knew that with
16:40
Speaker 1: car mechanics. If you um, when they say how much
16:43
Speaker 1: time it takes, it's really not how they don't time
16:46
Speaker 1: how long it takes. There's a manual that says, you know,
16:49
Speaker 1: changing a carburetor is one point five hours. I didn't
16:52
Speaker 1: know that. Yeah, I just know that Mr Goodbrand's posts
16:55
Speaker 1: is on the board him like McDonald's what like oh
17:01
Speaker 1: a menu. Yeah. Anyway, I agree with you about the
17:06
Speaker 1: medical standards, and it makes a lot of sense. I mean,
17:09
Speaker 1: chronic disease is a huge problem, especially preventable chronic disease.
17:12
Speaker 1: But that's not the only issue here. It's the fact
17:16
Speaker 1: that you can be charged almost literally in arm and
17:19
Speaker 1: a leg depending on where you go. That's rights. It
17:23
Speaker 1: will cost you some money, but if you have good
17:25
Speaker 1: insurance then that will help out. Uh. So here are
17:28
Speaker 1: there are basically five steps. The first is ovarian stimulation. Um,
17:33
Speaker 1: this is when you're gonna be taking fertility drugs. Uh.
17:36
Speaker 1: It's could be a couple of weeks of that um.
17:39
Speaker 1: Some are oral. Sometimes you're gonna be given shots to
17:41
Speaker 1: your wife, or if the ladies on our own should
17:43
Speaker 1: be given shots to herself. Because the good thing about
17:46
Speaker 1: ib F is you don't need a live man necessarily. No,
17:51
Speaker 1: you just need the sperma. So a lot of the
17:53
Speaker 1: could come from anywhere. Yeah, single ladies are all the
17:57
Speaker 1: single ladies or ladies in the l g BT community.
18:04
Speaker 1: I always want to mix up those letters. Oh yeah,
18:08
Speaker 1: like they doesn't need to be a man involved. No,
18:11
Speaker 1: I mean at some point, I guess if you could
18:14
Speaker 1: grow sperm in a lab from stem cells. Not directly
18:19
Speaker 1: technically you could do that, but no, it doesn't have
18:21
Speaker 1: to be involved in harvest sperm from a sperm bank,
18:24
Speaker 1: anonymous donor friend of a friend, transient who's just passing
18:29
Speaker 1: through town, whatever your standards are. You could conceivably get
18:34
Speaker 1: your hands on some sperm and then bam, you don't
18:37
Speaker 1: need a man. I was it from the besket I
18:39
Speaker 1: could get you some sperm by three pm. That is
18:42
Speaker 1: a great movie. Man. I saw that again for the
18:44
Speaker 1: first time in a while recently. Oh man, I think
18:47
Speaker 1: he's talking about a big toe. I can get you
18:49
Speaker 1: a big toe by three pm. Um. But yes, you
18:52
Speaker 1: will need sperm if you're the husband and it's uh,
18:55
Speaker 1: just your regular old husband and wife trying to conceive,
18:57
Speaker 1: or just a man and woman. Then the hus and
19:00
Speaker 1: will deposit that sperm and a little room designed to
19:05
Speaker 1: make that happen, and then they will take the sperm
19:09
Speaker 1: and wash it and hold it. Uh, and it's all
19:12
Speaker 1: timed out, you know appropriately. Of course they can't hold
19:15
Speaker 1: them to it forever. And so that's the ovarian stimulation.
19:18
Speaker 1: Like you're trying to get the eggs to come along,
19:20
Speaker 1: and not only are you trying to get that an
19:22
Speaker 1: egg to come along, you're trying to get several to
19:24
Speaker 1: come along. Yeah, that's the whole point is you want
19:26
Speaker 1: multiple eggs, right. So you know, a woman is born
19:28
Speaker 1: with all of the approximately four hundred thousand eggs she'll
19:31
Speaker 1: ever produce in her life. Um down right, during her
19:38
Speaker 1: menstrual cycle, one of those eggs enters a fallopian tube
19:42
Speaker 1: and um it becomes mature. Right. So what these hormones
19:47
Speaker 1: do is get a bunch of those eggs into their
19:49
Speaker 1: fallopian rappers and get them to mature over time. And
19:53
Speaker 1: the doctor um, I guess pays attention to how they're maturing,
19:57
Speaker 1: and when he decides these eggs are ready to get
20:00
Speaker 1: that's when you hit step two, which is the egg
20:02
Speaker 1: retrieval step. That's right, and that is not super complicated either.
