1.What kind of people need IVF
The indications for IVF treatment are: tubal infertility, such as tubal obstruction, adhesion, absence, post tubal ligation; ovulation disorders, such as polycystic ovaries, follicular unruptured luteinization syndrome; endometriosis; oligohydrospermia in the male partner; cervical infertility and immune infertility after other methods of treatment have failed; infertility of unknown origin.
2. What kind of people cannot do IVF
Contraindications to IVF treatment include: acute infectious diseases of the genitourinary system and sexually transmitted diseases in either of the spouses; drug addiction in either of the spouses; exposure to teratogenic rays, poisons and drugs in either of the spouses and during the period of action; hereditary diseases that prevent fertility under the reproductive health law in either of the spouses; the uterus of the woman does not have pregnancy function or serious The physical disease can not bear the pregnancy.
3. What tests should be done by the wife before IVF treatment
The wife should do the following tests: basic sex hormone test, usually in the menstrual flow 2-4 days to draw blood, check ovarian function; ultrasound examination, to understand the number of ovarian sinus follicles, to exclude ovarian cysts, tubal effusion, uterine fibroids, etc.; there are also some routine physical examinations such as routine blood, blood type, coagulation series, infectious disease series, liver function, kidney function, blood sugar, blood sedimentation, cervical smear, chlamydia, gonococcus, white belt routine, urine routine, electrocardiogram, etc. Urine routine, ECG, etc. In addition, there may be other tests depending on each individual case.
4. What tests are required for the husband of IVF treatment
The tests to be done by the husband are: semen routine, malformation rate, usually within 2-7 days after sperm discharge; infectious disease series, blood type, urethral secretion chlamydia, gonococcus, etc.
5.What documents should be prepared for IVF
Before starting IVF treatment, you need to prepare a birth certificate (birth certificate or family planning certificate), the original ID card and marriage certificate of both spouses and a copy. The names on the “three certificates” must be identical. In case of inconsistency, a certificate from the police station where the household registration is located should be issued. The ID card can be replaced by a certificate of identity such as a hukou book, military officer’s card or passport. All documents and certificates should be within the validity period. Beyond the validity period, should be accompanied by a certificate or other documents or certificates of equivalent validity. The method of issuing the birth certificate: if the woman is a rural household, the village committee in the household will issue a certificate, stamped with the special seal of the township for family planning; if the woman is an urban household, the resident committee or work unit in the household will issue a certificate, stamped with the special seal of the street office for family planning.
6.What the wife should pay attention to in the course of IVF treatment in daily life
In preparation for the IVF treatment process, the wife should first have adequate mental preparation, to carefully understand the process of IVF treatment, the success rate of IVF treatment, relaxed thinking, not too anxious; physical preparation should increase exercise, enhance physical fitness, normal rest and rest, a reasonable mix of diet, quit smoking and drinking, less coffee; in addition to a reasonable schedule, because in the positive use to start on The need for follow-up visits to the hospital every now and then, must be arranged in advance to work matters.
7.What should the husband pay attention to in the course of IVF treatment in daily life
The husband also needs to stop smoking and drinking during the treatment process, work and rest normally, and match his diet reasonably.
8. Can other drugs be used during IVF treatment?
If there are abnormalities in other systems of the body that require medication during IVF treatment, you should consult your doctor. If the medication is prohibited during pregnancy, you should not use it, and it is better to suspend the use of tonic drugs used for conditioning, because there may be mutual synergistic or antagonistic effects between the drugs.
9.What determines the medication regimen of IVF treatment?
Each patient needs to be considered in terms of age, basal FSH value, number of sinus follicles, ovarian volume, etc.
10.What is the long regimen?
The long regimen is mainly suitable for patients with good ovarian reserve function. For regular menstrual patients, ovulation treatment should be started on day 10 of the first cycle of menstruation to monitor follicle development until the day of ovulation is determined, and GnRH agonist should be used for pituitary descending regulation one week after ovulation, and formal ovulation should be started after the next menstruation until about mid-menstruation. For those who have irregular menstruation, they should start to take Mafron from the 5th day of menstruation and start to use GnRH agonist until the 21st day of menstruation.
