In vitro fertilization: What is IVF pregnancy in vitro
In recent years, more and more talk about IVF or In vitro fertilization. What lies behind this word? For some, this is the last hope to acquire offspring, and someone, considering that there is the fashion in medicine, wants to get pregnant using the latest technologies
What is In vitro fertilization
IVF, or in vitro fertilization, is the fertilization of an egg in vitro (in vitro) with subsequent cultivation (cultivation) and transplantation (transfer) of the embryo into the uterus.
The first successful IVF attempt was carried out in 1978 in England. In our time, this method has become so widespread that the number of children born and the result of IVF, have long ceased to count.
What are the indications for in vitro fertilization?
IVF is a treatment for infertility. At the same time, tubal infertility is an absolute indication for in vitro fertilization, that is, cases in which the fallopian tubes are broken and there is no possibility to restore it (this happens, for example, if there are adhesions after inflammatory diseases of the abdominal cavity or no uterine tube after ectopic pregnancy). This method is also used in immunological infertility when a woman produces antibodies that destroy the spermatozoa of this sexual partner. The above indications relate to female infertility, but IVF is also used to treat male infertility in cases where there is not enough sperm produced or enough sperm contains an insufficient amount of sperm.
It should be emphasized that in vitro fertilization is the last link in the sometimes very long chain of diagnostic and therapeutic procedures for infertility.
Another indication for in vitro fertilization is hereditary diseases, such as cystic fibrosis, hemophilia, when future parents and doctors want to protect children from these diseases. In these cases, donor material is used (eggs or spermatozoa).
Is it possible to use new reproductive technologies, including IVF, for women who do not suffer from infertility?
Theoretically possible. But IVF is a serious procedure, and it is worth resorting to it only for serious medical reasons. Thus, in the group of patients after IVF, the percentage of pregnancy complications is higher than in the group of patients with a naturally occurring pregnancy; these patients have more problems with the embryo nidation (attachment) to the wall of the uterus, premature termination of pregnancy, ectopic pregnancy, and other complications. But since IVF is the last stage of infertility treatment, complications are more often associated with the general health of the patient than with a lack of reproductive technology. However, if the infertile couples IVF gives a chance to experience the happiness of parenting, then in the absence of indications for in vitro fertilization should not resort to this complex set of medical procedures and manipulations.
How long is the preparatory stage before in vitro fertilization?
The very process of examination and treatment in the IVF cycle takes 1.5-2 months – until the ascertainment of the presence or absence of the fact of pregnancy. In the course of the examination, before in vitro fertilization, a woman is usually given an ultrasound examination, blood tests for hormones, tests for AIDS, hepatitis, syphilis, and a man – sperm If necessary, genetic analyzes are performed. This scheme is valid for the surveyed couples who have established the cause of infertility and have already been treated.
In previously unexamined families who first applied for infertility, the preparation time depends on the initial state of health and the underlying disease of sexual partners. Sometimes it is necessary to preliminarily perform certain therapeutic measures and operations, for example, correction of hormonal background, treatment of sexually transmitted infections (chlamydia, mycoplasmosis, toxoplasmosis, genital herpes, etc.), dissection of adhesions in the uterus, which takes a lot of time – up to several months.
What are the stages of in vitro fertilization?
The first stage of in vitro fertilization is the stimulation of ovulation. After the examination, women are prescribed hormonal drugs that stimulate the maturation of not one – two eggs, but several. This greatly increases the possibility of seizure and fertilization of the egg. In addition, it is noted that during the transplantation of several fertilized eggs, pregnancy develops more often, and one embryo develops, that is, for extracorporeal fertilization, it is necessary to have some stock of embryos. The duration of the introduction of hormonal drugs to stimulate ovulation is usually 2 weeks. At present, recombinant preparations obtained by genetic engineering are used to stimulate ovulation; they have advantages over previously used drugs obtained from the urine of women of the menopausal period. Such drugs caused allergic diseases, their use is unlikely, but infectious complications are possible.
