1. What is IVF?
IVF, also known as in vitro fertilization-embryo transfer (IVF-ET), is a technique that uses artificial methods to remove eggs and sperm from the human body, fertilize them in vitro, develop them into embryos, and then transfer them back to the mother’s uterus for the purpose of conception. The development process after embryo implantation is the same as that of a naturally conceived embryo. The usual process is: drug induced ovulation → ultrasound monitoring → egg retrieval → in vitro fertilization → embryo transfer → post-transfer treatment.
2. How long does it take to do IVF ovulation promotion?
The duration of ovulation induction depends on the patient’s responsiveness to the ovulation induction medication, which varies greatly from patient to patient and generally takes 8-14 days. The patient’s responsiveness to ovulation drugs cannot be predicted in advance and can only be judged roughly based on age, weight, basal FSH level and number of sinus follicles.
3. How is egg retrieval done for IVF?
The egg retrieval procedure is performed under the guidance of vaginal ultrasound. A matching puncture frame is attached to the vaginal ultrasound probe, and a very thin puncture needle is used to directly penetrate the follicle on the ovary through the lateral wall of the vaginal fornix, and the follicular fluid is aspirated under negative pressure to detect the egg in the follicular fluid. The procedure is relatively simple and takes only a few minutes to complete. Because the puncture needle is very thin, the procedure is minimally painful. Most patients do not need anesthesia for egg retrieval.
4. Can patients with premature ovarian failure have children of their own?
Premature ovarian failure refers to ovarian failure before the age of 40. The diagnosis of ovarian failure generally requires a basal endocrine test, when FSH>50IU/ml can be diagnosed as premature ovarian failure, but for IVF treatment, it is generally defined at about 15IU/ml, it is believed that if the basal FSH>20IU/ml the chance of pregnancy is very small, even if ovulation treatment is performed in such patients, it is difficult to obtain Therefore, patients with premature ovarian failure need to use other people’s eggs in order to do IVF, i.e. donor egg IVF.
5. Can I use my relatives’ eggs for IVF with donor eggs?
At present, the source of egg donation in China is the voluntary donor eggs of the patient undergoing IVF treatment. It is not possible to find your own eggs or use the eggs of your relatives.
6. What is the success rate of IVF?
The success rate of IVF depends on many conditions, as IVF is an emerging and mature technology to assist in pregnancy. Currently, the average success rate of IVF in major hospitals is 40%-50%. However, the success rate decreases for patients whose female partner is older than 35 years old, and the success rate is extremely low after 40 years old, around 10%.
7.Who needs IVF to assist pregnancy?
IVF is mainly suitable for female infertility caused by tubal factors, endometriosis, female polycystic ovary syndrome, severe ovulation disorders, immune infertility, unexplained infertility, and moderate to severe oligo-weak teratozoospermia in men.
8.Who is not suitable for IVF?
Any man or woman suffering from serious mental illness, acute infection of the genitourinary system, sexually transmitted diseases and other infectious diseases, immune diseases and hereditary diseases, or drug addiction of either sex, recent exposure to toxic and radioactive harmful substances, the uterus of the woman does not have the function of pregnancy or serious physical diseases that cannot bear pregnancy are not suitable for IVF. IVF” is not a suitable method of conception.
9.What tests are done before IVF treatment?
Not everyone can undergo IVF. Before doing so, we must first check the endocrine system, tubal patency, infectious diseases and the male partner’s condition, including semen routine, to confirm whether he is suitable for IVF to help conceive. The female partner should go to the hospital to check her fallopian tubes, ovarian ovulation and uterine condition.
10.What documents do I need to prepare before IVF treatment?
It is worth reminding that before undergoing IVF treatment, it is necessary to prepare the “three documents”, namely the original ID card and photocopy of both parties, the original marriage certificate and photocopy, and the family planning certificate issued by the family planning agency of the township, township or street where the household registration is located. The couple also needs to sign an informed consent form for in vitro fertilization-embryo transfer.
11. Preparation for the patient before consultation
First of all, we should clarify the cause of infertility and understand whether IVF is suitable. It is advisable to bring information and proof of past examinations and treatments to avoid wasting time on repeated examinations. The information includes
(1) Report of tubal patency test: X-ray film of iodine oil ionization of the uterine tubes, report of fluid passage under ultrasound, or discharge summary of laparoscopy or open surgery are all acceptable.
(2) Examination of whether ovulation is occurring: ovulation monitoring sheet under ultrasound.
(3) Routine laboratory test report of semen from DDU in the past year.
