The procedure of “in vitro fertilization” is the taking of mature eggs from a woman, fertilized by sperm in a special petrium panic in the laboratory and transfer of the resulted embryosback to the woman’s uterus 2-5 days after fertilization. This procedure is the choice of treatment for patients with damaged, obstructed or missing fallopian tubes. In addition, IVF applies to cases of sterility with unexplained origin, endometriosis, pelvic-inflammatory disease, early reduction of ovarian reserve (causing infertility), immunological factors, disorders in ovulation and mild to moderate forms in male infertility.
About 25-35% of women, who are undergoing in vitro fertilization, get pregnant – the probability of success of the procedure varies from 0 to 70% , which depends on factors such as age, cause of infertility and the team doing the procedure.
The IVF procedure can lead to physical and emotional stress, but the stress and anxiety can be reduced if the patients are well informed about the procedure.
In vitro fertilization involves the following steps :
First visit:
At your first visit, the doctor creates a plan for IVF treatment and the patients sign a form for informed agreement. During the examination, the size and shape are determined. This will help the treating physician to understand better where to put the embryos in the day of the embryotransfer. Before starting the IVF cycle it is neccessary for the partner to release semen liquid for analysis. If donor sperm is used, the donor is picked at this stage.
Ovarian stimulation:
The doctor discusses with the patients which stimulation protocol is most appropriate for them. Medicine for ovary stimulation is being prescribed, with the purpose of forming the optimal number of eggs – the treating physician will follow this process through ultrasound examinations and full tests for the study of horomons. Patients usually receive medications known as gonadotropin-releasing hormone agonist (Dесарерtуl) or gonadotropin-releasing hormone antagonist (Оrgаlutrаn, Сеntrоtіdе) – these drugs prevent the premature development and separation of ova from the ovaries during stimulation of the IVF procedure.
After that, medications known as gonadotropins are prescribed (Рurеgоn, Gоnаl-F, Меnоgоn), which stimulate the ovaries, with the purpose of forming the optimal number of eggs. Gonadotropins care used in the form of injections, injected in the stomach, in the upper arm or thigh. The treating physician determines the most appropriate dose for the patient and informs him about the possible risks, side effects, as well as the benefits of it.
Eggplantation:
The follicular puncture is performed under the influence of analgesic drugs. The procedure usually lasts about 30 minutes, depending on the number of follicles. When aspiration of ovaries it is used transvaginal ultrasound device, to which it is added special guide with a long thin needle. With this needle the fluid from the follicle is absorbed, which then is examined under a microsope for presence of eggs. The isolated eggs are transferred to the incubator, which supports the necessary temperature and conditions for fertilization and further development of embryos.
After the follicular puncture, patients stay for about 2 hours in the recovery room. The manipulation does not require hospitalization.
Inseminationa and egg fertilization:
In the day of the follicular punction, the partner excretes semen fluid, needed for the egg fertilization. Sexual abstinence of 3-5 days is recommended. The semen is subjected to special treatment and about 4-6 hours the egg is inseminated. On the next day, the eggs are evaluated for fertilization, the presence of 2 pronucleus is required. In one of them, the genetic material of the egg is stored, in the other one – the genetic material of the sperm.
