Artificial insemination, or IVF, is the only option for having children for couples who cannot conceive naturally. This method is used when the spouses have regular sex life and do not include the use of contraceptives, but pregnancy does not occur within 1–2 years. Currently, about 20% of families face this problem.
When the cause of infertility cannot be eliminated, conception can be achieved artificially. The procedure is carried out in specialized clinics involved in in vitro fertilization.
In vitro fertilization solves the problem. It can be used for any type of pathology, in particular when a man is sick.
The whole point of the procedure is that sperm penetrate the egg through a test tube and only after fusion the material is transferred into the woman’s uterine cavity. If the outcome of such manipulations is favorable, then often not one embryo develops, but two or three, since several eggs are used at once when attempting in vitro fertilization.
If a couple does not want to have more than one child, then the extra embryos are reduced (removed). In some cases, this causes a subsequent miscarriage. The effectiveness of artificial insemination is about 30–35%.
An auxiliary method for IVF is ICSI - intracytoplasmic injection of sperm into the egg. This procedure is carried out in cases where the quality of sperm is reduced: less than a third of sperm have the correct structure and sufficient mobility. For injection, viable material is specially selected, which is then injected into the egg using a microscope and special surgical instruments.
In addition to classical IVF and IVF with ICSI, methods of artificial insemination include:
- intrauterine insemination, when artificial insemination is carried out in the fallopian tubes and not in a test tube;
- GIFT, when male and female germ cells are introduced into the uterus and their fusion occurs naturally.
Indications for IVF and availability of the procedure
Artificial insemination is indicated for infertility in a woman or man that cannot be treated. For women it is:
- absolute tubal infertility or bilateral tubectomy;
- long-term conservative treatment obstruction of the tubes or plastic surgery on them in women over 30 years of age;
- unidentified cause of infertility during various examinations;
- diagnostic infertility, determined by a negative result of insemination of the partner’s sperm;
- diagnosed endometriosis in combination with unsuccessful attempts at natural conception during the year;
- age-related infertility, decreased functions of a woman’s reproductive system;
- the presence of anovulation, which cannot be eliminated by known methods.
Indications for ICSI are diseases such as:
- azoospermia (sperm is not released due to blockage of the vas deferens or their absence);
- varicose veins of the spermatic cord.
Sperm is obtained by puncture or surgery, and the healthiest cells are selected for subsequent connection with the egg.
In Russia, since 2015, artificial insemination can be done free of charge. To do this you need the following:
- Compulsory medical insurance policy.
- Indications for the procedure.
- Conclusion and referral of the medical commission for IVF according to the quota.
- The woman's age is 22–39 years.
- There are no contraindications to the procedure for men and women.
Future parents retain the right to choose a clinic; the main thing is that it must be on the list of organizations participating in the federal program. The new conditions provide for the opportunity to make an unlimited number of attempts at artificial insemination until a positive result is obtained.
For each attempt, the insurance company allocates up to 106,000 rubles; if expenses arise that exceed this amount, then their payment falls on the shoulders of the patients. Not only official married couples, but also partners who have not registered their relationship with the registry office, as well as single women, have the right to IVF under the compulsory medical insurance policy.
In order to get in line for IVF, you need to apply for a compulsory medical insurance policy, provide a passport of a citizen of the Russian Federation, undergo a full examination and confirm the diagnosis at the antenatal clinic or at the family planning center. After following all the doctor’s recommendations for infertility treatment, you need to obtain a referral from a medical commission, select a clinic and complete the documentation.
It is important to know: the ICSI procedure is not covered by the insurance company. If a male factor of infertility is identified, namely the unsuitability of sperm, you will have to pay for the procedure yourself (the average price is 10,000–20,000 rubles).
Artificial insemination can be carried out on a paid basis; its price in 2015 ranged from 120,000 to 150,000 rubles, depending on the clinic and individual treatment regimen.
Stages of the IVF procedure
The IVF procedure is quite labor-intensive and consists of several stages:
- Preparation. Lasts about 3 months, includes diagnostic examinations of a man and a woman, during which the diagnosis is confirmed. Also, diseases associated with infertility are identified that can negatively affect the result of the procedure. If possible, treatment is carried out and general health indicators are determined. Factors that oppose IVF include: overweight, bad habits, physical inactivity, susceptibility to infections (reduced immunity).