11.What is the short protocol
The short regimen is mainly used for people with poor ovarian reserve function, starting from the second day of menstruation and retrieving eggs in the middle of menstruation.
12.What is the extra-long regimen?
It is used for patients with endometriosis, polycystic ovaries, and hyper-LHemia, because long-acting GnRH agonists should be used for one to several months before ovulation treatment.
13.How long is the IVF treatment cycle
It takes about 2 months from the measurement of sex hormones 2-4 days after menstruation to the completion of the ovulation procedure for egg retrieval and transplantation. However, if there are some pre-operative laboratory abnormalities that need to be treated earlier, or if ovulation abnormalities occur during the natural cycle of ovulation monitoring, the treatment time may be prolonged as the menstrual cycle will need to be controlled with mafron again the following month.
14.Does the treatment require hospitalization?
The whole treatment process does not require hospitalization, because the treatment medication is related to the menstrual cycle, the wife needs to visit the hospital about ten times on time, each time depends on the specific situation, and it is not good to determine in advance, so it is necessary to arrange the work in advance so as not to delay the treatment. The husband usually only needs to visit the hospital 3-4 times during the whole treatment process .
15. Can I take folic acid during treatment?
The husband can also take folic acid and vitamin E. The husband can also take some garlic oil and lycopene when his sperm quality is poor.
16.What is the first generation of IVF
The first generation of IVF is to place the sperm and eggs outside the body using various techniques to fertilize the sperm and eggs naturally, culture them for a few days to form embryos and then transfer them to the uterus. It is mainly used for patients who need IVF because of tubal factors or ovulation disorders or endometriosis. 1978 British specialists steptoe and E. Dowrds customized the world’s first IVF, which is known as a miracle in the history of human medicine.
17.What is second generation IVF
Generally speaking, normal conception requires 30,000 to 100,000 sperm to be paired with an egg, but men with little or no sperm are unable to do so. In 1992, Dr. Palermo and Dr. Jiayen Liu from Belgium successfully used intracytoplasmic sperm injection (ICSI) for the first time in humans. The success rate of IVF technology has been greatly improved. ICSI treatment has greatly expanded the indications for IVF technology, especially for men with severe oligospermia.
18.What is the third generation of IVF
For genetic diseases, there is no effective treatment. Pre-implantation genetic diagnosis (PGD) is the genetic analysis of embryos before transfer into the uterus to avoid the transfer of embryos with genetic defects into the uterus, thus reducing the occurrence of genetic diseases, which is often referred to as the third generation IVF, mainly applied to sex-linked diseases, genetic diseases, chromosomal abnormalities and advanced age women.
19. Which of the three types of IVF has the highest pregnancy rate
The three IVF techniques are applied to different groups of people, and which one to use depends mainly on the cause of infertility, so the three techniques are not comparable, and it is not possible to say which one has a higher pregnancy rate.
20. Can IVF choose boys and girls
The first generation of IVF and the second generation of IVF can not choose the gender, the third generation of IVF can choose the gender, but only when there are sex-linked diseases, such as the birth of a girl is normal, the birth of a boy will have genetic diseases, will choose the gender, no indication of the choice of gender is not allowed.
21.Can I have IVF directly due to fluid in the fallopian tube?
Inflammation of the fallopian tubes causes adhesions at the umbilical ends and fluid from various sources collects in the fallopian tubes causing fluid accumulation. The fluid will enter the uterus through the peristalsis of the fallopian tubes, and the various inflammatory factors contained in the fluid that are detrimental to the growth of the embryo will affect the development and implantation of the embryo. Therefore, whether to have a tubal ligation depends on the specific situation and weighs the pros and cons.
22. Can the husband do IVF if he has no sperm?
If the husband’s semen is diagnosed as azoospermia, the patient should be seen in the male department, and some can do a testicular tissue biopsy. If there is no sperm in the testicular tissue biopsy, artificial insemination with donor sperm is needed. For those whose wives also have problems with their fallopian tubes, IVF with donor sperm is needed.
