Contents
IVF in the natural cycle
IVF preparation for women
The duration of training largely depends on the health status of the partners. (1) If a woman has gynecological diseases such as fibroids or endometriosis, it may take time to treat them.
IVF will also have to be postponed if the partner has poor sperm counts or one of the partners has hypovitaminosis.
A few months before the protocol, partners need to give up alcohol, smoking and other bad habits. At this time, future parents are prescribed a course of vitamin complexes.
The next stage is consultations with medical specialists. For women, this is a gynecologist, endocrinologist and mammologist. Men need to consult an andrologist.
Before proceeding with the implementation of the IVF protocol, it is necessary to pass the following tests:
- examination of the fallopian tubes for patency using hysterosalpingography, ultrasonic hysteroalpingography or laparoscopy;
- analysis of the blood group and its Rh factor;
- clinical blood test;
- hemostasiogram (coagulogram);
- blood chemistry;
- general urine analysis;
- blood test for syphilis, HIV, hepatitis B and C;
- blood test for hormones: FSH, LH, estradiol, prolactin, testosterone, TSH, free T4, DHEA, AMH (on the 2nd-3rd day of the menstrual cycle. Progesterone on the 21st day of the cycle;
- blood tests TORCH (IgM, IgG to toxoplasma, rubella virus, cytomegalovirus, herpes simplex virus);
- a smear on the flora from the cervical canal and the degree of purity of the vagina;
- cytological examination of scrapings from the cervix;
- swabs for infections: chlamydia, cytomegalovirus, herpes, genital ureaplasmas and mycoplasmas;
- conclusion of the therapist about the state of health and the possibility of carrying a pregnancy;
- fluorography or x-ray of the lungs;
- ECG;
- Ultrasound of the mammary glands in patients under 35 years of age, after 35 years of mammography;
- the conclusion of a mammologist about the possibility of ovarian stimulation.
How IVF is done for women
After receiving satisfactory test results, the doctor proceeds to the next stage – the choice of IVF protocol. There are several. Each is selected individually, depending on the cause of infertility and the patient’s ovarian reserve, information about the medical history.
Each IVF protocol consists of standard procedures:
- ovarian stimulation;
- follicle puncture to obtain eggs;
- egg fertilization and embryo cultivation;
- transfer of the embryo into the uterine cavity;
- hormonal support;
- analysis for hCG (human chorionic gonadotropin).
Surely you know that an increase in the level of hCG indicates the onset of pregnancy. In pregnant women, its rates double every 48 hours. If the result of the procedure is unsuccessful, the result of the analysis will show from 0 to 5 mU / ml.
The consequences of IVF for women
In vitro fertilization is a complex procedure that comes with certain risks for the female body.(2) These should always be kept in mind. These include:
- side effects of hormone therapy;
- ovarian hyperstimulation syndrome;
- multiple pregnancy.
At the preparation stage, a large number of hormones are introduced into the body. This may cause the following side effects:
- noise in ears;
- bleeding similar to menstruation;
- allergic reactions;
- lethargy, depression;
- decreased appetite;
- reduction or, conversely, weight gain.
During the period of ovarian stimulation, the growth of follicles occurs, in which the eggs mature. “Strong” hormonal preparations are used. Their use can also lead to the following consequences:
- ovarian hyperstimulation syndrome;
- blockage of blood vessels by a thrombus;
- bloating and pain in the abdomen;
- accumulation of fluid in the abdomen or chest;
- indigestion.
Hyperstimulation syndrome develops with excessive exposure to the ovaries and the use of high doses of hormones. The stimulation process is out of control. In this case, blood can thicken, and fluid can accumulate in the chest and abdominal cavity, increasing the risk of developing thromboembolism and other serious complications.
Popular questions and answers
The IVF procedure appeared relatively recently, a little over 40 years ago. And there are still many questions related to it. With the gynecologist Svetlana Murashko, we will answer the most common ones.
Does IVF lead to cancer in women?
Is IVF allowed for single women?
At what age can IVF be done?
Why do multiple pregnancies often occur after IVF?
With natural conception, the frequency of twins is not more than 1-1,5%, triplets are about 0,01%, quadruples – not more than 0%. After IVF, the total frequency of all multiple pregnancies reaches 005%.
The process of implantation of the embryo into the uterus does not always go smoothly. If only one is planted, the chance of pregnancy is too low. Therefore, there are certain rules:
• women under 35 are transplanted with 2 embryos;
• 35 embryos are transplanted to women over 3 years of age.
In this case, everyone can take root and, as a result, multiple pregnancy occurs. Another option is the division of the embryo into 2 or more embryos. This is possible due to the appointment of hormone therapy. Normally, only one follicle with eggs matures in the ovaries, and there may be several of them during the administration of drugs. Accordingly, the likelihood of multiple pregnancy increases.
Is the health of children born through IVF different from children conceived “naturally”?
Expert Commentary
Psychological preparation is also important.
– IVF is a complex, multi-stage procedure that requires both physical and moral preparation, – notes reproductive medicine doctor, Svetlana Murashko. – At the appointment, the doctor will definitely tell you in detail how to properly prepare for IVF. First of all, you need to give up bad habits. It is important to distribute physical activity and monitor your diet. A few months before the procedure, both partners should start taking multivitamins.
Psychological preparation is very important. It is necessary to prepare for a long multi-stage procedure, as well as for a possible negative outcome.
Before entering into the protocol, both spouses must pass tests that confirm the health of partners. After that, the reproductive specialist will select an individual scheme.
Sources of
- Likhacheva V.V., Markdorf A.G., Bazhenova L.G., Vlasenko A.E., Shramko S.V., Evaluation of the influence of clinical factors on the effectiveness of in vitro fertilization programs / 2018
- Vyalikova Yu. V., Alieva A. Ya., Naiko Yu. V., Shintaev T. K., Features of pregnancy and childbirth in patients after in vitro fertilization / 2015
- Novikova N. O., Ippolitova L. I., Features of the early neonatal period in children after in vitro fertilization / 2013