- Stimulation of superovulation. The stage lasts up to one and a half months. With the help of hormonal drugs, the production of eggs is stimulated. Enter medicines You can do it yourself at home, but it is important to adhere to a clear schedule. During this stage, diagnostic examinations (blood tests, ultrasound) are regularly carried out. The quality of the material for conception will depend on the correctness of all activities. At the same time, the doctor determines the IVF method, a set of medications and their administration regimen.
- Collection of follicles and sperm. Puncture of the follicles is performed transvaginally using a thin needle. The entire process takes place under the control of ultrasonic equipment and takes about 15 minutes. The extracted fluid is sent to the laboratory, where embryologists collect the eggs. The woman remains in the hospital under observation for 2 hours; before leaving, a control ultrasound is performed in order to exclude abdominal bleeding. A man donates sperm.
- Formation of embryos. A special solution is prepared in the laboratory, which is similar to the environment of the uterus. Eggs are placed in it and after some time they are fertilized. How exactly artificial insemination occurs depends on the quality of the sperm. This can be an in vitro method, when sperm are introduced into a solution with an egg and one of them penetrates it independently, or ICSI - the instrumental introduction of one sperm. After this, the embryo begins to form. The specialist controls each stage, recording the time and features of the process.
- Embryo introduction. This stage occurs from 2 to 6 days after fertilization. The introduction is quick and painless, without anesthesia. The catheter is passed through the cervix, thereby implanting the embryo. Russian legislation allows the introduction of 1 or 2 embryos. Larger amounts are transferred according to indications and with the written consent of the woman.
- Cycle maintenance and pregnancy diagnosis. Over the next two weeks, embryos are expected to attach to the walls of the uterus. The doctor prescribes hormonal therapy: estrogen, progesterone, human chorionic gonadotropin. Working women have the right to take sick leave during this time. The expectant mother is recommended to have maximum peace and rest, both physical and psychological. Therefore, it is best to stay at home, stay in bed and limit social contacts. If any symptoms appear, you should consult a doctor.
- Diagnostics. After two weeks, diagnostic procedures can be carried out to determine the presence of pregnancy: blood and urine tests to determine the concentration of hCG. But this sign is a probability, not a guarantee of pregnancy. An ultrasound scan is required for accurate confirmation. This procedure can be performed after another week, during which the position of the embryos and their number are clarified.
- Pregnancy. In general, this stage coincides with the natural pregnancy of women.
After artificial insemination, additional diagnostic examinations may be required:
- a homeostasis study can be prescribed at any time;
- 12-13 weeks - examination to identify the risk of spontaneous dilatation of the cervix;
- 10-14 weeks – measurement of the concentration of hCG and the hormone AFP, to identify malformations and pathologies of the unborn child;
- 16-20 weeks - determination of the amount of male sex hormones to prevent miscarriage;
- as in a normal pregnancy, routine ultrasounds are prescribed, and closer to childbirth - Dopplerography and CTG.
Children after artificial insemination are born in the same way as after natural insemination. If a woman has diseases that require certain preparation and delivery, they will be taken into account. But this does not apply to the method of fertilization.
IVF is a complex and multi-stage procedure. From the moment you consult a doctor until the birth of the child, at least a year passes, and in case of unsuccessful attempts and complications - more.
Complications during IVF
At various stages of IVF, more or less serious complications may arise. Most they can be successfully overcome with the assistance of a doctor.
It happens that too frequent attempts to get pregnant deplete male and female reserves. In such cases, it is advised to have sexual intercourse once a month, then it will lead to. In more complex cases, technological methods are used.
If all types of infertility treatment do not bring results, then they turn to life-saving fertilization outside the body - (In Vitro Fertilization). In vitro fertilization can be used in all cases of infertility. During in vitro fertilization, a pre-extracted egg is artificially fertilized “in vitro.” The embryo develops for about 5 days in the clinic incubator. Next, for further growth, the embryo is transferred to the uterus.
Artificial insemination
The effectiveness of artificial insemination
The average IVF protocol success statistics are as follows:
- Under the age of 35, the birth of a child occurs in 40%
- In women aged 35-37 years, a child is born in 30%.
- In patients aged 38 to 40 - in 20% of cases.
