In vitro fertilization - the most effective method of fertility treatment, regardless of its cause.
In the 1970s, in vitro fertilization (IVF) was developed to help women with obstructed fallopian tubes. However, it became effective in the treatment of infertility in individuals suffering from endometriosis, as well as infertility associated with poor sperm quality or inability of its origin.
In Vitro fertilization is performed in extremely sterile laboratory conditions by placing eggs obtained from sperm on nutrient medium from a woman and sperm in a specialized embryo tank. Before taking the egg, a woman undergoes hormonal treatment. Ovarian stimulation. The eggs are removed from the follicles by ovarian puncture under the control of an ultrasound machine.
Eggs and sperm are cultured in a special incubator in the laboratory. An incubator mimics the conditions existing in the human body. Supports a certain temperature, gas, humidity.
During the normal menstrual cycle in a woman’s ovaries, as a rule, one egg matures and separates, while the other developing testicles die. In the cycle of artificial insemination, a woman receives hormonal treatment, under the effect of which many ovarian follicles and the eggs present in them mature once in her ovaries.
Hormone treatment is planned individually for each woman. Depending on the treatment method used, it lasts 2–4 weeks. Hormonal drugs are injected under the skin. Control of egg development is done using ultrasound and, if necessary, hormonal studies through blood tests. During hormonal treatment, you can continue your normal life, go to work, and engage in your hobbies.
Selection of eggs
The eggs are removed from the ovarian follicles via the vagina with a special thin needle under the control of an ultrasound machine. Egg extraction from the ovaries is performed under short-term intravenous anesthesia with local anesthesia of the lower uterus.
For one process, 10 eggs are usually removed, but their numbers vary.
After extracting the eggs, the woman remains under observation in the clinic for several hours.
Sperm extraction from testicular tissue
If male sperm do not have sperm, they may be present in testicular tissue. The testicle tissue is taken under local anesthesia. A sick leave is issued on the day of the procedure. Sperm cells are secreted from the tissue, which are then inserted into mature eggs using the ICSI technique. The results of the procedure are similar to the separation of sperm from sperm.
16–20 hours after the connection of progenitor cells, egg fertilization is checked. Already at this stage, the fetus can be transferred to the uterus, however, prolonged cultivation increases the chances of obtaining a viable fetus with the best diagnosis of pregnancy.
The average duration of embryo cultivation in the laboratory is 2-3 days. Cultivation continues until the stage of division, at which point the best two-day embryo has four cells, and the three-day embryo has eight cells, respectively. Sometimes it is advisable to extend embryo cultivation to the blastocyst stage for 4-5 days.
Based on the fetal development schedule and appearance, it is possible to estimate the probability of pregnancy. Of the embryos with a good prognosis, the best selection is made for transplantation, and the remaining high-quality embryos undergo cryopreservation and can be used later.
Embryo transfer In Vitro Fertilization
Embryo transfer is a procedure in which a 2–5-day-old fetus is inserted into the uterine cavity. Fetal control is by using a special plastic catheter under ultrasound control. To prevent the development of multiple pregnancies, only one fetus is usually implanted. The doctor decides on the number of the fetus implanted, coordinating the issue with the couple, taking into account the history of her treatment and wishes. Hormone treatment continues through the vagina after embryo transfer.
A pregnancy test is performed two weeks after implantation of the fetus. If the pregnancy test is positive, the first ultrasound examination is performed approximately five weeks after fetal implantation. If the pregnancy progresses without deviation, the pregnant woman continues to be monitored in the antenatal clinic.
Of the embryos obtained during fertility treatment, the best are selected for transfer to the uterus, and the remaining embryos of good quality are deep frozen. Embryos are stored in liquid nitrogen at −196 ° C under carefully controlled conditions for possible future use in In Vitro Fertilization cycles. If necessary, the embryo can be stored for several years.
The cryopreserved fetus can be implanted in a woman’s uterus at a suitable time in the natural menstrual cycle or with hormonal drugs that encourage ovulation. Over 70% of frozen embryos tolerate thawing well. On average, 20–40% of transplanted embryos perish in pregnancy.