IVF in vitro fertilization procedures and precautions to increase success rates

Fertility infertility is becoming more and more common in modern life. The proportion of couples suffering from infertility is increasing. However, with the progress of science and technology, fertility support measures such as IUI, IVF ... have helped bring hope to many couples. In the article below, let's learn about IVF and IVF procedures.

What is IVF?

IVF (In vitro fertilization) - In vitro fertilization is a method of fertility assistance by fertilizing eggs and sperm outside the body to form embryos. After a period of incubation, the embryo is sent back to the womb's uterus for implantation and pregnancy begins.

IVF is different from IUI (Intra-uterine insemination) in that, when doing IUI, sperm will be put into the uterus at the time of ovulation for fertilization in the uterus, while during IVF, the egg is removed. the mother's body and fertilization are carried out in a laboratory environment, until the embryo becomes a new embryo to the mother's body to develop into a fetus.

The success rate of in vitro fertilization in Viet Nam is 35-40%, which decreases from 2-10% for older women (after age 40). Mother's age is one of the key factors determining the success rate of IVF . The younger the woman is, the better the quantity and quality of eggs. If combined with the husband's healthy sperm, the more good embryos are formed, the higher the chance of successful embryo transfer.

When is IVF needed?

IVF in vitro fertilization performed when the husband and wife registered had one of the following reproductive organ abnormalities:

Clogged two oviduct

Endometrial optimism

Rarely of unknown origin, injecting sperm into the uterus several times but fails

Few, weak, retrograde or non-ejaculating sperm, spermatogenesis

Post urethral rupture due to a rupture of the pelvis

Please eggs

IVF in vitro fertilization process

Reproductive physical exam is the first step in the IVF process

This is the first step in the IVF process. The couple will have a reproductive health check and do some specialized tests, specifically:

Gynecological (female) and testicular ultrasound (male): detect uterine fibroids, ovarian cysts, polycystic ovaries ... or other abnormalities in the genital organs of the couple; The wife also needs an ultrasound to count the basal follicles on the 2 ovaries on the first day of the menstrual cycle.

Endocrine tests: Quantify levels of sex hormones (estrogen, progesterone, ...) and gonadotropic hormones (LH, FSH).

Semen map of the husband to check and evaluate the number and quality of current sperm: sperm low, weak sperm, abnormal or non-sperm.

Blood test for sexually transmitted diseases such as syphilis, HIV, hepatitis B in both husband and wife.

In case the husband does not have sperm, some other tests will be additionally conducted such as sex hormone quantification, an ultrasound of the scrotum ...

Click the eggs

On day 2 of the menstrual cycle, if the wife is healthy enough to perform, the doctor will start to stimulate the ovaries according to the appropriate regimen. The wife may be prescribed an oral / oral stimulant or both, depending on the specific regimen and condition.

The duration of use of stimulants ranges from 10-12 days. During ovarian stimulation, the doctor will monitor the follicle through ultrasound and blood tests to adjust the dose of the drug accordingly.

When the number of follicles is enough, the doctor will administer the last injection to stimulate mature eggs (the nose stimulates ovulation), this nose needs to be injected on time.

Ovarian stimulation will make the ovaries bigger, causing a feeling of heaviness in the lower abdomen, 2 tense breasts and possibly nausea. However, these sensations only happen in the last 2-3 days of the ovarian stimulation process and will quickly disappear after aspiration.

Long-term use of stimulants can cause ovarian failure. If the 3-6 months of stimulant treatment is not effective, couples should pause for a while to allow the ovaries to rest for a few cycles before doing it again.

Ovulation is an important step in the IVF procedure

Within 24 - 36 hours after the injection of ovulation, the egg will be poked from the wife's body for fertilization in the laboratory. Before performing, the wife should note to abstain from sex for 3-5 days; do not use beer, alcohol and stimulants; abstain from eating and drinking at least 6 hours before puncture; do not use makeup, perfumes, or scented cosmetics; do not wear jewelry; Remove nail polish, toenail (if any) because chemical odor can cause toxicity to embryos, ovules and eggs.

During the procedure, the wife is under local anesthesia so she will not feel any pain. The steps to pull eggs are as follows:

The entire vagina and the area around the external genitals are cleaned by rinsing with sterile water.