- At 40 years of age, the IVF birth rate is about 10%, and the percentage decreases with age.
Do not confuse IVF with intrauterine insemination (IUI or otherwise artificial insemination). This medical procedure is also classified as assisted reproductive technology. IUI involves the introduction of a man's previously obtained sperm, rather than an embryo, into a woman's uterus.
Video: Artificial insemination
- Start:
When contacting the clinic, the couple must prepare the necessary test results. The doctor must be completely sure that the woman has no contraindications to IVF. According to the law, there are no contraindications for a man’s health for IVF. The decision on the advisability of artificial insemination is made by the doctor and the couple.
- Egg:
After additional examinations and consultations, the patient is prescribed a course of treatment. To achieve superovulation, injections of hormonal drugs are used. Ovarian hyperstimulation will allow you to obtain more than one egg during one menstrual cycle. The effectiveness of the artificial insemination method depends on the number of eggs. In most cases, the use of hormone therapy does not adversely affect a woman's health. But sometimes complications arise, consult your doctor about measures to be prepared on your part to promptly identify dangerous symptoms. Be aware of how to react when they occur. Also on at this stage The endometrium is prepared for embryo transfer a few days later.
- Sperm:
The man independently obtains sperm through masturbation according to medical instructions. In cases where this is not possible, use surgical methods: aspiration or biopsy. The best time to obtain sperm is on the day of fertilization. But it is also possible to freeze and store previously obtained sperm. In the laboratory, on the day of transfer, sperm are separated from the seminal fluid. The highest quality livestock will be used in fertilization.
Cryopreserved sperm
- Fertilization:
Embryologists carry out the procedure using the in vitro method or the ICSI method (intracytoplasmic sperm injection). During insemination, one out of 100 thousand sperm penetrates the egg completely independently. This fertilization takes about 2-3 hours. With regard to the quality of sperm, microsurgical instruments come to help in fertilization. Then the ICSI method is used, which involves mechanically introducing sperm into the egg.
From the moment of fertilization, the embryo is stored in an incubator for up to 6 days. Embryos are kept in plastic Petri dishes or Nunk dishes. There they are kept in a nutrient medium based on blood serum. The number of cells that make up the embryo increases many times from 1 cell on the first day, 4 cells on the second, to 200 cells on the fifth.
Fertilized embryos
By the way, viable embryos can be used for repeated transfer into the uterus. In this case, additional embryos are frozen, which is called cryopreservation. The embryos will be stored until they are used. This allows you to try again if the first transfer did not continue with pregnancy.
- Embryo transfer:
Already 2 days after fertilization, the embryo can be transferred to the uterus. This procedure is carried out a few days later. In any case, no anesthesia is required. The transfer procedure lasts only a few minutes. To increase the chances of pregnancy, 2 embryos are usually transferred. Using a thin elastic catheter, they are transferred directly into the uterus. How artificial insemination occurs is shown in the video below.
Video: The process of artificial insemination
When discussing the topic of ways artificial conception Most of us think of the technique of in vitro fertilization, in other words, IVF. Of course, this method is the most effective and widespread in recent decades, so many childless couples are ready to wait their turn and pay for this expensive procedure. For many, in vitro fertilization is the only hope for creating a full-fledged family. However, in addition to IVF, there are a number of other types and auxiliary methods of artificial insemination, which we will talk about today.
Methods and types of artificial conception
Various types and methods of artificial insemination are used in cases where a woman, for some reason, cannot conceive and give birth to the desired child on her own. The principle of each of these methods is the same and comes down to various ways of fertilizing an egg not in a woman’s body, but in laboratory conditions.
Any woman or couple who wants to conceive a child has the right to resort to one of the methods of artificial conception. To do this, you must be in an official (or civil) marriage and be at least 18 years old. Patients over 38 years of age can apply for this method of conception without preliminary tests and examinations.
This or that method of artificial insemination is selected depending on the causes of infertility in the spouses and on a number of other factors. Any type of artificial conception, like other manipulations in medicine, has its own indications and contraindications.
Intrauterine insemination (IUI) - this type of artificial conception involves the introduction of the spouse's ejaculate directly into the uterus of his partner. Intrauterine insemination is allowed only for those patients whose fallopian tubes are completely patent and free of adhesions. Most often, this method is preferred in cases where a man’s sperm does not have very high characteristics, and the chance of pregnancy occurring naturally is extremely low.
