In-vitro-fertilization is a procedure prescribed to couples who have difficulty with conceiving. The high-tech method consists of many stages. Its essence lies in the retrieval of the egg from the woman’s ovary and the fertilization of the oocyte with the sperm of the sexual partner. In the result of such manipulations, a viable embryo is formed, which is then implanted into the uterine cavity. IVF is indicated for many diseases of the reproductive system: tubal obstruction, anovulation, polycystic ovarian syndrome, structural disorders of the genital organs, etc. The procedure is performed step by step, observing each stage of the technology of artificial insemination.


The specialists of the reproductive health clinic “ECO” have achieved tremendous results in the treatment of female and male infertility. Doctors use the standard method of in vitro fertilization, ICSI, intrauterine insemination, donation of oocytes or sperm, as well as surrogacy. Treatment is selected individually after undergoing laboratory, functional and instrumental examinations. As a result of the manipulations, the couple may have a long-awaited and healthy baby.


REASONS FOR IVF

In vitro fertilization is indicated in case of female or male infertility. It is diagnosed if a patient who cannot become pregnant after the 1 year of an active sex life without contraceptives. In 60% of cases, infertility is caused by the female factor, in the remaining 40% - by the male factor.


IVF method can be performed with:


endocrine infertility - caused by hormonal imbalance, leads to disruption of the maturation process and the further release of the egg into the fallopian tube;

tubal-peritoneal pathologies - these can be adhesions that cause obstruction of the fallopian tubes, deformation of the uterus, etc.

immunological infertility - in this condition, the woman's body contains antisperm antibodies that prevent the conception of a child (lead to the death of viable sperm cells);

age-related changes - IVF is indicated for patients after 40 years of age who have a reduction in ovarian reserve and ovarian exhaustion;

endometriosis is a disease of the functional layer of the uterus that can be treated with medication or surgery, but if there is no positive effect, reproductologists prescribe in vitro fertilization;

male infertility - azoospermia, a lack of motile sperm in the ejaculate, etc. can become its cause.


IVF method can be used in case of:


  • endocrine infertility, which is caused by hormonal imbalance, leads to deformation of the maturation process and the further release of the egg into the fallopian tube;

  • tubal-peritoneal pathologies - these can be adhesions that cause tubal obstruction, deformation of the uterus, etc.

  • immunological infertility - in this condition, the woman's body contains antisperm antibodies that prevent the conception (leads to the death of viable sperm cells);

  • age-related changes - IVF is indicated for patients over 40 years who have a diminished ovarian reserve and ovarian exhaustion;

  • endometriosis is a disease of the functional layer of the uterus that can be treated with medication or surgery, but if there is no positive effect, fertility specialists prescribe in-vitro-fertilization;

  • male infertility, associated with azoospermia, a lack of motile sperm in the ejaculate, etc.


The IVF procedure is regulated by the Order of the Ministry of Health of the Russian Federation. All procedures are performed by a fertility specialist, who can involve a gynecologist, embryologist, geneticist, urologist, endocrinologist and other specialists from related medical fields in the treatment.


CONTRAINDICATIONS TO IN-VITRO-FERTILIZATION


IVF is a minimally invasive procedure that carries minimal risks for the female body compared to alternative methods of conceiving a child. Despite this, IVF cannot be performed in case of:


  • congenital pathologies of the development of the genital organs, which prevent the implantation of the embryo into the uterine cavity for further bearing of the child;

  • malignant and benign tumors in the ovaries and other organs of the reproductive system (in some cases, IVF can be performed after treatment of such diseases);

  • inflammatory processes and acute infections (syphilis, chlamydia, herpesvirus, ureaplasmosis, etc.);

  • mental disorders, which are contraindications for bearing the child.


Important! In order to identify contraindications to the procedure, a complex diagnosis is prescribed. As a result of examinations, specialists can detect several diseases at once, which impede IVF. Most of them can be eliminated by medical or surgical approach.


IVF PROGRAM


The in vitro fertilization can be carried out in a staged manner according to two schemes: in a natural or stimulated cycle. The first type of treatment is prescribed to patients who do not have abnormalities in the ovulatory phase. From such women, the embryologist can get one or more viable eggs by puncture. Stimulated cycle treatment is indicated for women suffering from ovulation disorders. In this case, experts prescribe hormone therapy, aimed at stepping up the process of formation and maturation of oocytes, which are necessary for further fertilization.

Egg retrieval should be performed under ultrasound guidance. At the time of the puncture, the specialist punctures the vaginal wall and ovary with a thin needle in order to remove the oocyte from the mature follicle for further insemination.


Then comes fertilization process, which occurs outside the female body. After the manipulation, specialists expect the embryo to mature, which can last from 3 to 5 days. It is followed by the phase of implantation of the embryo into the uterine cavity. With a successful procedure, conception occurs.