23.What are the drugs used to promote ovulation
The main ovulation stimulating drug used in IVF treatment is follicle stimulating hormone (FSH), which mainly acts on the ovaries to regulate the growth of follicles, and there are two main types of drugs used, one is FSH purified from urine and the other is genetically recombinant FSH.
24.What is ovarian hyperstimulation syndrome?
Ovarian hyperstimulation syndrome (OHSS) is the most common complication during IVF, mainly manifested by ovarian enlargement, abdominal distension, abdominal fluid accumulation, pleural exudation, blood concentration, oliguria, electrolyte disturbance, etc. Patients with OHSS can eat normally, and those with abdominal distension should eat less and more often, with a high protein diet, avoid excessive fatigue and exercise, and avoid abdominal pressure and bruising. The majority of patients can safely pass through with positive psychological adjustment and general clinical management.
25.How long does ovulation promotion take?
The duration of ovulation promotion depends mainly on the patient’s responsiveness to ovulation-promoting drugs, which varies greatly among individuals and generally takes 8-14 days. The patient’s responsiveness to ovulation medication cannot be predicted in advance and can only be judged roughly based on age, weight, basal FSH level and number of sinus follicles.
26. How is the egg retrieval procedure done and is it painful?
The procedure is performed under the guidance of vaginal ultrasound. The ultrasound probe is fitted with a puncture frame and a very thin needle is inserted directly into the follicle on the ovary through the lateral wall of the vaginal fornix, and the follicular fluid is aspirated under negative pressure. 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.
27. What are the risks of egg retrieval?
The main complications of the egg retrieval procedure are bleeding, infection, and damage to the surrounding organs, but the incidence of these complications is very low. Occasionally, symptoms of vagal excitation such as fainting, sweating, nausea, vomiting, weakened pulse, and decreased blood pressure can occur.
28. What the wife needs to pay attention to on the day of egg retrieval
In the morning of the day of egg retrieval, the wife needs to clean her vulva, eat appropriate high-calorie food, avoid drinking water, do not wear make-up, especially lipstick, to facilitate the observation of the condition, and do not spray perfume and hair wax, etc., so as not to affect the air quality of the operation. Empty your bladder before entering the operating room. For anesthesia surgery, an empty stomach is required.
29. What to pay attention to after egg retrieval
After egg retrieval, antibiotics should be given to prevent infection and progesterone injections should be started. Keep an eye on the vaginal bleeding. If there is persistent or heavy vaginal bleeding, you should contact your doctor, as well as if you have an elevated body temperature. If you have a large number of eggs and large ovaries, you should avoid strenuous exercise, lightly turn over, drink more soy milk, protein powder, juice, etc., and pay attention to the amount of urine.
30. What to do if the husband has difficulty in retrieving sperm
In order to avoid contamination of semen, the husband cannot have intercourse with the sperm. Therefore, those who have difficulty in sperm retrieval by masturbation should practice sperm retrieval by masturbation at home in advance and inform the doctor in advance before the surgery. Those who have difficulty in sperm retrieval on the day of the procedure will be induced by video or medication. If the above methods do not work, sperm retrieval by egg freezing or testicular puncture will be performed.
31. Can you have intercourse during the medication and after the egg retrieval surgery?
Avoid sexual intercourse during medication because the ovaries may become enlarged after ovulation promotion and ovarian torsion may occur. Sexual intercourse should be prohibited after egg retrieval and transfer.
32. Is the embryo transfer procedure painful?
Embryo transfer is performed by inserting a soft tube with embryos in advance into the uterine cavity under ultrasound guidance through the cervix and then inserting the embryos into the uterus. If you have any previous history of difficult transfer or ectopic pregnancy, you should inform your doctor in advance.
33. What to pay attention to before the transfer procedure
Eat normally and hold urine moderately before the transfer. It is recommended to drink 1000ml of water after emptying urine and try not to urinate without permission in the middle of the transfer.
34.Do you need bed rest after transplantation?
