help desperate childless couples came science. No one is surprised by the phrase "test-tube babies". Although, of course, who would like to know that he began his existence in this way - in a test tube? However, it's not worse, than to be found in cabbage or fly with the stork. The fact remains: has appeared in more than one million "in vitro" children, a large number of families have found happiness through artificial insemination, in particular the method of IVF - in vitro fertilization.
In vitro fertilization IVF (1VF) - in vitro fertilization (in vitro) is an increasingly widely used infertile parents.
IVF (IVF) was originally proposed and applied in patients with tubal infertility, and those of them who was doomed to childlessness. The results were so impressive that IVF were used in almost all forms of infertility.
IVF (in vitro FERTILIZATION) is a complex, multistep process. It requires the use of various drugs and multiple assessments of women during the cycle in which you are trying IVF (in vitro FERTILIZATION).
The method consists of the following steps:
- the determination of the causes of infertility;
- the purpose of the hormones that stimulate the growth of multiple follicles;
- ultrasound and hormonal studies to determine the response of the ovaries to the influence of drugs;
- the determination of the moment when it is necessary to make a puncture of follicles (as close as possible to the time of natural ovulation) using analyses of blood serum or urine to determine the concentration of hormones, ultrasound;
- follicle puncture, aspiration (suction) of their content, the extraction of eggs, placing them in a special culture medium and conditions;
- obtaining and preparation of spermatozoa;
- the connection of eggs and sperm in a test tube and placing them in an incubator at 24-42 hours;
- the transfer of embryos into the uterus of the mother;
- the appointment of agents that support the implantation and development of the embryo;
- diagnosis of pregnancy;
- the management of pregnancy and childbirth.
So, after identifying the causes of infertility doctor decides about the use of IVF. If you have a chance, start to hormonal stimulation of the ovaries. Stimulation starts from the second day of the menstrual cycle with the help of the hormonal drugs and tablets and injections. Typically used clomiphene in combination with human over atropine and drugs, encouraging the production of pituitary gonadotropins. Such support is necessary to ensure, to the time of ovulation in the ovaries of the woman ripen several eggs ready for fertilization.
From the 8th to the 14th day is a series of ultrasound, trace the growth of the follicles and maturation of eggs in them.
The last injection, determining the moment of final maturation of the follicles is done from the 10th to the 16th day of the menstrual cycle. 36 hours after this injection the doctor pulls all the eggs from the ovarian follicles women (through the vagina or abdominal wall in the special needle). The same day the egg is fertilized with sperm from the husband or a donor. In the case of low activity of spermatozoa and their inability to penetrate the egg independently of the outer shell of the egg is incised.
If the number of sperm in the semen is very low, the sperm is injected directly into the egg.
Upon successful fertilization of an egg after about 40 hours a woman is injected into the uterus three to four embryos. Three weeks after the transfer of embryos to undergo ultrasound examination to determine the number of "entrenched" embryos.
The effectiveness of IVF (in vitro FERTILIZATION) for today is on average 20-30%, but in some centers exceeds 50%. This is a very high percentage.
Complications in IVF
Feature ECO is a very high frequency of multiple pregnancies: the multiple pregnancy, including twins, triplets and four of a kind, occurs in approximately 50% of all pregnancies.
Farrow, especially more than two fruits, creates a high risk of complications for both the mother and child during pregnancy and childbirth. Today the methods of removal (reduction) of "excess" fruits (two or more) under ultrasound control.
Actually superfluous fruits are not removed, and by injecting special solutions ensure that they cease to evolve and gradually dissolve.
This procedure is performed on the 7-8th week of pregnancy and usually not accompanied by a threat of miscarriage other fruits. Often resorption of excess fruits happen by itself, without any intervention.
Ovarian hyperstimulation syndrome
In the treatment of infertility with IVF can experience this complication, as ovarian hyperstimulation syndrome.
Ovarian hyperstimulation syndrome (ohss) is a complex of pathological symptoms that occur on a background of application of ovulation stimulants, which is characterized by a significant increase in ovarian cancer, sometimes they rupture and haemorrhage, embolism (thromboembolism) great vessels and a number of other symptoms. In recent years, because of the wide distribution of infertility treatment method of in vitro fertilization, including the first phase of the ovulation stimulation, ohss attracts more and more attention.
There are three degrees of severity of ohss - light, medium and heavy.
Classification of ohss in severity:
Mild - the feeling of heaviness, tension, bloating, there are weak dragging pain in the abdomen.
General condition is not violated. The ovaries increased to 5-7 cm, they identified many follicles and cysts (with ultrasound).
Medium - abdominal pain strong enough, there are nausea, vomiting, possible diarrhea. The overall condition is violated slightly. Marked weight gain and increased abdominal circumference. The ovaries increased to 8-12 cm in diameter, in the abdominal cavity is detected in ascitic fluid (serous fluid, at least - containing blood or lymph).
Severe - the General condition of moderate or severe. Appear shortness of breath, tachycardia, and hypotension. Belly increased in volume due to ascites (fluid accumulation in the abdominal cavity), and tense.
Prevention. Prevention of ovarian hyperstimulation syndrome is the individual approach to each individual case. When this takes into account the original size of the ovaries and estrogen levels; select the dose of gonadotropins, since the minimum; reduce the period of stimulation - earlier appointment of hormonal drugs; reduce their ovulatory dose or completely refuse them.
In addition, daily observe the General condition of patients, the size of the ovaries during treatment and within two-three weeks after its cancellation; controls the level of estrogen in the blood and carry out ultrasound, allows you to monitor the size of the ovaries and follicles.
In milder forms usually medical treatment is not required. Prescribe bed rest, drink plenty of water and observe the General condition. Treatment of moderate and severe forms should be in the hospital with careful monitoring of the function of the cardiovascular and respiratory systems, liver, kidneys. Watching the dynamics of weight and change okruzhnostiami.
The prognosis for ohss mild and moderate favorable. The symptoms usually disappear after 3-6 weeks from the beginning of its manifestation. Severe ohss threatens the health and lives of women.