For more than twenty years, couples who have problems conceiving and having a baby have had a chance in the form of an in vitro fertilization program. Of course, at the moment this is a rather expensive procedure, the result of which does not always meet the expectations of patients, but still this is a chance for those who want their child genetically. Cultivation of embryos makes it possible to select only the most viable ones, as well as to exclude some gene diseases.
Terminology
In vitro fertilization is a branch of reproductive technologies that involves the fertilization of the mother's egg outside the uterus and the implantation of the finished embryo for a period of five to seven days.
Cultivation of embryos is the maintenance of the development and vital activity of human embryos before transplanting them into the uterine cavity.
IVF stages
The artificial insemination procedure consists of several successive steps or steps:
1. Stimulation of superovulation, in parallel with the monitoring of folliculogenesis andgrowth of the endometrium.
2. Follicle puncture.
3. Ovum fertilization and in vitro embryo culture.
4. Artificial maintenance of the luteal phase of the menstrual cycle.5. Embryo transfer and pregnancy diagnostics.
For young women IVF without superovulation is possible.
Indications and contraindications for IVF
Recommendation for this medical manipulation is the presence of infertility in a woman who is not usually amenable to therapy, provided that IVF gives the highest probability of conception.
Contraindications also include:
- extragenital pathologies that threaten abortion;
- malformations and deformities of the uterus;
- neoplasms of the uterus and ovaries;
- acute inflammatory diseases (not only of the reproductive system); - history of oncology.
Preparation for the IVF method
The first stage is the collection of analyzes and the identification of pathologies. To do this, the patient needs to take a blood test for sex hormones, as well as detailed general tests for biochemistry and glucose tolerance. A comprehensive check for urogenital infections and an ultrasound examination of the internal reproductive organs are being carried out.
The partner is obliged to do a spermogram to make sure there is no male infertility. It is necessary to take a smear for cytology and colposcopy in order to exclude precancerous conditions. Expectant mother being tested for TORCH infection(rubella, toxoplasmosis, herpes, cytomegalovirus and chlamydia), as this may affect the development of the unborn fetus. At the end, an ultrasound of the mammary glands and thyroid gland is performed.
The second stage is carried out immediately before the start of treatment. It consists of three points:
- spouses must pass tests for HIV, viral hepatitis, syphilis, get the results of their blood type and Rh factor;
- a woman needs to be tested for blood sugar, general analysis blood, urine and biochemistry, as well as to know the clotting time;- the expectant mother must have a therapist's conclusion that there are no contraindications to pregnancy.
IVF procedure
First, the doctor, after all the necessary tests, stimulates the woman's ovaries in order to obtain several he althy eggs. The introduction of drugs begins on the 21st day of the menstrual cycle, and lasts a whole month. During this time, the doctor constantly monitors how the follicle matures and the endometrium grows in the uterine cavity using ultrasound. And also, women are tested for hormones in order to see the whole picture. As soon as the eggs mature, the procedure for their removal is carried out on an outpatient basis. However, some factors can interfere with this process:
- lack of ovarian response to stimulation;
- presence of adhesions in the pelvic cavity;
- premature ovulation;- anovulatory cycle (when mature follicles do not contain an egg). All these features must be taken into account beforeencourage the couple to start IVF.
As soon as the future father or an anonymous donor donate their genetic material, you can carry out the fertilization procedure. Long-term cultivation of embryos in vitro is necessary in order to select the most viable embryos. Five or six days after fertilization, several embryos are placed in the mother's uterus. Two weeks later, the mother-to-be has a blood test for human chorionic gonadotropin (hCG) to determine pregnancy.
Long-term embryo culture
Most often, patients who seek such specific medical care have many questions. One of them sounds something like this: “Cultivation of gametes and embryos, what is it?”, The answer is quite simple and complex at the same time. This is a method by which the fetus remains alive until it is placed in the mother's body. Long-term cultivation of embryos in vitro is an expensive, high-tech procedure that requires specific knowledge and skills. Modern laboratories are constantly improving in fertilization techniques and equipment. The latest novelty is the cultivation of embryos in the EmbryoGen medium. Additional growth factors provide a high probability of implantation of the embryo in the uterine wall.
Previously, cultured embryos were born only to the cleavage stage and placed in the uterus as early as three days after "conception", but they took root in only a quarter of all IVF cases. But after the development of the cultivation methodembryos in vitro up to the blastocyst stage, the effectiveness of the method has increased. This required new growth media and incubators.
Pros and cons of the procedure
This procedure takes the cultivation of embryos to a new level.
- Helps to select the most promising embryos in terms of implantation.
- Chromosomal abnormalities are decreasing as they can be detected and prevented at the blastocyst stage.
- Has a more physiological approach.
- The risk of multiple pregnancy is reduced because only two embryos are needed, instead of five, as before, to get pregnant.
- Ectopic pregnancy is much less common than before.
However, there are also disadvantages of this procedure. The first is that not all embryos can grow to the required stage. Still, incubation systems and nutrient media still need to be improved, bringing them as close as possible to natural conditions. And if fewer than four embryos survive, then the likelihood that they will be ready for replanting is extremely small. The second disadvantage, as in previous versions of IVF, is the lack of a 100% guarantee of success. Not a single fertility doctor in the world will undertake to declare that this method is true in the last instance. Scientists still have something to strive for.
IVF side effects
Undesirable effects after IVF, during which long-term embryo culture is used, include:
- multiple pregnancy, sinceseveral embryos are implanted at once;
- ectopic pregnancy (movement of the embryo inside the uterus cannot be ruled out);
- excessive ovarian stimulation (ovarian hyperstimulation syndrome leads to infertility);- infections and bleeding.