20:08
Speaker 1: It's called the name sounds complicated, transvaginal ultrasound aspiration, but
20:14
Speaker 1: what it really is is a mild sedative and a
20:17
Speaker 1: suction device that sucks out the eggs and that's really
20:23
Speaker 1: all there is. Do it. It's pretty amazing. Um. If
20:26
Speaker 1: you cannot use the um TU a method, you will
20:30
Speaker 1: have to undergo a more involved procedure called laparoscopic surgery,
20:34
Speaker 1: which isn't super involved either. It is also a short process,
20:39
Speaker 1: but there's a small incision in the abdomen to locate
20:42
Speaker 1: your ovaries. Yeah, they put a little video camera in there.
20:46
Speaker 1: So um more involved obviously because it is a surgical procedure,
20:50
Speaker 1: but it's not like you're staying in the hospital for
20:52
Speaker 1: a week or even right. Yeah, it's just more involved
20:55
Speaker 1: because you have to use more anesthesia to which automatically
20:58
Speaker 1: increases risks exactly with the other one aspiration. Yeah, uh
21:03
Speaker 1: the uh, I guess you just need a mild seditive.
21:06
Speaker 1: It sets here. Yeah, it's like like twilight sleep alright.
21:10
Speaker 1: So step three, you've got your eggs. You've got your
21:12
Speaker 1: multiple eggs. They're all looking good. Then you yeah, because
21:15
Speaker 1: they go through and they look at them and ye
21:17
Speaker 1: and say this one looks good. This one looks good, man,
21:20
Speaker 1: not this one. Yeah, And I'm not sure when pg
21:23
Speaker 1: D can take place. I think after would think yeah, yeah,
21:29
Speaker 1: I guess it would have to be yeah, okay, that
21:30
Speaker 1: makes sense. Um. So then you've got your insemination. And
21:34
Speaker 1: like I said, you're you've got your sperm. However you
21:37
Speaker 1: got it. We ain't asking whatever it was a transient
21:42
Speaker 1: on the street, More power to you. Um. They examine
21:45
Speaker 1: the eggs and say these look robust and juicy and full,
21:49
Speaker 1: and these are the best ones. So we're going to
21:52
Speaker 1: use these. And that's when the sperm is at it
21:54
Speaker 1: and the best sperm um is picked and then it's
21:58
Speaker 1: in a culture and it's doing its thing right. And
22:00
Speaker 1: depending on the sperm um, they might injected directly into
22:04
Speaker 1: the egg, which is called um oh intra citoplasmic sperm injection.
22:12
Speaker 1: They could also just right, that's like the sperm doesn't
22:17
Speaker 1: have to go into the egg, it gets put into
22:19
Speaker 1: the egg um. But more traditional methods are just inserting
22:23
Speaker 1: it into the near the egg in the culture, right,
22:27
Speaker 1: and the culture can be artificial, but um it's also
22:30
Speaker 1: often made of the endometrium from the woman or um
22:34
Speaker 1: some in addition to possibly like her um uh cervical fluids.
22:40
Speaker 1: So like it's it's basically mimicking what will what would
22:44
Speaker 1: be going on in like the fallopian tube or something.
22:46
Speaker 1: That's all they're doing is taking the process that normally
22:48
Speaker 1: happens inside the woman's body and outside for a little while.
22:52
Speaker 1: And so you've got the egg and the sperm in
22:54
Speaker 1: the same culture and it's within possibly an hour, fertilization
22:59
Speaker 1: might have taken place. There's an open bar, everyone's getting
23:01
Speaker 1: to know each other, everyone's getting friendly. Little icebreaker happens,
23:06
Speaker 1: and like you said, it can be hours when they
23:09
Speaker 1: are doing the fertilization dance. And the next day your
23:13
Speaker 1: doctor is gonna confirm visually that there are two pro
23:17
Speaker 1: nuclei and that is the basis of your embryo right there.