Before introducing sperm, it is processed in a special way, maximizing the viability and motility of sperm. Another indication for intrauterine insemination is the so-called incompatibility of spouses, in which a woman’s vaginal secretions contain antibodies that negatively affect sperm. Thus, contact of sperm with mucus can be avoided, which makes it possible for the sperm to merge with the egg. This type of artificial insemination can be performed several times in one menstrual cycle.
For the ICSI procedure (intracytoplasmic sperm injection into the egg), only one, the healthiest and most viable sperm is taken, which is injected directly into the egg itself using a thin catheter. The ICSI method can safely be called extreme, since it is prescribed when the couple has already tried all known methods of artificial conception, but they have not brought a positive result.
Often, ICSI is resorted to in situations where male sperm contains an insufficient number of high-quality sperm that could independently produce conception. After a special puncture, the most suitable sperm are extracted and used for conception. According to statistics, with ICSI, almost every third infertile woman gives birth to a healthy baby.
In vitro fertilization (IVF) is the most commonly practiced method of artificial conception. With this method, the fusion of male and female biomaterial occurs not in the woman’s body, but in laboratory conditions. Hence the common expression - “test tube babies”. Most often, the most common indications for IVF are:
- acquired or congenital anomalies of the fallopian tubes;
- complete absence of fallopian tubes;
- hormonal imbalances;
- diseases of the female genital area;
- idiopathic infertility.
In vitro fertilization is such a highly effective type of artificial conception that many couples are willing to wait for any period and pay considerable sums in order to have the opportunity to undergo IVF. The essence of the procedure is as follows: first, the woman undergoes a course of hormonal therapy in order to stabilize hormonal levels and increase the likelihood of ovulation in the current cycle; then the eggs are transferred from the woman’s body to a special environment where they await fusion with sperm. The resulting embryos are kept in a nutrient medium for several days, after which they are transplanted into the uterus of the expectant mother.
Important! If the patient does not have a permanent partner, or her spouse’s sperm is not able to participate in conception, in this case the IVF OD method (donor insemination) is used.
ISD (artificial insemination with donor sperm)- a technique that is used when the quality of sperm is too low or when partners are completely incompatible. Technically, the manipulation is practically no different from standard intrauterine insemination with the partner’s sperm. The procedure can be performed several times in one cycle; before performing it, the patient’s body must be prepared.
If we talk about the effectiveness of ISD, it is quite high and is approximately 70%
GIFT method (short name for gamete intrafallopian transfer) involves the process of transferring mixed male sperm with a previously prepared egg into the fallopian tube of an infertile woman. The manipulation must be carried out at a strictly defined time (middle of the cycle). A prerequisite for its implementation is the absolute patency of the patient’s tubes. Most often, the GIFT method is used when the spouse’s sperm count is poor. In one menstrual cycle It is allowed to carry out only one manipulation during the period of egg release.
ZIFT method (an abbreviation for the English phrase zigote intrafallopian transfer) - The main difference from the previous method is that the embryo itself is implanted into the cavity of the fallopian tube. Both of these methods are used exclusively within the walls of a special medical institution under ultrasound supervision. These two methods differ in the ways of introducing biomaterial - with GIFT the mixture is introduced through abdominal cavity, and with ZIFT the embryo is transferred to the uterus through the vagina.
The manipulation can be carried out once per cycle, during the period of ovulation. Before that female body prepare for pregnancy using special hormonal agents.
Important! The methods of artificial insemination GIFT and ZIFT are used infrequently in Russia, but they are practiced in foreign countries.
How to prepare for artificial conception
A married couple faces an important stage of comprehensive preparation before the artificial insemination procedure, regardless of the method they choose. A woman is usually prescribed:
- ultrasound examination of the pelvic organs;
- blood test for hormones;
- blood tests for hepatitis, AIDS and syphilis;
- identifying the presence of sexually transmitted diseases;
- gynecological examination.
For a man, the list of necessary examinations is much smaller. It includes sperm analysis, examination for sexually transmitted diseases, as well as hepatitis, syphilis and AIDS.