STAGES OF IVF


In vitro fertilization greatly increases the chances of a couple to become pregnant. In order to make IVF procedure successful, it is carried out in several stages. These include:

  • preparation and delivery of medical tests;

  • taking medications (protocol selection);

  • follicular growth control;

  • egg selection;

  • fertilization;

  • in-vitro embryo cultivation;

  • embryo transfer;

  • expectation;

  • result of manipulation;

  • final stage of the procedure.

All manipulations should take into account the requirements established by the Ministry of Health of the Russian Federation and the World Health Organization.

PREPARATION AND ANALYSIS 

At this stage, both woman and man are required to undergo the examinations. The woman is prescribed an examination by an embryologist, gynecologist, endocrinologist, and in some cases, genetics. The man has to visit an urologist. Doctors conduct a physical examination, take medical history, figure out the history of past illnesses, the particular lifestyle of the couple, working conditions, the regularity of sexual intercourse, etc. The next step is the diagnosis.

The woman has to undergo a lot of laboratory tests. Some of them are:

  • complete blood count;

  • common urine analysis;

  • blood test for syphilis, HIV, hepatitis B and C, herpes simplex virus;

  • coagulogram;

  • Pap smear;

  • blood test for hormonal panel

  • PCR smears on chlamydia, ureaplasma, mycoplasma;

Before IVF the woman also has to undergo instrumental diagnostic, which includes:

  • ultrasound- the method is necessary to detect abnormalities in the characteristics of the pelvic organs (in structure, shape, size, etc.);

  • mammography/ultrasound of the mammary glands - it allows ou to diagnose malignant and benign tumors of the breast;

  • hysterosalpingography - it must be done if there are suspicions of adhesions or obstruction of the fallopian tubes;

  • postcoital test - it allows to identify antisperm antibodies in the female body.

Men also undergo examinations, sd they also have a risk of infertility. Spermogram, PCR smears, a MAR test, as well as tests that detect sexually transmitted infections are prescribed to men. Thanks to these examinations, specialists can identify the true cause of infertility. Depending on this, the most effective method of conception is selected.

PRESCRIPTION OF MEDICINES (SELECTION OF PROTOCOL)

Before in vitro fertilization, ovarian stimulation is often indicated. It is achieved by the use of hormonal drugs that increase the levels of estrogen and progesterone in the patient’s blood. The treatment regimen, dosage, protocol type and medications are selected individually. Hormone therapy is aimed at normalizing ovulation, accelerating the process of maturation of oocytes, as well as preparing the endometrium for embryo implantation.

CHECKING THE FOLLICLES’ GROWTH

The process of maturation is directly related to the menstrual cycle. The follicle reaches its greatest size in the ovulatory phase. It can be more than 2 cm in diameter. To control growth and maturation, both instrumental (ultrasound) and functional diagnostic methods are used.

SELECTION OF EGGS

Oocytes obtained from healthy ovaries are suitable for fertilization. If a woman is diagnosed with polycystosis or early deterioration of the reproductive organ, her eggs may not work. Puncture of oocytes should be done at the time of complete maturation of the follicle. Their harvesting is carried out with a needle, which pierce the wall of the vagina and ovary. The selected egg is placed in a nutrient solution to meet with the ejaculate of the sexual partner.

FERTILIZATION AND CULTIVATION OF EMBRYO

This stage involves the fusion of sperm and egg. Sexual gametes are placed in a test tube in which conception artificially occurs. Upon successful fusion, the oocyte is transferred to an incubator that maintains a stable temperature. Maturation of the embryo may take some time. It usually takes up to 5 days to form a zygote.

EMBRYO TRANSFER

The procedure is performed using a thin catheter. An embryo is inserted into the vagina, and then into the uterine cavity. The implantation process takes a minimum of time and is painless for the patient. In the framework of one manipulation, no more than two embryos can be implanted, otherwise there may be a risk of multiple pregnancy, accompanied by the death of the fetus.

FINAL STAGE OF THE PROCEDURE

After IVF, doctors prescribe supportive hormone therapy so that the embryo takes root in the endometrium. Pregnancy is recorded after 14 days. For diagnosis, a blood test for human chorionic gonadotropin (HCG) is used. The entire period of gestation is under the supervision of a physician who systematically prescribes ultrasound and the delivery of laboratory tests.

APPLYING FOR IVF AND THE COST OF PROCEDURE

The first visit to a doctor, who will subsequently conduct successful IVF, is one of the most important stages of the treatment. Before applying for an IVF to a specific specialist, you need to familiarize yourself with the qualification of the doctor and the methods of his/her work. Your state of mind is important when you come to the doctor. Patients should be as open as possible so that the doctor quickly finds the true causes of infertility. To undergo an initial examination, it is worth to visit a private medical centers specializing in reproductive health.


How much can IVF treatment cost? The price depends on:


  1. the location of the clinic;

  2. price list of a specific medical center;

  3. the amount of examinations, prescribed to diagnose a health condition;

  4. the selected method of IVF (donor egg or sperm, ICSI, IMSI, etc.).


The price will include all manipulations performed by doctors (stimulation of ovulation, follicle growth control, oocyte puncture, insemination, embryo implantation, etc.). IVF is not always successful on the first try, so a cycle of procedures may be required.