23:23
Speaker 1: You see that, then that means things are ahead in
23:24
Speaker 1: the right direction because the pro nuclei from the sperm
23:27
Speaker 1: and the pro nuclei from the egg you're gonna fuse
23:29
Speaker 1: to make a single nuclei and that becomes the embryo,
23:35
Speaker 1: which divides into well, that becomes the zygote I'm sorry,
23:40
Speaker 1: which divides into two cells, and then I think by
23:43
Speaker 1: the time it's either two or four cells, it becomes
23:45
Speaker 1: an embryo, right, yeah, and then that's a couple of
23:49
Speaker 1: days after fertilization. Is when you get to that stage. Yeah. Yeah,
23:52
Speaker 1: the cell division is very slow at first, but then
23:55
Speaker 1: it starts to pick up time. By the time you
23:57
Speaker 1: reach day five or six, you've got what's called the
24:00
Speaker 1: asked the system. By this time, there's um fetal tissues
24:04
Speaker 1: growing in like uh, embryonic fluid cavity, and this thing
24:09
Speaker 1: is yeah pretty much. Um this the doctor is not
24:14
Speaker 1: normally gonna see this. They're gonna observe the egg, the
24:17
Speaker 1: fertilized egg or embryo for maybe a couple of days
24:21
Speaker 1: to make sure everything is progressing normally, and then they'll
24:23
Speaker 1: put it back into the mom. Yeah. I mean that
24:26
Speaker 1: can be done after one day, but um, your your
24:30
Speaker 1: doctor that they'll have a plan of when they think
24:32
Speaker 1: the best time is. And you're being monitored and all that.
24:36
Speaker 1: Not you with the man, but the woman is being
24:38
Speaker 1: monitored they don't care about the man. And then depending
24:41
Speaker 1: depending on where they put it, that that's the type
24:46
Speaker 1: of UM assisted reproductive technology that's being used. Right, So,
24:51
Speaker 1: like if you're using IVF, the thing has been fertilized
24:55
Speaker 1: outside of the womb, outside of the body, and then
24:57
Speaker 1: introduced into the the uterus. Yeah, it's called the transfer. Yeah,
25:03
Speaker 1: and they basically just usually catheter right, Yeah, it's UM.
25:07
Speaker 1: It's it's suspended in fluid um to I guess, just
25:11
Speaker 1: make it easier to get in there. It's like those
25:13
Speaker 1: UM peanuts, the foam peanuts for shipping. It's that version exactly.
25:19
Speaker 1: So it's suspended in the drop of fluid and it
25:21
Speaker 1: is a long, thin cafeter and it's um placed into
25:26
Speaker 1: the vagina, pass the cervix right there in the uterus
25:28
Speaker 1: and squirt there it goes. And it's really that easy.
25:33
Speaker 1: There's another process called um zygo introphallopian transfer where UM
25:40
Speaker 1: it's the same process, but instead of depositing the fertilized
25:43
Speaker 1: egg into the uterus, they put it into the fallopian tube. Right,
25:47
Speaker 1: And I think that has not as great a chance
25:49
Speaker 1: as as ib F. Is that right, I think you
25:51
Speaker 1: try ZIFT is what it's abbreviated as UM before IVF okay,
26:00
Speaker 1: but again all those rules are subthing to change depending
26:02
Speaker 1: on your doctor in your situation. UM. And then your
26:07
Speaker 1: embryo hopefully well attach to the uterine wall, uh if
26:11
Speaker 1: it attaches. I think we said at up topic, pregnancy
26:14
Speaker 1: is when it does not attached to the uterine wall,
26:18
Speaker 1: but outside of the uterus, but usually the Filippian two
26:22
Speaker 1: I think, right, it like never descends into the uterus,
26:25
Speaker 1: and so you can't get pregnant that way, or you
26:26
Speaker 1: can't have a kid that way. No, you can't, like
26:28
Speaker 1: even if the kids starts to develop, you have to
26:31
Speaker 1: terminate the pregnancy because it will kill you, that's right.
26:33
Speaker 1: Or you can get what's called a chemical pregnancy, which
26:36
Speaker 1: is basically just a really early miscarriage, super early in
26:41
Speaker 1: the process chemical pregnancy. Yeah. Uh, And those are just
26:45
Speaker 1: a couple of things that can go wrong along the way. Uh.