All of the methods described above are relatively highly effective, do not take much time and are practically painless, which makes it possible to do them with the required frequency before pregnancy. However, it should be remembered that any type of artificial conception does not solve the issue of infertility, but only overcomes it. As a result, the couple gets the opportunity to become parents with the help of reproductive specialists.
Whatever method of artificial conception you choose, you should remember that conception in a laboratory is an extremely complex procedure that requires many years of experience and a large amount of knowledge. It is best for future parents to contact specialized, reputable medical centers staffed exclusively by professional doctors. Our Department of Reproductology has been practicing various methods and types of artificial conception for many years, and our doctors have already managed to give more than 1,500 couples the joy of having a baby!
Artificial insemination- this is a real miracle for those couples who cannot conceive a child themselves.
If many years of unsuccessful attempts lead to zero results, then the spouses experience despair. In this case, artificial insemination becomes the only option.
The achievements of modern medicine make it possible to make dreams of children come true. These days, no one is surprised to hear about IVF.
What do you need to know?
If you want to use artificial insemination, then you need to familiarize yourself with its basic principles. Reviews from people who have gone through this procedure are always a good help.
According to statistics, Most infertile couples prefer artificial insemination. This procedure has an affordable cost. It is done in many Russian clinics.
Average price for artificial insemination (artificial insemination) fluctuates around 15,000 rubles.
The advantage of this procedure- it does not require a break from your usual life. That is, immediately after the session the woman can begin her work.
Reviews about this procedure, usually positive. Here we must understand that success depends not only on the skills of doctors. The health status of the spouses is the most important factor, which determines the outcome of the session.
Regarding in vitro fertilization, then sometimes such a procedure is the only way out. Judging by the reviews, women who have gone through IVF recommend choosing a clinic carefully.
It is important to determine what medical equipment the center is equipped with. It is equally important to find out the level of qualifications of embryologists.
If the embryology of the clinic is at a low level, then the procedures may fail. In this case, treatment turns into a banal pumping of money out of an infertile couple.
But IVF performed by professionals works wonders. There are excellent specialists in Russia who have helped many people become happy parents. Therefore, choose a medical center need recommendations, and not by the cost of services.
Methods and types of artificial insemination
Under artificial insemination understand a whole range of special methods for treating infertility.
This includes in vitro fertilization with transplantation of fragmented embryos into the uterus and fertilization by artificial insemination.
What is artificial insemination?
This method is also called insemination. In this option, sperm is injected into the lumen of the fallopian tubes or into the uterine cavity.
Artificial insemination is used in the following cases:
- for certain diseases of men (impotence, hypospadias, lack of ejaculation, etc.);
- anatomical changes in the cervix;
- vaginismus that cannot be treated;
- if antisperm antibodies are detected in a woman’s cervical mucus.
Before the procedure specialists examine the man's sperm. They find out the cause of infertility.
Insemination is carried out 2-3 times during one cycle. The procedure is repeated for at least 3 cycles.
If the examination revealed that the husband’s sperm has pathological changes (a decrease in the number of sperm or no sperm at all), then we are talking about the donor’s sperm.
Sometimes the reason for using donor sperm becomes, which cannot be treated, as well as genetic diseases in the husband’s closest relatives.
Thus, the man’s seed is introduced into the female reproductive tract, bypassing barriers that are harmful to it. The procedure mechanism here is as follows: sperm are placed in the genital tract or uterine cavity.
Next one of them fertilizes a mature egg (artificial insemination). After this, it is implanted into the wall of the uterus, and the embryo continues to develop. With such fertilization there is no problem of “extra” embryos.
The positive result of the procedure largely depends on the diseases that the couple has. Sometimes a woman may miss her period even though she is not pregnant. Therefore, you can definitely find out about conception only with the help.
If ovarian stimulation is not performed, then insemination can be performed several times.
As a rule, after insemination with donor sperm, pregnancy occurs in 80% of cases. Women who have undergone artificial insemination are under the supervision of a specialist from the antenatal clinic.
Typically, pregnancy and childbirth proceed without complications. Anomalies of fetal development in such cases do not occur more often than in other pregnant women.
You can take a hormone test or buy one.
If you want to carry out insemination on your own, then Please note that sperm remains active for no more than 2 hours. It cannot be properly frozen and stored at home.
That is, it will not be possible to completely imitate the conditions of a clinic. Therefore, sperm should be used immediately after ejaculation.
