1. What is IVF
IVF is the common name for in vitro fertilization and embryo transfer (IVF-ET). This technique involves removing the eggs and sperm of an infertile couple from outside the body, fertilizing them in an in vitro culture system and developing them into day 3 or 5 embryos before transferring them into the uterine cavity in the hope of achieving a pregnancy.
2. When IVF treatment is recommended
There are indications for performing IVF treatment.
(1) Female partner with gamete delivery disorder due to various factors, such as bilateral tubal obstruction;
(2) Ovulation disorders;
(3) Endometriosis, where pregnancy has not been obtained after conventional medication or surgery;
(4) male partner with oligospermia, weak or teratogenic spermatozoa, who has not obtained pregnancy after treatment with intrauterine insemination technique, or the severity of the male partner’s factors is no longer suitable for obtaining pregnancy through the implementation of intrauterine insemination technique;
(5) Immunological infertility and unexplained infertility, who have repeatedly failed to obtain pregnancy through intrauterine insemination techniques or other conventional treatments.
3. IVF treatment process
(1) Infertility consultation: to clarify the cause of infertility and to formulate a treatment plan.
(2) Appointment for IVF: through the consultation with the physician, you will learn more about the IVF process, the attention to be paid, the rights of infertile couples, and the signing of the contract.
(2) Appointment for IVF: the physician will provide detailed information about the IVF process, the precautions, the rights and interests of the infertile couple, sign the informed consent form, and undergo routine pre-conception examination.
(3) Controlled ovulation promotion: The use of drugs can obtain multiple eggs in one menstrual cycle.
The overall cost of IVF is related to the dosage and quantity of ovulation control drugs.
(4) Transvaginal ultrasound-guided egg harvesting.
(5) Sperm retrieval and semen optimization.
(6) In vitro fertilization and embryo culture.
(7) Embryo transfer.
(8) Blood/urine hCG test 14 days after embryo transfer, positive indicates biochemical pregnancy.
(9) Ultrasound 28 days after embryo transfer to see gestational sac and fetal heartbeat suggesting clinical pregnancy.
(10) Obstetrics clinic with regular check-ups until delivery.
4. What is the meaning of the first generation of IVF?
In fact, this is a less accurate term. It usually refers to the first generation (conventional IVF technique), the second generation (ICSI: single sperm intra oocyte microinjection technique), etc., and the third generation (PGD: pre-embryo transfer genetic diagnosis technique). There is no hierarchy between the generations, and they are suitable for different patients: the first generation is suitable for couples whose male partner’s semen is basically normal or poor; the second generation is suitable for couples with repeated fertilization failures or serious problems with the male partner’s semen; and the third generation is suitable for couples with genetic factors and need to select healthy embryos for transfer.
5. What is needed to prepare for IVF treatment
(1) Examination of the female partner: routine physical examination and gynecological examination; hysteroscopy, laparoscopy or iodine oil imaging, immunological and other relevant examinations on the etiology of infertility; reproductive endocrine examination, examination of infectious diseases and sexually transmitted diseases.
(2) Examination of the male partner: routine physical examination, routine and functional examination of semen, etiological examination, examination of infectious diseases and sexually transmitted diseases.
(3) Preparation of documents: ID card of both parties, marriage certificate, original and copy of family planning service certificate of the female party
6.What documents are needed for artificial insemination or in vitro fertilization
According to the relevant policies of the Ministry of Health, all patients receiving assisted reproduction treatment technology need to provide the hospital with the ID card of both parties, marriage certificate and family planning service certificate. If the patient couple is a foreigner or a person from Hong Kong, Macau or Taiwan, they only need to provide the marriage certificate, ID card or passport, and all documents need to be photocopied for record.
Why should I use ovulation promotion drugs? After egg retrieval, is there any effect on subsequent ovarian function
During the natural menstrual cycle, multiple follicles develop each time, but only one of them eventually matures, while the others are atretic and die. The use of ovulation stimulating drugs can encourage more follicles to develop and mature together, allowing more eggs to be retrieved and more embryos to be formed for selection. Ovulation stimulation allows eggs to mature that would otherwise fail to grow and die during the natural cycle, thus not consuming additional eggs. It takes some time for the ovaries to return to their pre-retrieval state after egg retrieval and generally has no effect on the ovarian reserve function in the future.
7. Why am I not pregnant when I have selected good quality embryos for insertion into my uterus?
The success rate of IVF is influenced by the quality of embryos, endometrial tolerance and other factors. In IVF, we select high quality embryos for insertion into the uterine cavity, but the implantation rate of embryos is only about 15%-30% in China and internationally. This is because the current method of determining the quality of embryos is based on morphology, which means that we can predict whether the embryos are of good or bad quality based on their appearance. The probability of successful implantation is high. In addition, whether the embryo can be planted or not is affected by the tolerance of the endometrium, which is like the land, if the land is not good, the seeds will not germinate and grow.
8. Why the older the woman is, the lower the success rate
Generally speaking, as the woman’s age increases, fertility gradually declines, especially after the age of 35 years decline more obvious, and this process is irreversible, there is no drug can make a woman’s fertility “back to the old”. This is mainly due to the fact that the older you are, the worse your ovaries function, the fewer eggs you have and the poorer the quality, for example, some studies have found that the older a woman is, the higher the incidence of chromosomal abnormalities in her eggs.
9. Why do I not have the same number of embryos in the end when I have a good number of eggs?
First of all, not all the eggs obtained are necessarily mature, the maturity rate is usually around 80%, only mature eggs can be fertilized, the fertilization rate for conventional IVF is usually around 70% and for microinjection fertilization is usually 80-90%.
Secondly, not all eggs can be fertilized to develop into embryos, and the rate of egg cleavage is usually over 95%.
Thirdly, even if the eggs are fertilized and cleaved, the quality of the embryos that develop can vary, and only good quality embryos can be transferred and frozen. In some patients, the fertilization rate, egg cleavage rate and high quality embryo rate are significantly reduced due to poor egg quality or sperm quality problems, and sometimes there are no good embryos available for transfer.
10. What to pay attention to after the transfer
After the transfer, it is important to avoid strenuous activities, heavy lifting, overexertion, cold, greasy and spicy food, and contact with toxic and harmful substances, as well as smoking and alcohol cessation.