26:48
Speaker 1: You know, it's a stressful time for the couples because
26:50
Speaker 1: they're probably at there it's probably their last step towards
26:54
Speaker 1: having a natural as they call them UM. And then
26:58
Speaker 1: the woman is also getting injections for hormones throughout that
27:03
Speaker 1: can be rough on on the lady as well. I
27:06
Speaker 1: can imagine so um, in addition to being infected with hormones,
27:11
Speaker 1: having your eggs harvested, getting laproscopic surgery like um, your
27:16
Speaker 1: husband being in a room where he has to ejaculate
27:19
Speaker 1: into a cup and like all of this stuff, Um,
27:22
Speaker 1: there are actual risks involved, like physical risks. So like
27:26
Speaker 1: we said with if you get the laproscopic surgery, when
27:29
Speaker 1: your eggs are harvested, UM, like you have the risk
27:32
Speaker 1: that comes from any kind of anesthesia, any kind of
27:35
Speaker 1: surgery like that. So um there are things like chest pains, um.
27:41
Speaker 1: What else. Well, there's one risk called o h s
27:45
Speaker 1: S Ovarian hyper stimulation syndrome, and that's when you're overari
27:49
Speaker 1: swell up, which is super painful and about of patients
27:54
Speaker 1: UM experience that. But it can range from mild cases
27:58
Speaker 1: where you just take over the countermens two more severe
28:01
Speaker 1: cases UM moderate to severe where you know gas and
28:05
Speaker 1: alge and vomiting and no appetite. Uh. And I think
28:08
Speaker 1: only one to two of women experienced severe ohss. That
28:13
Speaker 1: means you're probably gonna gonna go to hospital, gain a
28:16
Speaker 1: lot of weight, like things that women don't like. And
28:19
Speaker 1: and that's the result of those fertility drugs, like the ovaries. Like, whoa, whoa,
28:25
Speaker 1: I did not sign up for this. You're over stimulating
28:28
Speaker 1: me and I'm fighting back pretty much. Um. But yeah,
28:31
Speaker 1: it's it does sound like it's fairly common, at least
28:34
Speaker 1: in a mild form, and it's in the mildest form
28:36
Speaker 1: apparently it clears up on its own. Um. So then,
28:42
Speaker 1: like I said, with a retrieval, you have the general
28:45
Speaker 1: anesthetic issue. Um. And then even with the lighter aspiration procedure, Uh,
28:51
Speaker 1: there's still problems. Like you can get an infection, Um,
28:54
Speaker 1: you can have structural damage. But speaking of structural damage, um,
29:00
Speaker 1: in addition to in vido fertilization, you could also try surgery.
29:05
Speaker 1: That's another avenue that some people try to UM solve
29:08
Speaker 1: their infertility. Like if you have if your fallopian tube
29:12
Speaker 1: is blocked or whatever, they can go in and yeah, yeah,
29:14
Speaker 1: like if you have a physical problem. Yeah. So chuckers,
29:18
Speaker 1: we already mentioned ZIFT. Have you heard a gift? I
29:22
Speaker 1: have gamme eat inter phallopian transfer similar to IVF, but um,
29:29
Speaker 1: it's in the fallopian tubes. Now, what's the difference between
29:32
Speaker 1: XIFT and GIFT? Then okay, I'll explain. Oh wait, wait,
29:35
Speaker 1: Ziff is in a lab. Gift is in the Philippian tubes. Yeah,
29:39
Speaker 1: like you go in and and artificially inseminate the egg
29:43
Speaker 1: in the fallopian tube. Okay, that makes sense. Yeah, but
29:46
Speaker 1: if you have damage phallopian tubes, you can't use the
29:49
Speaker 1: gift method. But that the Gift method, the advantage of
29:52
Speaker 1: it is much much more closely mimics natural birth or
29:57
Speaker 1: natural pregnancy because the egg is inseminated in the fallopian
30:02
Speaker 1: tube and then it just goes about its normal process
30:04
Speaker 1: from there. Yes, so aside from having sperm introduced through
30:07
Speaker 1: a needle, it's totally natural. But it's not used. It's
30:11
Speaker 1: only like two of cases, and I think Ziff is
30:15
Speaker 1: only one percent. Yeah, I saw even less than I
30:17
Speaker 1: saw that. Both of them are less than one percent.
