What is IVF
IVF, the common term for in vitro fertilization-embryo transfer (IVF-ET) technology, is an artificially assisted reproductive technology that helps infertile couples obtain healthy offspring. Usually, IVF is classified into four generations, depending on the indications for the assisted reproductive technology, including
First generation of IVF: IVF-ET (conventional in vitro fertilization-embryo transfer)
Second generation IVF: ICSI (single sperm intracytoplasmic injection)
Third generation IVF: PGD (preimplantation genetic diagnosis)
IVF: Oocyte Plasmapheresis
The following is an introduction to the indications, procedures and considerations for each of the four generations of IVF.
I. First generation IVF for the following cases.
1.Sperm and egg encounter disorder caused by tubal factors
2. Ovulation disorder
3. Mild oligospermia, weakness and teratogenicity of the male partner
4, immune infertility (anti-sperm antibodies, etc.)
5.Endometriosis
6. Infertility of unknown origin
(No abnormalities were found in the fertility-related examinations of both spouses, and the infertility has exceeded 2 years)
7. Three times of unsuccessful artificial insemination
II. Second-generation in vitro fertilization, applicable to the following cases
1. Severe oligospermia, weakness or teratogenicity (or failure to meet the sperm requirements of the first generation of IVF)
2. obstructive azoospermia
3.Spermatogenic dysfunction
4. Unsuccessful in vitro fertilization and remedial treatment
5.Sperm without acrosome or abnormal acrosome function
6. Non-fusion of sperm and egg
III.Third generation IVF.
PGDS is to prevent the pregnancy and birth of children with genetic diseases by obtaining some cells of early embryos, conducting genetic screening and transferring embryos without genetic diseases into the uterine cavity. Its indications are mainly for couples with chromosomal or genetic defects, or couples with genetic diseases that can be passed on to the next generation, with more than 30 types of diseases currently diagnosed.
IV.IVF.
IV IVF is mainly for older pregnant women who are unable to form quality embryos due to aging of their eggs (firstly in follicular plasma). By partially replacing the follicular plasma of the younger women with that of the older patients
This is done by replacing the follicular plasma of a young woman with that of an older patient, so that the older infertile woman can obtain her own offspring.
IVF procedure
1. Outpatient consultation to determine the IVF treatment plan according to the couple’s fertility status, sign an informed consent form and perform routine preoperative examinations.
2. prepare original and photocopies of documents (ID card, marriage certificate, birth certificate).
3. Determine the ovulation promotion plan according to the endocrine test results of the woman, and follow the medical prescription for ovulation and follicle monitoring.
4. Monitor follicle development continuously by B ultrasound, inject HCG on the same night when the follicle is mature (~20mm), and sign the informed consent form for egg retrieval surgery.
5. 36 hours after HCG injection, egg retrieval is performed by puncture and aspiration of follicular fluid under ultrasound guidance, which takes about 5 to 15 minutes.
6. On the day of egg retrieval, the male partner will take semen to determine the fertilization plan (1st or 2nd generation).
7. 2-6 hours after egg retrieval, fertilization will be observed the next day and embryo transfer is routinely performed on the third day.
8. Morning urine will be measured 14 days from the day of transfer to check the fertilization status and decide whether luteal support is available.
Precautions
I. Ovulation promotion.
1. Female partner’s cooperation: Once the ovulation promotion program is formulated, the female partner should strictly comply with the requirements, take the correct medication on time and in the correct dosage, while maintaining a good psychological state. The whole process usually takes 1 to 2 months, so you should arrange your time well, relieve your worries and accept the treatment without worry.
2, the husband with: the male partner should stop smoking and alcohol, pay attention to rest. He should complete one to three semen analyses before entering the cycle to ensure that he has enough high quality sperm to meet the IVF requirements.
II. Before egg retrieval.
1. 36 hours before surgery, intramuscular HCG injection, strictly follow the doctor’s instructions and follow the dosage on time so as not to delay the treatment.
2. On the day of egg retrieval, pay attention to your diet in the morning, it should be light and not greasy.
3. Drink as little or no water as possible before the operation, and empty the bladder before the operation so as not to affect the operation with a full bladder.
4. Both husband and wife should arrive at the operating room in the morning of the operation day to prepare for the operation.
5. Pay attention to emotional regulation, avoid mental tension and rest before the operation, and pay attention to cleanliness and hygiene for both spouses the night before the operation.
3. After egg retrieval
1.After egg retrieval, take rest, avoid strenuous activities and eat properly.
2. On the day of egg retrieval, the male partner should take semen or puncture sperm (for azoospermia patients), and the sperm should be processed and confirmed to be correct before leaving the hospital.
3. On the first day after egg retrieval, the couple should arrive at the laboratory at around 9:00 am to confirm the fertilization status.
4. The couple can rest at home on the second day after egg retrieval if there are no special circumstances, but the woman should contact the doctor in charge if she has any abdominal distension or other discomfort for timely treatment.
5. On the third day after egg retrieval, the couple should arrive at the laboratory at around 9:00 am to prepare for the embryo transfer. The woman should hold her urine before the transfer.
Post-transfer.
1. Lie down for 30-60 minutes after the transfer and get up. Go home and take rest, avoid heavy physical activities and prohibit sexual intercourse. It is not necessary to be completely bedridden, relax, which is conducive to embryo implantation. Mental tension may stimulate the contraction of the uterus and affect the implantation.
2. Diet should be light, nutritious and avoid diarrhea. If abdominal distension, reduced urination and loss of appetite occur, contact the doctor in charge for timely intervention.
3. Use luteal support medication as prescribed by the doctor (you can consider Chinese medicine to help bedtime and promote development).
4.Take morning urine test 14-16 days after transplantation and inform us of the test results so that we can deal with them accordingly.
5.Please make sure to come to our center for ultrasound test around 50 days after pregnancy (5 weeks after transplantation) in order to know whether intrauterine pregnancy and multiple pregnancy.
7.After 3 months of pregnancy, we will establish a pregnancy test file in your local area and inform our center of the ultrasound observation results.
Success rate and cost of in vitro fertilization
The success rate of in vitro fertilization is about 30-40% on average worldwide, but note that this is a population success rate, i.e. out of 100 couples undergoing in vitro fertilization, 30-40 couples conceive successfully, for a specific couple, it is either 0 or 100.
The medical cost of one IVF is about $25,000 to $30,000, but if the woman has normal ovarian function, enough reserve follicles, a high number of eggs obtained at a time as well as a high number of quality embryos formed, the embryos can be frozen for transfer, which costs about $2,000 for the transfer. Ideally, multiple transfers can be done in one IVF to increase the success rate.
Preparation for IVF and preoperative examination (varies from place to place)
Supporting documents: marriage certificate, birth certificate (required), ID card
Pre-operative examination: full set of biochemistry (liver and kidney function + blood sugar), routine blood, blood type (ABO and Rh blood type, routine white belt, routine urine, cervical discharge examination, coagulation function, full set of hepatitis + HIV + syphilis, reproductive immune antibodies (ACA, ANA, etc.), ECG + chest X-ray, chromosome, thyroid function, etc.