Insert the ultrasound probe into the vagina, identify the ovaries and mature oocytes, count the follicle count, and the probe's accessibility to the ovaries.

Attach the needle to the syringe (or aspirator), and rinse the needle and syringe with the culture medium. Proceed to poke and suck all follicle fluid containing eggs, transfer to the laboratory.

Check back to make sure there is no internal bleeding. The vaginal area is cleaned again, the speculum is removed and the procedure is complete.

Note after pulling eggs

After poking the eggs, the wife needs to remember not to drive herself or do heavy work; avoid vigorous activity; do not use alcoholic beverages; do not have sex or soak in water to help the vagina quickly recover completely.

If there are unusual manifestations such as nausea, vomiting, diarrhea, shortness of breath, excessive bleeding, burning pain when urinating, difficulty urinating, fever, bloating, you should immediately contact the medical facility for assistance. .

At the same time, the husband will either have to take the sperm to prepare the embryo transplant or to sample the frozen sperm that has been frozen before. If infertility is caused by male factors such as lack of sperm, immobilization / deformity, low sperm count, surgical techniques for spermatogenesis and laser sperm selection or A magnetic field is applied to get the best sperm quality.

Embryogenesis is the next step in the IVF process

Eggs and sperm are transferred to the laboratory for fertilization and embryogenesis. The embryo will be cultured outside for 2-5 days.

If embryos are transferred immediately after embryogenesis, this is called fresh embryo transfer. In case the wife is not healthy enough to transfer fresh embryos, all qualified embryos will be frozen and the wife will be transferred to the next cycle.

During this time, the wife takes oral and vaginal medications in preparation for the transfer of the embryo.

Transfer of embryos

Embryo transfer is the next step in the IVF procedure, after unifying the number of transferred embryos, the strongest embryos are put into the uterus to prepare for implantation and develop into a fetus when the uterine lining meets conditions. for embryo to nest and develop.

The embryo transfer procedure is relatively gentle, the doctor uses an exposing device to reveal the cervix and inserts the embryo into the uterus through a tiny soft catheter in order not to damage the uterine lining. When transferring embryos, the wife must abstain from urination.

 

Transfer of embryos takes about 5 minutes or more if the mother's cervical position is abnormal. After the transfer of the embryo, the wife will be prescribed medications to support the development of the fetus. If transferring frozen embryos, the woman has an ultrasound and a mucosal monitoring drug from day 2 of the next menstrual cycle for 14-18 days, then the doctor chooses the right time to transfer the embryo.

Pregnancy test

After 2 weeks of embryo transfer, the mother is assigned a blood test to check the beta HCG levels . If the beta HCG level is> 25 IU / l, it is determined to be pregnant, depending on the person whether this level is high or low.

This concentration increases by a half or more after 2 days, it is defined as a developing fetus and continues to administer the fetal medicine until the day of ultrasound to identify the fetal sac and cardiac fetus.

If results do not increase or decrease after 2 days, continue monitoring. In the case of a biochemical pregnancy, the beta HCG concentration returned to a negative (<5 IU / l).

In the case of not pregnant but still storing embryos, the wife will continue to use the stored embryo to transfer into the uterus in the next cycle without having to repeat the steps of stimulating eggs, pulling eggs.

Epilogue

In vitro fertilization is a lengthy process and requires a lot of preparation before performing both financial, health and psychological. The total cost for an IVF case is about 70-100 million VND.

Some hospitals that have performed IVF with high success rates today can be referenced by parents including: Post Hospital (about 75 million), Tu Du Hospital (about 60 million), Tam Anh Hospital (about 90). million), Hong Ngoc Hospital (about 170 million), Vinmec International Hospital (about 100 million)… This is a reference cost and may vary depending on the case.

Although the fertility method has a high success rate, couples should also be mentally prepared for the possible failure in the first time.

The above article partly explains the IVF process for couples who are looking for a child. Determine that it will be a more difficult journey than usual, but just thinking about holding your baby in your arms, every parent will surely be motivated to do it.

see more

IVF conception after 40 years old - Reduce birth defects for babies!

Correct understanding of infertility - A worry of modern couples

Few eggs when making IVF capable of pregnancy?