30:19
Speaker 1: And the big blockbusters in vitro fertilization. Uh. And then
30:23
Speaker 1: there's something called I C S I UH intra cytoplasmic
30:27
Speaker 1: sperm injection and that's a treatment that you'll do alongside IBF.
30:32
Speaker 1: Remember I was saying like, depending on how the sperm
30:35
Speaker 1: is introduced, that's one way that it might work. Yeah.
30:38
Speaker 1: At about cases, I think they use the the I
30:41
Speaker 1: C S I method, and that's just injecting the sperm
30:45
Speaker 1: basically into vegg. Well, a single sperm that's like your
30:49
Speaker 1: sperm has problems, and so we're gonna pick out one, dude, hercules, hercules. Uh.
30:57
Speaker 1: And the cool thing about IVF is literally, yeah, if
31:01
Speaker 1: you have multiple eggs um that are really great, um,
31:06
Speaker 1: you can freeze the ones you don't use, and if
31:08
Speaker 1: you want to go back for round two, you can
31:10
Speaker 1: skip the first part of the harvesting and go directly
31:14
Speaker 1: to uh, the next steps. Yeah, I guess you could
31:17
Speaker 1: skip all the hormones and all of the possible over
31:20
Speaker 1: stimulation of ovary. Yeah, the initial hormones, but you still
31:23
Speaker 1: have the ones on the backside. That it's being able
31:25
Speaker 1: to skip that that first bed is a big relief
31:27
Speaker 1: to a lot of women, I can imagine. Yeah. Yeah,
31:30
Speaker 1: I'm sure it's worth the expense too. Ut freezing Yeah yeah.
31:34
Speaker 1: So um. What's crazy about all this chuck is that
31:39
Speaker 1: not all insurance covers this. A lot of insurance treats
31:42
Speaker 1: UM IVF procedures as an elective procedure. UM. As a result,
31:48
Speaker 1: some states, I think fifteen states have laws on the
31:51
Speaker 1: book saying if you're an insurance company operating in our state,
31:55
Speaker 1: you have to at the very least cover infertility treatments. Yeah,
31:59
Speaker 1: and I mean just check with your insurance if you're interested.
32:02
Speaker 1: They may cover some but not all. UM, but you'll
32:06
Speaker 1: probably get some assistance, you hope. Yeah, Or you can
32:10
Speaker 1: just move to a state like Massachusetts that has like
32:13
Speaker 1: UM law. Yeah. Basically the law is like you cover
32:18
Speaker 1: ivfly they have right, they have the best some of
32:22
Speaker 1: the best IVF doctors up there. Yeah. I read an
32:25
Speaker 1: article that interviewed this one couple and they were like,
32:28
Speaker 1: what some state that didn't have any insurance laws about
32:32
Speaker 1: IVF and they moved to Massachusetts, and they said it
32:34
Speaker 1: was like going from a place, going from a hospital
32:38
Speaker 1: that didn't even have X ray technology going into like
32:41
Speaker 1: the most cutting edge type of hospital you could possibly imagine,
32:44
Speaker 1: just because because it's required there. The doctors by nature
32:50
Speaker 1: are all just experts at it because they've done so
32:52
Speaker 1: much work on it. They're trying to make little baby liberals, right,
32:56
Speaker 1: little take Kennedy tone and around you anything else. I
32:59
Speaker 1: got a thing else. So let's speed the couples out
33:02
Speaker 1: there going through this stuff. Yeah, God's being good luck. Yeah,
33:05
Speaker 1: we wish you well. Um, and if you want to
33:08
Speaker 1: learn even more about this, you can type in vitro
33:11
Speaker 1: fertilization in the search part how stuff works dot com
33:14
Speaker 1: and that brings up listener mail. I'm gonna call this,
33:19
Speaker 1: uh work surveillance. Good. We did that one people employees
33:24
Speaker 1: spying on you, the employers spying. That's just true. Hey, guys,
33:28
Speaker 1: I work for blank company on a large shipping corporation
33:33
Speaker 1: let's call ship Co. Yeah, ship Co for seven years.
