The event, which radically changed the treatment options for infertility occurred in 1978: the first successful IVF - in vitro fertilization - in the heart of Cambridge in England conducted by Christopher Patrick Steptoe and Robert Edwards. It is known that the first "test tube baby" was Louise Joy Brown. In Russia, the first "test tube baby" was born in 1986 in Moscow. Healthy girl who was named Helen, was born in the clinic of Scientific Center for Obstetrics, Gynecology and Perinatology ramp. In the same year in St. Peterburi boy was born - the second Russian "test-tube baby."
The development of technology IVF Of course, many specialists took part, but the contribution of Robert Edwards is considered to be the maximum, he came up with the idea in vitro fertilization , A way to determine the most appropriate time for taking an egg from the female body, the conditions for the selection of material and non-traumatic method of withdrawal. Also, it belongs to the first successful test of the method artificial insemination .
Edwards polished all stages IVF : First experiments in mice have been, then other mammals.
Reasons for resorting to the method of artificial insemination
1. The most common in women: obstruction of the fallopian tubes (fallopian tubes through which the egg enters the uterus from the ovaries). Men too low activity of sperm.
Further, according to statistics:
2. Endocrine infertility women with failure of conservative treatment.
3. Barrenness of unknown origin.
4. The depletion of ovarian or resistance.
5. The masterbatch form infertility .
How to start IVF
Before potseduroy in vitro fertilization neobodimo pass the most complete gynecological examination, including ultrasound, x-ray study of the state of the uterus and fallopian tubes (gidrosonografiya, hysteroscopy, fertiloscopy, laparoscopy), endometrial biopsy, bacteriological examination of material from the cervical canal, etc. When neobodimo undergo treatment.
Survey and men need to go: blood tests, spermorammu, examination for infections, etc.
The main stages of IVF
Stage 1
Initially, the doctor prescribes special preparations: puregon, Gonal-F, Menopur, aimed at stimulating activity of the pituitary gland and the ovaries, to trigger the so-called superovulation - aging a large number of viable ova Instead of one, as in a natural menstrual cycle. Using ultrasound control the growth and development of ova in the ovaries do special analyzes determining the level of estrogen in the blood and, consequently, the degree of maturity of oocytes.
Stage 2
When egg formed, they are removed under the control of US and placed in a special container. The procedure is performed directly before ovulation.
Stage 3
Carefully study egg to analyze their capacity to fertilize. In parallel, on the day of egg retrieval husband delivers sperm.
The special container for the medium, wherein the simulated conditions of the human body, i.e. It maintains a certain temperature, gas, humidity, combine the egg and sperm are the most viable. Fertilization usually occurs in 18-20 hours, but not all the eggs are fertilized, it depends on the quality of eggs and sperm. As a rule, fertilize several eggs to increase the chances of a successful outcome. It is important that the fertilized egg is already beginning to share.
Stage 4
Directly procedure transplant, transplantation of the fertilized egg, the most difficult stage, it is carried out in two or three days after insemination.
Transferred 2 -3 embryo in order to increase the likelihood of implantation and subsequent development of pregnancy. Embryo transfer is carried out using a special plastic catheter under ultrasound.
It is very important at this time to provide a sufficient level of the hormone progesterone in a woman's body. If "natural" conception oranizmom progesterone released in response to fertilization, and when artificial insemination need for a further one and a half to two weeks in the form of injections administered chorionic gonadotropin. It is necessary for the successful attachment of the embryo and the extra stimulation of the hormonal system of the woman to prepare the body for carrying a child.
The first results are evaluated after 2 weeks after transfer of the level of hormones. After 3 weeks, carried ultrasound.
The main thing - it's the right attitude
Doctors believe that the success of IVF depends on the following factors:
1. The age of the woman,
2. The response of the ovaries of women employed in the preparations,
3. timeliness of mature eggs capable of fertilization;
4. techniques perform puncture and embryo transfer;
5. The quality of sperm;
6. mental attitude infertile couples.
If a woman is contraindicated hormonal stimulation (as well as her own request) and her regular ovulatory cycles, the drugs that stimulate the simultaneous growth of several follicles, do not apply.
The use of IVF in the natural cycle
It has the features:
- After fertilization obtained only one embryo,
- You have to cancel the cycle of ovulation occurred,
- Possible to obtain enough mature egg, no embryos to transfer,
- A small chance of pregnancy.
Advantages of this method are:
- Do not use hormones.
- No risk of multiple pregnancy.
- Reducing the financial costs due to elimination of hormones.
- Psychologically transferred more easily.
Contraindications for IVF
1. The physical and mental illness, is a contraindication to carrying a pregnancy and childbirth.
2. Congenital malformations or acquired deformities of the uterus, which prevent embryo implantation or child bearing.
3. ovarian tumors, benign uterine tumors requiring operative treatment.
4. Acute inflammatory diseases and malignant tumors of any localization.
Complications of IVF
Unfortunately, about 5-6% of patients suffer from complications connected with IVF. This percentage is higher in comparison with the general population. The most frequent complication - an ectopic pregnancy. There are also the so-called ovarian hyperstimulation syndrome (OHSS) - the body's response to stimulation of superovulation, the risk of multiple pregnancy. Generally itself infertility , Age, the presence of multiple pregnancy may increase the risk of premature birth or stillbirth.
It should therefore be constantly observed by a doctor and do the analysis.
Quantity becomes quality
Now 20 to 40% of all IVF pregnancies end. Doctors are unanimous: a negative result does not mean that IVF is not effective for you. Subsequent attempts may be successful. Interestingly, with each subsequent attempt to the general chances of pregnancy increase significantly. Doctors recommend between attempts to make the interval of about 2 months.
The procedure artificial insemination It has no effect on pregnancy.
Finally.
According to experts, to date it has no data on the deviation in the development of children "test tube" is not revealed. Now these children in the world of about 4 million.
Oksana Herasymenko
Pregnancy and Gynecology
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