The procedure is carried out using a syringe without a needle. To collect sperm you will need a sterile and dry container. You can use a vaginal dilator.
After receiving sperm from the donor, wait for it to liquefy (no more than 20 minutes). After that sperm is drawn into a syringe and inject it into the vagina.
At the same time is strictly prohibited inject sperm into the uterine cavity. Independent manipulations should not affect the sterile cavity. This can lead to infection or injury.
If home insemination is successful, the result will be pregnancy.
Despite the fact that artificial insemination does not always result in conception, don't despair. Persistent attempts, patience and professional approach of specialists are important factors for success.
The reward for your work will be a long-awaited baby.
ECO. School of Doctor Komarovsky.
Unfortunately, not every woman can experience the happiness of motherhood through natural fertilization. Due to various physiological and psychological reasons, many representatives of the fair sex experience certain difficulties in conceiving. In this case, various methods of artificial insemination may be the only possible way to overcome diagnosed infertility. What is the difference between artificial insemination, in vitro fertilization and other types of ART? Which method is most reliable and safe? A little medical education will help you understand the features of the most popular procedures and make an informed decision that will help the couple experience the thrill of parenthood.
In what cases should you think about artificial insemination?
Assisted reproductive technologies used in medicine are relevant in the case of diagnosed infertility in a woman or her partner, which could not be relieved by drug and surgical therapy. Suspicions of a disappointing diagnosis may arise if a couple of childbearing age has an active and regular sex life without the use of contraceptives, but the desired pregnancy does not occur for one year or more. This period may be extended depending on the age of the partners: for example, women over 35 and men over 40 may need more time to successfully conceive, despite full fertility.
And even after being diagnosed with infertility, you should not despair and consider artificial insemination methods as the only possible option - most of the causes of infertility can be successfully treated with proper therapy. If fertility decreases, not only the woman, but also her partner will have to undergo a thorough examination, because, despite the prevailing stereotype, in approximately 30% of cases the cause of infertility lies precisely in the man, and another 15-20% are due to combined factors, in which an equal contribution Both partners contribute to the emergence of a pathological situation. And only if infertility treatment does not bring the desired result, you will have to think about assisted reproduction.
Fertilization methods: classification and features
Modern approaches to assisted reproductive technologies are not limited to in vitro fertilization - there are many different ways to help desperate spouses have a child, it all depends on the diagnosis, the reasons that caused infertility, and the characteristics of the patient’s medical history. The most common types of ART are:
- artificial insemination;
- various types of IVF, including short and long protocols, using donor material (sperm or eggs), additional manipulations to increase the chance of successful implantation (ixie, pixie, etc.).
Let's take a closer look at each of the proposed methods.
Artificial insemination
This medical procedure is one of the simplest and natural methods assisted reproduction. In this case, the partner’s pre-cleaned and processed ejaculate is injected directly into the woman’s uterus through a thin catheter, which significantly increases the chance of successful fertilization. The high efficiency of the proposed technique in comparison with the natural process is explained by the fact that the seminal fluid does not have to independently overcome the fallopian tubes, and special treatment of sperm before insemination makes it possible to increase the concentration of active germ cells and enrich the seed with nutrients necessary for fertilization.
Artificial insemination can be performed for many reasons, but the most common are:
- pathologies of seminal fluid that are not amenable to drug therapy;
- excretory problems in a man, in which the ejaculate cannot enter the uterus on its own;
- the special structure of the cervix, which impedes the passage of seminal fluid;
- irregular sex life.
If it is difficult to obtain a semen sample for the procedure (for example, with erectile dysfunction or obstruction of the vas deferens), a puncture may be required to obtain the ejaculate. If this procedure turns out to be useless, you can use donor material.
Stages of artificial insemination
As before any serious medical procedure, before artificial insemination, future parents are thoroughly examined for hidden pathologies and contraindications. Both men and women must undergo STI smears and blood tests. In addition, the patient may be prescribed an ultrasound of the pelvic organs, and her partner may have a three-time spermogram.
After eliminating contraindications, the attending physician performs ultrasound monitoring of ovulation, which allows you to determine the most optimal moment for artificial insemination. As soon as the eggs are ready for fertilization, the centrifuged seed is directly introduced into the uterine cavity. If the expectant mother has reproductive problems (for example, lack of ovulation or disrupted hormonal levels), mild pharmacological stimulation may first be required.
