What is meant by In Vitro Fertilization (IVF)
Infertility is caused by blockage of the fallopian tubes due to various reasons, which prevents the sperm and egg from meeting. The solution is to try to make the sperm meet the egg outside the body and fertilize it, which is often called IVF. This is often referred to as IVF. This is done by using medication to encourage the growth of more eggs from both ovaries and then removing the eggs when they are mature and placing them in a culture that simulates the human body;
After a period of incubation, the sperm and eggs are fused to form a fertilized egg that divides into 4-8 cells, and then 2-3 of the best developed embryos are selected and placed back into the uterine cavity to continue their growth. The medical term for IVF is in vitro fertilization-embryo transfer. It is the only option for couples who are infertile due to tubal failure, but of course, it can also be used to treat other causes of infertility that have not been treated with other methods.
Who is suitable for IVF?
1. Severe tubal disease, such as tubal blockage and fluid retention due to pelvic inflammatory disease; or tubal tuberculosis with normal endometrium; or tubal blockage after ectopic pregnancy surgery
2, endometriosis
3, immune infertility, the presence of anti-sperm antibodies in the semen of the male partner or the cervical mucus of the female partner
4. male factor, i.e. oligospermia, weak spermia, teratospermia
5. Infertility of unknown origin
6. Other causes of infertility that have not been treated
7.Hereditary diseases requiring pre-transplant diagnosis
8.Other: such as follicle non-rupture syndrome, etc.
Who is not suitable for IVF?
1.The female partner has important organ function abnormalities, such as heart, liver, kidney disease, etc., and cannot withstand pregnancy and delivery
2.The presence of acute or chronic active infectious diseases or acute infectious emergencies in the woman’s body
3. The female partner has malignant tumor of ovary, uterus or breast, which cannot accept embryo transfer and growth.
How much does IVF cost?
The cost of IVF generally includes two major parts. One part is the cost of ovulation-promoting drugs, which can vary greatly due to the use of imported and domestic drugs, ranging from 3,000-20,000 RMB, and generally costing around 5,000-10,000 RMB. In addition, the older you are, the higher the amount of medication used and the higher the cost. The other part is the cost of surgery and laboratory operations, which varies depending on the treatment. It is usually about $10,000. The total cost varies from more than $10,000 to more than $30,000.
What is the success rate of infertility treatment?
The chance of conceiving in a month for a woman of normal reproductive age (non-infertility) is about 20%, and the World Health Organization defines infertility as lasting one year. The success rate of infertility treatment varies from hospital to hospital. In general in China, patients undergoing IVF treatment have a success rate of about 20-40% per treatment (per menstrual cycle), which is similar to the conception rate of women of normal reproductive age.
Factors affecting the success rate
1. Female factor: The age of the female partner, i.e., the older oocytes, significantly decreases her oocyte reserve and the quality of her oocytes when she is over 35 years old, significantly affecting the pregnancy rate of IVF.
2. Male factor: mainly refers to the quality of sperm, especially when the sperm motility is less than or equal to 4% or the proportion of deformed sperm is greater than or equal to 60%, the success rate of IVF will be significantly reduced. In addition, if the sperm density is less than or equal to 5 million per milliliter, conventional IVF has no chance of success.
3. Infertility causes: The pregnancy rate of IVF is not the same for patients with different causes, for example, the success rate is higher for infertility caused by bilateral tubal obstruction. For example, the success rate is higher for infertility caused by bilateral tubal obstruction alone, while the success rate is lower for women older than or equal to 35 years old or with severe semen abnormalities.
4. The influence of induced superovulation: the different responsiveness of ovaries to drugs, the number, size and development rate of follicles, etc. all affect the success rate.
5. Influence of laboratory environment and operation: The laboratory culture system, environmental conditions such as temperature, humidity and cleanliness, and the proficiency and precision of the manual operation process may have adverse effects on the oocytes, sperm and embryos, thus affecting their pregnancy rate.
Pre-operative examination.
1.Female: Pre-operative examination after menstruation, including: routine blood test, liver function, hepatitis B and C antibodies, AIDS and syphilis antibodies, sex hormones, eugenics IV (TORCH), immune antibodies, leucorrhoea, gonococcal and chlamydia tests.
2. Men: 2-7 days abstinence visit for examination: items include: hepatitis B and C antibodies, HIV and syphilis antibodies, TORCH, immune antibodies, gonococcus and chlamydia, semen routine and semen functional examination.
How is the IVF treatment process?
1. Induction of superovulation: normal women only ovulate one egg per menstrual cycle in their natural state. The development and maturation of multiple follicles can be obtained through medication, increasing the success rate of surgical egg retrieval and in vitro fertilization, etc. This process is known as the induction of superovulation.
2. To monitor follicle development and determine the time of egg retrieval, in order to evaluate the effect of ovarian stimulation and decide the time of egg retrieval, usually 5 days after the superovulation medication, vaginal ultrasound will be done to monitor the development of follicles, together with urine LH and blood estrogen level check, adjust the medication dosage and continue the medication until the day before egg retrieval. HCG 5000U will be injected on the night of follicle maturation and eggs will be retrieved 34 – 36 hours later.
3., Egg retrieval: Under the guidance of vaginal ultrasound through posterior fornix puncture, the eggs are aspirated and transferred to the culture medium for 3-6 hours for fertilization. It is basically non-invasive.
4. Sperm optimization treatment: The semen its optimized to screen the sperm with high motility and excellent fertilization ability. Semen should be retained at the same time on the day of ovulation.
5.In vitro fertilization and early embryo culture: 2-6 hours after egg retrieval, the oocytes are optimized and the sperm are cultured in the culture fluid in a certain number of proportions to fertilize them in vitro. If the fertilized eggs are formed and develop normally, they will be transferred to the culture dish containing the growth solution and continue to be cultured for 1-3 days before embryo transfer.
6.Embryo transfer: The well-developed embryo is put back into the uterine cavity through the transfer catheter to facilitate the embryo’s smooth implantation and continued growth and development in the uterine cavity. Lie flat for 2-4 hours after the transfer and avoid strenuous activities for 24-48 hours.
7. Post-transplantation management: Progesterone or HCG is given after transplantation to promote the proliferation of luteinizing cells, to promote the synthesis and secretion of progesterone and to support the luteal function. 2 weeks later, check whether there is pregnancy, and if pregnancy is used for 3 full months.
How long does it take to perform IVF?
The time required varies somewhat depending on the ovulation protocol used. In the case of long protocols, it takes about 30 days from the start of the Ovulation Promotion medication to the end of the embryo transfer. If the regimen used is a short regimen, low stimulation or antagonist regimen, it will take about 15-20 days from the start of ovulation pills to the end of embryo transfer.
After embryo transfer, luteal support therapy is needed for 2 weeks to check for pregnancy and to continue the medication if pregnant, or stop it if it fails.