The activity should be reduced in the first 3 days after transplantation, but it is not necessary to be completely bedridden, otherwise it will aggravate the mental concern and cause mental tension. Complete bed rest after transplantation will affect the blood circulation in the lower limbs and the uterus, which is not good for embryo implantation. The woman should avoid heavy physical labor and strenuous exercise and prohibit sexual life during this period.
35.Do you need to pay attention to the diet after the transplantation procedure and what not to eat?
The diet should be high protein, high vitamin and easy to digest food (such as fish, meat, shrimp, fruits, vegetables, etc.), not to eat spicy and stimulating food to avoid diarrhea. In case of gastrointestinal discomfort (such as nausea, vomiting), abdominal distension, difficulty in urination and breathing, or lower abdominal pain, you should communicate with your doctor in time to avoid delaying treatment.
36.Can you watch TV and computer after transplantation?
You can watch TV and computer after transplantation, their radiation is very weak, there is no effect, in addition, through these entertainment can be distracted, not to mental tension, but the time should not be too long, should be moderate.
37. Can I urinate immediately after the transfer and will the embryos placed in the uterus fall out?
The uterus is usually a closed cavity, and the embryo inserted is located between two layers of endometrium, so it will not fall out. It is recommended to hold urine properly and not to drink too much water.
38.Why do you need a lot of progesterone after the transplantation procedure
The GnRh agonist applied during pituitary descending regulation has an inhibitory effect on the pituitary gland, which cannot be recovered in a short period of time, resulting in low luteal function of the ovary, plus the granulosa cells on the follicle wall will be aspirated during egg retrieval surgery, which will also affect the luteal function of the ovary, so large doses of progesterone are needed for luteal support after transplantation.
39. What about vaginal bleeding after transplantation that is less than the time to detect pregnancy?
This is a normal phenomenon, first of all, do not be nervous, continue to use the original amount of luteinizing support drugs, pay attention to bed rest can be.
40.How long after transplantation can we detect pregnancy?
13 days after transplantation, you can test your morning urine to see if it is positive. 14 days after transplantation, you can test your blood HCG to determine if you are pregnant. Do not test too early to avoid false positive due to the effect of drugs.
41. What are frozen embryos?
More embryos may be obtained in one ovulation cycle, but not all of them will be transferred, because implanting too many embryos may cause the risk of multiple births, so only 2-3 embryos will be transferred back to the uterus each time, and the rest of the embryos will be carried out can be frozen and preserved, which is called frozen embryos. If the treatment cycle is not successful, the preserved embryos can be directly thawed and transferred back to the mother later without the need for ovulation promotion, which not only eliminates the pain of surgery, but also saves a lot of money and increases the chance of conception once more. In some special cases, such as when ovarian hyperstimulation syndrome occurs during the medication cycle, or when the uterine environment is not suitable for embryo transfer, such as fluid in the uterine cavity or endometrial polyps, the implantation of cryopreserved embryos can be held off until the uterine environment is improved and then frozen embryos can be thawed for transfer. Since the embryos are preserved in liquid nitrogen at -197 degrees Celsius, they are theoretically available indefinitely.
42. Can people with premature ovarian failure undergo IVF?
Premature ovarian failure refers to ovarian failure before the age of 40. The diagnosis of ovarian failure is generally considered to be basal FSH > 50 IU/ml, but for IVF treatment, it is generally defined to be around 15 IU/ml. It is believed that if the basal FSH > 20 IU/ml the chance of pregnancy is very small, and it is difficult for such patients to obtain eggs even with ovulation treatment, so patients with premature ovarian failure need to use Therefore, patients with premature ovarian failure need to use other people’s eggs to do IVF, i.e. donor egg IVF.
43. What is the source of eggs for donor egg IVF and can you use your own relatives’ eggs?
At present, the source of donor eggs in China is the voluntary donor eggs of the patient undergoing IVF treatment. It is not possible to find your own eggs by applying your relatives’ eggs.