33:38
Speaker 1: When I started, I love the company and the job.
33:40
Speaker 1: As things shifted more towards the bottom line oriented attitude
33:43
Speaker 1: with the company, I start to get pretty burnt out
33:45
Speaker 1: began looking for something else to do with my life.
33:48
Speaker 1: I always had an intense I'm sorry, in interest, we'll say,
33:52
Speaker 1: an intense in an electric guitars, not just as a player,
33:56
Speaker 1: but something I studied from a historical standpoint and always
33:59
Speaker 1: enjoy taking apart and messing with my guitars. At some
34:03
Speaker 1: point it became interested in lutheriory and decided to become
34:07
Speaker 1: a guitar maker. So what I ended up happening doing
34:10
Speaker 1: Luther Yeah, like a luthier. As a guitar maker, like
34:14
Speaker 1: a cooper makes the barrels. Yeah, wine barrels in it. Yeah,
34:19
Speaker 1: a luthier makes a guitar. I did not know that,
34:22
Speaker 1: l U t h I e er Uh what ended
34:26
Speaker 1: up happening. I would finish up my workload for the
34:28
Speaker 1: day and tidy up the store, and if there were
34:30
Speaker 1: no customers I would work on my guitar designs at work.
34:33
Speaker 1: For a while, the management didn't care, but as the
34:35
Speaker 1: pressure started being put on them, they had to tell
34:37
Speaker 1: me to stop. But I didn't because I found my passion. Finally,
34:42
Speaker 1: one day I was pulled into the office and handed
34:43
Speaker 1: screenshots that I hadn't taken of my guitar design work
34:48
Speaker 1: that I was doing on the clock. So they had
34:50
Speaker 1: a program that wasn't just sending keystroke information of their
34:53
Speaker 1: security team, sending actual screens of everything going on on it. Yeah.
34:58
Speaker 1: We talked about that one. Yeah, I don't remember. It's
35:00
Speaker 1: called man. I would freak out if someone handed me screenshots. Uh.
35:03
Speaker 1: Needless to say, I was put on disciplinary probation. Didn't
35:06
Speaker 1: make it to the end of that because I quit
35:09
Speaker 1: to pursue my dream and I'm happy to say that
35:11
Speaker 1: I've been a full time professional luthier ever since. It's
35:15
Speaker 1: one of my guitars. Is even on the cover of
35:17
Speaker 1: a recent issue of Premier Guitar magazine that's like the
35:20
Speaker 1: Premier Guitar Magazine. There's a second story about a robbery
35:24
Speaker 1: that happened while I was on that probation period, but
35:27
Speaker 1: I'll leave that for anyone curious enough to google my name.
35:32
Speaker 1: Tantalizing all right. That is from Paul Roney R H
35:36
Speaker 1: O N E. Y. And he says, if either one
35:39
Speaker 1: of you guys once a handmade USA electric guitar by
35:42
Speaker 1: a company that doesn't spile and some employees and hit
35:44
Speaker 1: me up, I will hook you up. Wow. And I
35:47
Speaker 1: checked them out and they're sweet. Yah. Yeah, I'm gonna
35:49
Speaker 1: see what hook you up means and when you stuff, yeah,
35:55
Speaker 1: we'll see. But yeah, that is from Paul Roney. And
35:58
Speaker 1: good for you for fighting ship co. Yeah and pursuing
36:02
Speaker 1: your dreams. Mr Roney, congratulations and you're doing a good
36:06
Speaker 1: job that since you're beautiful. So uh, if you want
36:10
Speaker 1: to let us know about how you stuck it to
36:12
Speaker 1: the man, you can tell us via Twitter at s
36:16
Speaker 1: Y s K podcast on Facebook dot com slash stuff
36:19
Speaker 1: you should know, uh, through email. It's stuff podcasts at
36:22
Speaker 1: how stuff Works dot com and check out our website
36:25
Speaker 1: while you're at it, Stuff you Should Know dot com
36:32
Speaker 1: for more on this and thousands of other topics. Is
36:35
Speaker 1: it how stuff works dot com.