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IVF - In vitro fertilization
An assisted reproductive treatment technique in which an egg is fertilized by a sperm in the laboratory.
Usually the methodology consists of 3 main stages:
- induction of ovulation (ovarian stimulation);
- obtaining eggs, their fertilization 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 sperm and expect fertilization to occur.
Before the advent of ICSI, it was the only way of IVF (in vitro fertilization).
Currently, this method is almost not used in the classical form. -
ICSI
The process of introducing sperm into the cytoplasm of the egg by microinjection.
Sperm selection is carried out under a microscope with 400x magnification. By far the most commonly used method of assisted fertilization. -
IMSI
Sperm selection using special magnification up to 8,000 times.
Under such magnification, sperm defects that cannot be seen in a conventional microscope become visible, despite the obvious theoretical and clinical justification of this method, there is no unequivocal evidence of 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 sperm DNA fragmentation.
When is assisted insemination recommended?
Male and female infertility is a problem that is relevant not only in Ukraine but all over the world.
If during 12 months of regular sexual life without contraception, pregnancy does not occur, we advise you to consult a specialist and start the examination.
Пацієнткам віком від 36 років слід проконсультуватися з репродуктологом після 6 місяців безуспішних спроб завагітніти.
The causes of infertility can be health problems in both women and men.
Thus, infertility in women can be the result of such problems:
- absence or obstruction of the fallopian tubes,
- anomalies in the development of female genitalia,
- benign uterine tumors,
- endometriosis;
- ovulation disorders,
- inflammatory diseases after infections or incorrectly performed abortions,
- various metabolic disorders (obesity, diabetes, thyroid dysfunction, etc.),
- age of the woman (after 36 years).
In men, a common cause of infertility is a pronounced decrease in the number of active sperm 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 rest of the follicles regress and the eggs 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 hormone (FSH) and luteinizing hormone (LH). These substances are involved in the natural process of ovulation.
The drugs are injected subcutaneously and less often intramuscularly, you can make injections yourself at home or in our clinic.
Ovulation induction lasts from 8 to 12 days. Under ultrasound control, we monitor the growth of follicles and, if necessary, control the level of blood hormones.
In total, during the stimulation, you will visit the clinic 3 - 4 times.
When do you need sperm?
In assisted insemination, in most cases, the partner's sperm is used. Less often, donor sperm is used in compliance with all legal requirements and selection based on the results of the patient's requests.
Semen is obtained by masturbation on the day of egg oocyte collection. Cryopreserved sperm can also be used if necessary.
In case of using donor sperm, its samples are always frozen.
Less commonly, the method of sperm collection is aspiration (TESA) or biopsy (TESE) of testicular tissue. Both of these technologies are used in case of complete absence of sperm in the ejaculate.
How are eggs collected?
Eggs are obtained during an ovarian puncture, which is carried out under the control of ultrasound.
This is a simple intervention that is performed under anesthesia. The woman does not feel 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 can go home in 1.5 - 2 hours after egg collection.
What happens to the egg between fertilization and transfer to the uterus?
After fertilization of eggs, we observe their development in the embryological laboratory.
All this time, the resulting embryos are stored in special incubators that simulate the natural conditions of the uterine cavity and create ideal conditions for their development.
After 18 - 20 hours we control the onset of fertilization. Every day, the development of each embryo is observed until day 5, when the embryos are transferred to the uterine cavity.
This long cultivation of up to 5 days allows us to select embryos (blastocysts) with the greatest ability to implant, thus increasing the chances of pregnancy.