44. What is used to assess ovarian function
The responsiveness of the ovaries to gonadotropin stimulation and whether multiple follicles can develop at the same time is the key to the success of IVF treatment. This responsiveness is the reserve function of the ovaries, which is judged mainly based on: FSH level and E2 level measured 2-4 days after menstruation, ultrasound examination of ovarian volume and number of sinus follicles, inhibin B level, etc.
45. 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 natural pregnancy (10-15%), and there is also the possibility of ectopic pregnancy (about 3%), which occurs mainly in patients undergoing IVF treatment due to tubal abnormalities for reasons that are not well understood. Any fetal abnormality that occurs in a natural pregnancy can occur in IVF, but the incidence is not higher than in a natural pregnancy.
46. Is IVF related to the season
In vitro culture is performed in a laboratory where the humidity, temperature, CO2 concentration, etc. are constant and most suitable for embryo survival, so IVF is the same no matter what season it is.
47. What are the causes of unsuccessful IVF generally related to
There are many reasons for the failure of IVF treatment, such as the patient’s age, years of infertility, the quality of eggs, the quality of sperm and the cause of infertility. On the other hand, the technique of doing IVF itself has a great impact on the success rate. That is to say, when doing IVF, all aspects are very important and can affect the success rate of IVF.
48. How to choose the transfer time for frozen embryo thawing and transfer
Frozen embryo transfer is mainly based on the ovulation and endometrial condition in the month of transfer to determine the transfer time, which is also generally in the middle of menstruation. For people with normal menstruation and spontaneous ovulation, ovulation will be monitored in the middle of menstruation and the transfer time will be determined according to the number of days of culture when the embryos are frozen after determining the natural ovulation time; for people with sparse or irregular menstruation, such as those with polycystic ovaries, those with premature ovarian failure, and those with endometrial dysplasia in the natural cycle, the endometrium can be prepared with an artificial cycle, i.e. the application of estrogen in the first half of menstruation is the endometrial growth, and the endometrium will grow. In addition, for people with good ovarian function but no ovulation in the natural cycle, ovulation-promoting cycle can be used for frozen transplantation, i.e. ovulation-promoting drugs are applied at the beginning of menstruation, and follicles are expelled after maturation in the middle of menstruation, and then the transplantation time is set, and the thickness of the endometrium needs to be checked since then.
49. Who is suitable for IUI?
IUI is mainly suitable for male infertility such as oligospermia, abnormal semen liquefaction, sexual dysfunction and genital malformation: infertility due to cervical factors, inability to have intercourse due to genital tract malformation and psychological factors, immune infertility and infertility of unknown origin.
50.How is artificial insemination by husband and sperm done?
The process of artificial insemination is as follows: the wife monitors ovulation, the husband comes to the hospital around the time of ovulation in the middle of menstruation to masturbate and extract sperm, and the discharged semen is properly processed in the laboratory, mainly to remove sperm plasma, inactive sperm, deformed sperm and other harmful substances, and to keep the sperm with high motility and quality, and then injected into the wife with a hose. Depending on the location of the injection into the wife, it is mainly divided into intravaginal insemination, intracervical insemination, intrauterine insemination, intrafallopian insemination, intraperitoneal insemination, and intrafollicular insemination, and currently most of them are intrauterine insemination.
51.Is there a requirement for fallopian tubes for IUI?
Artificial insemination treatment is only to inject the husband’s semen into the wife after treatment. It requires the fallopian tubes to pick up the eggs, transport the eggs and fertilize the sperm-egg combination by themselves, so at least one of the fallopian tubes is completely open before artificial insemination can be performed.
52. Can you use medication for other diseases during IVF?
If you are suffering from other systemic diseases during IVF, you should first visit a specialist and inform your doctor that you are ready to do IVF, so that your doctor can choose drugs that are not harmful to the fetus or have little effect on it. Do not abuse drugs or listen to “prescriptions or secret recipes” to prevent accidents. Avoid using advertised drugs or new drugs that you don’t know about, especially not abusing health products. When taking medications, pay attention to the words “caution, contraindicated or prohibited for pregnant women” on the package. It is impossible for doctors to know all the drugs that have these words, so they should remind them if they can be used.