IVF-In vitro Fertilization
An auxiliary reproductive therapeutic technique in which an egg is fertilized by a sperm in the laboratory.
Usually the method consists of 3 main stages:
- ovulation induction ( ovarian stimulation)
- obtaining eggs, fertilizing them and growing embryos at an early stage;
- transfer of embryos into the uterine cavity.
IVF or in vitro fertilization is considered the standard method of assisted fertilization. Its essence lies in the fact that we create conditions for the contact of one egg and more than 100 thousand spermatozoa and expect the onset of fertilization.
Before the advent of ICSI, this was the only method of IVF (in vitro fertilization).
Currently, this method is almost not used in the classical form.
The process of introducing spermatozoa into the cytoplasm of an egg using microinjections.
The selection of spermatozoa is carried out under a microscope with a 400 - fold magnification. By far the most commonly used method of assisted fertilization.
Selection of spermatozoa using a special magnification up to 8000 times.
Under such an increase, the shortcomings of spermatozoa are noticeable, which cannot be seen in a conventional microscope, despite the obvious theoretical and clinical justifications of this method, there is no unambiguous evidence of a higher efficiency of IMSI cycles compared to ICSI cycles.
Thus, the use of IMSI is more often recommended in cases of severe teratospermia with proven fragmentation of sperm DNA.
When is assisted fertilization recommended?
Male and female infertility is a problem that is relevant not only in Ukraine, but also around the world.
If pregnancy does not occur during 12 months of regular sexual life without contraception, we advise you to contact a specialist and start an examination. Patients older than 36 years should seek the advice of a reproductive doctor after 6 months of unsuccessful attempts to get pregnant.
The causes of infertility can be health problems in both women and men.
So, infertility in women can be a consequence of the following problems:
- absence or obstruction of the fallopian tubes,
- anomalies of the development of female genital organs,
- benign tumors of the uterus,
- ovulation disorders,
- inflammatory diseases after infections or incorrectly performed abortions,
- various metabolic disorders (obesity, diabetes mellitus, thyroid dysfunction, etc.),
- the age of the woman (after 36 years).
In men, the most common causes of infertility are a pronounced decrease in the number of active spermatozoa or their absence.
How are the ovaries stimulated?
In a normal cycle, growth begins with 10 -15 follicles, but only 1 of them matures, and the egg ovulates. The remaining follicles regress, and the eggs that are in them die.
In the assisted fertilization program, our goal is to allow several eggs to mature at once. This increases your chances of successful treatment.
To induce ovulation in the IVF cycle, we use preparations of analogues of your own controlled hormones - follicle-stimulating (FSH) and luteinizing (LH). These substances are involved in the natural process of ovulation.
The drugs are administered subcutaneously and less often intramuscularly, you can do the injections yourself at home, or at our clinic.
Ovulation induction lasts from 8 to 12 days. Under the control of ultrasound, we monitor the growth of follicles and, if necessary, monitor the level of blood hormones.
In total, during the stimulation, you will visit the clinic 3-4 times.
When are spermatozoa needed?
In most cases, the partner's sperm is used for auxiliary fertilization. Less often, the donor's sperm is used if all the requirements of the law are met and the selection is based on the results of the patient's requests.
Seminal fluid is obtained by masturbation on the day of collecting oocytes of the egg. Cryopreserved sperm can also be used if necessary.
When using donor sperm, its samples are always frozen.
Less often, the method of collecting sperm is used-aspiration (TESA) or biopsy (TESE) of testicular tissue. Both of these technologies are used in the case of a complete absence of spermatozoa in the ejaculate.
How are eggs collected?
Eggs are obtained by puncture of the ovaries, which is carried out under the control of ultrasound.
This is a simple intervention that is performed under anesthesia. The woman does not experience any pain. At the same time, there are no aftereffects and effects that characterize a longer use of anesthesia. Since this is an outpatient procedure, the patient will be able to go home after collecting eggs in 1.5 - 2 hours.
What happens to the egg between fertilization and transfer to the uterus?
After fertilization of eggs, we observe their development in the conditions of an embryological laboratory.
All this time, embryos and eggs are stored in special incubators that mimic the natural conditions of the uterine cavity and create ideal conditions for the development of embryos.
After 18-20 hours, we control the onset of fertilization. Every day, the development of each embryo is observed until day 5, when the transfer of embryos into the uterine cavity is carried out.
This long cultivation of up to 5 days allows us to select the embryos (blastocysts) with the greatest implantation ability, respectively increasing the chances of pregnancy.