It is no secret that many couples today are faced with some difficulty in trying to conceive a child. Infertility is the diagnosis that is made to the spouses if, during the year of regular sexual life without the use of contraceptives, the pregnancy has not come.
Fortunately, modern medicine has a rich arsenal of means to defeat this disease—families who cannot have the desired baby come to the rescue of assisted reproductive technologies. The most effective of them is the procedure of in vitro fertilization. This method is recognized as the most effective in treating various forms of female and male infertility.
What is IVF?
Many couples have no idea what the method of in vitro fertilization is, how safe it is for health, where, and how the procedure is carried out. The very essence of the technique lies in the name: Extra (from Latin extra – outside) Corpus (from Latin corpus – body) Fertilization.
That means conceiving outside the woman’s body, the connection of the sperm and egg in vitro. After some time, the embryo is transferred to the uterine cavity.
It should be noted immediately that the children of IVF are no different from ordinary children conceived naturally. One should not be afraid that the way of conception in vitro would have any negative impact on the health and development of the future baby.
Step-by-Step IVF procedures description
To give birth to a child, the couple is offered IVF. The procedure is carried out in several stages. Of course, like many therapeutic effects, some of them are not too physically pleasing, but there is nothing terrible in them. As a rule, all stages of the procedure are performed on an outpatient basis, which means that you do not have to stay in the clinic, and you can go home after it. There are four main stages of the process, which take about two months to complete.
Step 1. Preparation for IVF. Stimulation of ovulation
For the successful in vitro fertilization procedure, as a rule, several mature oocytes are needed. This is achieved by hormonal stimulation of the woman’s body. Scheme of treatment, type, and dosage of drugs developed by the doctor based on a thorough analysis of the patient’s history and survey results. The IVF protocol can be “short” or “long” It depends on the state of the organism of each particular woman.
The goal of hormonal stimulation is the preparation of fertile oocytes and the preparation of the endometrium of the uterus to receive the embryo. The whole process is under constant ultrasound control. The most common protocol is a long GnRH-agonist, where the secretion of gonadotropin hormones is inhibited to prevent premature ovulation.
Once suppression is achieved, the next step is to replenish several injections of gonadotropin follicles every day. When the lead follicles reach the desired size, the final maturation of the eggs is carried out by the administration of HCG. The retrieval of an egg is planned 36-38 hours after HCG injection.
Step 2. Puncture of follicles
Once the follicles are ripe, the next stage of preparation for IVF comes. This is the step of extracting the follicles. As a rule, this procedure is performed transvaginally (through the vagina under the supervision of ultrasound). It is performed under intravenous sedation. The ovarian follicles are taken using a needle guided by transvaginal ultrasonography.
The doctor called the embryologist scans follicular fluids to locate and take all available eggs. The eggs are put in a specialized laboratory dish and cultured in an incubator until insemination.
Step 3. Fertilization
After the doctor was convinced that the sperm parameters are normal, from about 40,000 to 100,000 motile sperm are transferred to a dish that contains eggs. This procedure is called standard insemination. The ICSI method is used to fertilize mature eggs if the parameters of the sperm are abnormal. The process is performed under a powerful microscope.
The embryologist collects one spermatozoon using a thin glass microneedle and injects it directly into the cytoplasm of the egg. ICSI increases the likelihood that fertilization will occur if the sperm sample has a small number of spermatozoa or mobility, reduced progression, or poor morphology. If there is no semen in the ejaculate, sperm can be obtained surgically. ICSI is always used to achieve fertilization if sperm is extracted surgically.
Fertilization of the patient is estimated 18-20 hours after ICSI or insemination. Fertilized eggs are called zygotes, and they are cultivated in a specially developed nutrient medium that supports their growth. They will be evaluated on the second and third days after the extraction.
If a sufficient number of embryos show good growth and development, they can be selected for cultivation in the blastocyst stage in a specially developed culture medium. Blastocyst culture has a number of advantages. Embryos at this stage have a higher potential for implantation, so on the 5th day, the number of embryos can be reduced to reduce the likelihood of multiple pregnancies.
The low number of embryos and the poor quality of the embryo reduce the chances of proper blastocyst development.
Step 4. Embryo transfer and pregnancy after IVF
Actually, the embryo transfer is carried out on the 3-5 day after fertilization. Embryos get into the uterus by means of a thin catheter. It is absolutely painless and does not harm either mother or future baby. Nuclei of the third day are called embryos of the cleavage stage and have approximately four-eight cells.
When analyzing these embryos, the doctor not only looks at the number of cells, but also how symmetrical they are, and whether there is any fragmentation. Fragmentation occurs when cells divide unevenly, which leads to cellular structures that displace the embryo. Fragmentation is not preferable, but some are acceptable. The fourth class represents the highest quality embryos. Nuclei of the fifth day are called blastocyst embryos. At this stage, embryos increased in size and still more developed.
They resemble a ball of cells with a liquid inside. One of the important things is how much these embryos are enlarged. The more it expands, the better the quality of the fetus. These embryos are also classified on a scale from 1 to 6. The sixth grade is the best quality blastocyst.
Of course, we must bear in mind that pregnancy from the first attempt does not always come. However, do not despair. The procedure of in vitro fertilization is not an easy process. There are cases when pregnancy after conceiving in vitro occurred with the fourth and even with the tenth attempt.
Check this: Most famous countries for the IVF procedure abroad