The procedure itself is absolutely painless and therefore does not require anesthesia or subsequent hospitalization. It will be possible to evaluate the effectiveness of artificial insemination no earlier than after 14-16 days (using a regular pregnancy test). The result can and should be confirmed in 3-4 weeks using ultrasound.
All about in vitro fertilization
Today, IVF is one of the most effective methods that allows you to cope with diagnosed infertility that is not amenable to either drug or surgical treatment. The process of in vitro fertilization itself implies that conception will be carried out “in vitro,” that is, outside the body of the expectant mother. The standard IVF method includes several key steps:
- hormonal stimulation with pharmaceuticals;
- Ultrasound monitoring to track the process of follicle maturation;
- puncture of a woman’s mature germ cells and obtaining the man’s seminal fluid (by any suitable method);
- artificial fertilization of the obtained eggs with the sperm of a partner (or donor) and cultivation of zygotes;
- transfer of embryos into the uterine cavity;
- hormonal support allowing the embryo to take root;
- diagnostics of the effectiveness of the performed manipulations.
This list can vary significantly depending on the patient’s medical history and condition, so the necessary IVF protocol is determined only by the attending physician after detailed diagnosis and research.
Hormonal stimulation before IVF
Stimulation of ovulation before in vitro fertilization can be carried out using a short or long protocol. The first method is usually recommended for women under 35 years of age for primary transplantation. Short hormone therapy is carried out in relatively small doses of drugs and is less likely to cause adverse reactions, however, is less effective than the long one.
A long protocol significantly increases the number of mature eggs capable of fertilization, allows you to control the ovulation process, and therefore increases the likelihood of successful fertilization. However, a long course of high doses of hormones in this case increases the risk of pituitary complications in the expectant mother. This method is usually prescribed to older patients or women with a history of unsuccessful IVF attempts.
Ultrasound monitoring of ovulation
Ultrasound examination allows you to evaluate the effectiveness of hormonal stimulation, determine the number and degree of ripening of follicles. If a woman’s reproductive system does not respond to hormones (or does not respond sufficiently), the cycle is considered unsuccessful, and the doctor either interrupts the protocol or adjusts the dosage of the drug. If everything goes according to plan, egg puncture is scheduled for artificial insemination.
In vitro fertilization
When the ultrasound shows that the follicles are in the final phase of ripening, the patient undergoes egg aspiration. The procedure itself is slightly painful and therefore requires local anesthesia or general anesthesia. After extracting the follicular fluid, the most promising eggs are released from it, which participate in subsequent fertilization.
At the same time, the man must provide a fresh ejaculate sample required for the procedure. If the husband's sperm is absolutely non-viable, donor material can be used in agreement with both patients.
Fertilization itself is carried out in laboratory conditions using the standard insemination method or using ixie, when the sperm is introduced inside the egg. The resulting zygotes are placed on a nutrient medium and sent to a thermostat for further cultivation. After 3-5 days, the most viable embryos are examined for the absence of various pathologies, after which they are prepared for replanting.
Transfer of the embryo into the uterine cavity
Typically, the time interval between puncture and replantation takes from 2 to 5 days, depending on the speed of development of the embryos and the condition of the expectant mother. To increase the likelihood of success of in vitro fertilization, 2-3 of the most promising embryos are implanted - this is why the chance of multiple pregnancy after IVF is significantly higher than with natural conception.
The process of transferring embryos is carried out using a special catheter that passes through the cervical canal. The procedure is quite simple and usually takes no more than an hour, so the patient can be discharged home the next day. However, for pregnancy to occur after replantation, a woman will need two weeks hormone therapy, which will allow you to maintain the desired phase of the cycle in the body.
The effectiveness of IVF is assessed only after 3-4 weeks using ultrasound, since standard pregnancy tests can give erroneous results due to hormonal therapy.
The choice of one or another method of artificial insemination should be made after a thorough diagnosis of both spouses and in accordance with the recommendations of doctors, however, basic knowledge will allow you to make an informed decision. Only a careful and scrupulous approach will help you overcome infertility and experience true happiness while holding your long-awaited baby in your arms!