A complication of this stage of in vitro fertilization may be ovarian hyperstimulation syndrome. This condition is manifested by abdominal pain, bloating. With the timely diagnosis, the syndrome is amenable to correction and does not affect the possibility of pregnancy.
With a certain number and size of follicles 1 thickness of the inner layer of the uterus, the level of blood hormones proceeds to the next stage of in vitro fertilization – puncture 2 follicles and egg collection. This small operation is performed on an outpatient basis for one day. This is the only procedure during in vitro fertilization that requires anesthesia. Short-term intravenous anesthesia is most commonly used. Puncture of the ovary is performed with a needle through the vagina under the control of ultrasound; as a result, several eggs are produced. After this procedure, there are no complications.
The connection of the egg with the sperm is carried out by embryologists in a special embryology laboratory. After 2-4 days, the embryos are ready for transfer to the uterus. Embryo transfer into the uterus is the simplest and most painless procedure that is performed using a special catheter. After embryo transfer, one should not be subjected to physical and emotional stress, therefore a sick leave may be issued for the period following in vitro fertilization. The remaining embryos are subjected to cryopreservation (freezing), and you can save the egg with sperm. If an in vitro fertilization attempt is unsuccessful, the previously obtained material can be used next time.
After the embryo has been inserted into the uterine cavity, the woman is injected with drugs that help preserve the pregnancy and prevent egg rejection. This therapy is carried out before the statement of the fact of pregnancy, and in case of failure, until the next menstruation.
What are the problems associated with pregnancy, after in vitro fertilization?
The main problem that occurs after IVF is multiple pregnancies. Often twins are born, rarely triplets. In cases of multiple pregnancies, at the request of the woman, as well as for medical reasons, it is possible to carry out the reduction of embryos, as a result of which one or two fetuses remain.
It should be noted that in vitro fertilization is not always successful. Thus, on average, pregnancy occurs in 30 cases out of 100, with only 24 out of 100 attempts at in vitro fertilization ending in childbirth. In the world practice of IVF, the frequency of labor is always lower than the frequency of pregnancy. That is, on average, 6% of the pregnancies that end up end prematurely.
Complications may occur in the future during pregnancy; This is related to the fact that in vitro fertilization is one of the methods of infertility treatment, that is, it is used in women with genital and extragenital pathology, which causes the most frequent complications of pregnancy in the group of IVF patients.
How are childbirth in patients after IVF?
Theoretically, the method of fertilization does not affect the course of labor, but in vitro fertilization performed by women after many years of infertility, especially if this is not the first IVF attempt, is a relative indication for a cesarean section. That is, if in addition to the method of fertilization, nothing more aggravates the condition of the woman, then the birth is carried out through the birth canal; if there are any other pathologies on the part of the mother and the fetus or during childbirth complications arise, then the childbirth ends with a cesarean section
Are children born after conception by the IVF method different from children conceived in the “usual” way?
Embryos obtained by in vitro fertilization undergo so-called pre-implant preparation. This research, possible thanks to the achievements of modern genetic technologies, is carried out before the embryo is transferred into the uterine cavity. It allows you to identify gross malformations, chromosomal diseases, such as Down syndrome; You can determine the sex of the child. Thus, even before getting into the uterine cavity, the baby is insured against genetic diseases.
As is known, the abilities and skills of children are determined not only by the genetic material received by the child from the parents but also by the extent to which the parents strive to develop the abilities of the baby.
Since children born after IVF, as a rule, are long-awaited, parents often over-care for the baby, doing everything possible to bring up and educate their long-awaited children. Probably, this is what determines the fact that children after IVF usually show good results in school.
What would you like to wish our readers?
I would like to wish them good health and remind you that all health problems need to be addressed in a timely manner. A gynecologist should be visited not only when signs of disease appear, but also prophylactically – at least once a year. Then they will be able to avoid the need for such a fairly complex multi-step procedure such as in vitro fertilization, and if there are indications for IVF, the results will be most favorable.