(4) Surface antigen antibody, e antigen antibody and core antibody of hepatitis B, antibody of hepatitis C, liver function, blood group laboratory report, antibody of syphilis AIDS virus for both husband and wife.
12.How many embryos can be transferred at one time for IVF?
In order to improve the success rate of IVF, according to the relevant regulations of the Ministry of Health, two embryos can be transferred at a time for patients under 35 years old who are undergoing IVF for the first time; for patients over 35 years old or who have undergone IVF several times, two embryos can be transferred at a time. For patients over 35 years old or who have done IVF several times, 3 embryos can be transferred at a time. However, in general, the number of fetuses present in the mother cannot exceed two, and in the case of a triplet, a reduction procedure is required. The reason is that once there are three fetuses, it is extremely harmful to the mother and child.
13. Is the child from IVF my own child?
One of the major psychological barriers for many couples who do not accept IVF is the misconception that IVF babies are “artificially created” for them by medical methods, or that the hospital uses eggs from the egg bank and sperm from the sperm bank to produce them, not their own flesh and blood. In fact, most IVF babies are produced from the eggs and sperm of the couple, unless the couple has no eggs (e.g. premature ovarian failure) or no sperm (e.g. azoospermia) and apply and sign an Informed Consent Form to request the hospital to provide eggs or sperm.
14.Is IVF prone to spontaneous miscarriage and ectopic pregnancy?
The occurrence of miscarriage or intrauterine arrest of embryonic development after IVF pregnancy is similar to that of natural pregnancy (10-15%), and there is also the possibility of ectopic pregnancy (about 3%), mainly in patients undergoing IVF treatment due to tubal abnormalities. Any fetal abnormality that occurs in a natural pregnancy can occur in IVF, but the incidence is not higher than in a natural pregnancy.
15. Can I choose a boy or girl for IVF?
First generation IVF and second generation IVF cannot choose the gender. Third generation IVF can choose the gender, but only when there are sex-linked diseases, such as having a normal girl and having a boy will have genetic diseases, the gender will be chosen, and gender selection without indications is prohibited.
16. Is second generation IVF better than first generation IVF?
First generation IVF is an assisted reproduction technique in which the patient’s eggs and sperm are mixed in a Petri dish to allow the eggs to be naturally fertilized, and then the embryos resulting from the fertilized eggs are cultured in vitro and transferred into the patient’s uterus. The first generation of IVF is also known as conventional IVF, or IVF-ET, and the second generation of IVF is also known as intracytoplasmic single sperm injection (ICSI). It is a precise and delicate technique that requires microscopic manipulation. Second-generation IVF is not necessarily superior to first-generation IVF, but simply takes a different approach for different indications.
17.What patients are suitable for IUI to help conception?
The male partner has mild oligospermia, semen opacity, etc., the female partner has at least one side of the fallopian tube is open, immune infertility and unexplained infertility.
18.What tests and preventions are needed for patients with recurrent miscarriage?
Spontaneous miscarriage refers to the embryo or fetus that is expelled from the mother automatically before 28 weeks of pregnancy for some reason, also called embryonic arrest, the incidence of which is about 15% to 20%. The incidence of spontaneous abortion is about 15% to 20%. If spontaneous abortion occurs for 3 or more times in a row and occurs within the third trimester, it is called recurrent early spontaneous abortion and used to be called habitual abortion), and the incidence is about 1% among couples who want to get pregnant. Treatment includes hysteroscopic surgery, treatment and adjustment of various drugs, immunotherapy, IVF with pre-implantation genetic diagnosis, etc.
19.Which patients need tubal angiography?
Hysterosalpingography is suitable for those patients who suspect infertility due to tubal incompetence. Patients who have a previous history of abortion and uterine cavity manipulation, a history of suspected pelvic inflammatory disease, and no other cause of infertility is found should undergo hysterosalpingography. If you have an acute pelvic infection or an episode of infection in another part of the body (e.g. toothache), imaging should not be performed.
20.Which patients need hysteroscopy?
Various conditions such as endometrial polyps, submucosal fibroids, longitudinal malformations of the uterus, failure to visualize the fallopian tubes during imaging, unexplained difficulties in embryo implantation, endometrial tuberculosis or inflammation, etc. require hysteroscopy for diagnosis and treatment. In cases of poor endometrial morphology, suspected endometrial polyps, or 2 or more embryos with unexplained difficulty in implantation, hysteroscopy is usually scheduled one cycle prior to IVF. A gentle curettage may be performed during the examination and the scraped endometrium will be sent to the pathology department for histological examination. Hysteroscopy needs to be performed at the same time as the laparoscopic procedure when lesions are present in both the pelvic and abdominal cavities.