Everything you need to know about IVF
The first person to be born through IVF is now 44 years old – she is healthy and leads a happy life in England. Every year, thanks to the IVF procedure, several tens of thousands of children are born. This is a real salvation for people with problems of the reproductive system. However, there are many myths around this topic, and the procedure itself seems very complicated. Let’s figure it out together with an expert reproductive specialist.
Shamugiya Nato Livterovna answers questions about IVF — Candidate of Medical Sciences, Associate Professor of the Department of Obstetrics and Gynecology of the Russian Medical Academy of Continuing Professional Education, Head of the GMS Clinic Women’s Health Center, Leading Reproductologist, Obstetrician-Gynecologist, Ultrasound Diagnostics Doctor. Work experience as a reproductive specialist – 22 years.
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When to think about going to a doctor’s consultation on IVF issues?
If you are under 35 and have not become pregnant within a year of regular sexual activity, this is a reason to see a doctor. If you are over 35 years old, make an appointment with a specialist after 6 months of fruitless but regular sex life. Another indication for ART is absolute infertility, that is, changes in the genitals that exclude pregnancy. For example, the absence of the uterus, ovaries, obstruction of both fallopian tubes, azoospermia.
Is ART given to single women?
A man and a woman – married or not – have the right to use assisted reproductive technologies in the presence of mutual informed voluntary consent to medical intervention. Sometimes single women with no reproductive health problems are prescribed artificial insemination.
Insemination is when donor sperm is injected into the cervical canal or uterus.
Can IVF be done for free?
It is possible to conduct IVF at the expense of compulsory medical insurance (CHI). At the same time, the couple can independently choose a clinic for procedures from the proposed list.
Free of charge under the CHI policy:
- ovarian stimulation, including necessary drugs prescribed by a doctor;
- monitoring the growth of follicles and endometrium;
- puncture of follicles, anesthesia allowance (protection from unforeseen situations during the operation);
- fertilization of oocytes, including the ICSI method, and cultivation of embryos (obtaining and growing embryos in artificial conditions);
- transfer of embryos into the uterine cavity;
- cryopreservation of embryos.
The CHI program does not cover ART with donor oocytes (eggs) and surrogate programs.
What determines the success of IVF?
The success of IVF depends on many factors: age, the cause of infertility, concomitant gynecological or somatic pathology, etc. However, the main determining factor is the woman’s age, since the quality of the oocyte and the embryo as a whole depends on it.
The success of embryo implantation also depends on the quality of the endometrium (the inner lining of the uterine cavity). Its improvement plays a separate role in the IVF cycle before transfer: with the help of hormonal preparations, optimal conditions are created for embryo implantation and its further development.
Pregnancy is diagnosed 12-14 days after the transfer by the content of the hCG hormone in the blood and 3-4 weeks after the transfer – by ultrasound.
Preparation for IVF
What tests to bring with you to the first consultation with a reproductologist?
At the first appointment, it is advisable to take a blood test for hormones and spermogram with you. Further, the doctor may prescribe additional examinations. These are MRI of various organs, ultrasound, examination of the uterine cavity, etc.
Do couples or single women need to undergo therapy before IVF, change their lifestyle?
Before IVF, you need to get rid of bad habits 2-3 months before, lead a healthy lifestyle: eat a balanced diet, sleep at least 7-8 hours, move more during the day and allocate 30-60 minutes for exercise at least three times a week .
How is IVF
What are the stages of the ART cycle?
First, ovarian stimulation is carried out in order to obtain as many mature eggs as possible. The reproductive specialist selects IVF protocols individually for each patient. ART is also possible in a natural cycle without drug-induced superovulation.
When the eggs are mature, they are removed from the ovarian follicles. Then they are artificially fertilized in laboratory conditions in a test tube (in vitro).
Embryos develop from fertilized cells. They grow 5-7 days in “test tubes”. After that, they are transferred to the uterus or cryopreserved – stored in liquid nitrogen at a temperature of -196 ° C. This temperature allows you to stop all biochemical processes in cells, while maintaining their ability to divide after defrosting. Used when the patient wants to store embryos for future pregnancy.
How exactly are eggs obtained?
The sampling of oocytes is carried out with intravenous anesthesia and under the control of an ultrasound machine. Through the vault of the vagina, an injection is made into the ovary using a special needle. Then the follicular fluid is taken – the reproductologist will give it to the embryologist so that he can find the oocyte under a microscope.
What is done next with the received oocytes?
The eggs are cleaned from the environment with the help of special enzymes and fertilized with the sperm of a partner or donor, or cryopreserved.
When and how does the embryo transfer take place?
The transfer of a fresh embryo is carried out in the cycle of ovarian stimulation on the third, more often on the fifth day of its development. Or they transfer a thawed embryo in a natural cycle after ovulation. The procedure is painless, even anesthesia is not required.
If multiple embryos are fertilized in the lab, how are they treated?
In this case, the embryos are cryopreserved. By law, only one or two embryos can be transferred at a time. The decision on a larger number is made by the patient after the doctor explains all the risks associated with such a procedure: miscarriage, premature birth, low survival, high probability of disability in premature babies.
Does the embryo always take root?
Unfortunately no. It depends on the age of the patient, the thickness and structure of the endometrium.
Who and why is preimplantation diagnosis prescribed?
The decision to prescribe preimplantation genetic testing (PGT) is voluntary and is carried out only with the consent of the patients after consultation with a gynecologist and geneticist.
With the help of testing, it is possible to identify an altered number of chromosomes, monogenic diseases (mutations of individual genes) and chromosomal structural rearrangements.
Usually, PGT-A is recommended for women over 35 years of age. Also indications are repeated unsuccessful attempts to transfer embryos or miscarriages. Be sure to prescribe genetic testing to carriers of chromosomal abnormalities, gene mutations and families that have a child with genetic abnormalities.
How long does one IVF cycle take?
One ART cycle takes 14-19 days.
If the embryo has taken root, pregnancy has come – what’s next?
Observation by an obstetrician-gynecologist, taking drugs to maintain pregnancy for 8-12 weeks.