In vitro fertilization (IVF) is a method for sperm and an egg to conceive outside the body, and then transfer the embryo into the uterus at the right time. This is one of the solutions for couples suffering from infertility – infertility and is often done when artificial insemination fails.
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What is in vitro fertilization (IVF)?
In vitro fertilization (IVF) is a popular fertility aid. This method is done by taking sperm and eggs, then fertilized outside the body (test tube) and transferred to the female uterus after the embryo has formed. The embryo implants in the uterus and develops into a fetus.
Besides artificial insemination , in vitro fertilization is the optimal solution for infertile couples – infertility and unable to have a natural pregnancy. The success rate of IVF depends largely on the age of the wife and on reproductive function abnormalities of both husband and wife. Although it is relatively effective, this method is an invasive procedure, costly to perform and has a significant impact on psychology – especially the wife.
When should in vitro fertilization be performed?
In vitro fertilization (IVF) is a complex process that costs more and affects the emotions of both spouses than in vitro fertilization. Therefore, this method is only indicated in the following cases:
- Women damage or block both of the ovaries, preventing the egg from moving to the uterus and “meeting” sperm.
- Moderate to severe endometriosis
- Premature ovarian failure prevents the egg from producing or releasing an egg each cycle, leading to no fertilization and infertility – infertility.
- Women with fibroids are also encouraged to perform artificial insemination because eggs are difficult to implant in the uterus and are virtually unable to get pregnant naturally.
- Women who have had their tubes tied but cannot be removed for many reasons can also intervene with IVF to get pregnant and give birth.
- Couples experiencing genetic disorders may perform in vitro fertilization to select healthy sperm and limit the genetic disorders for the next generation.
- Men have a low sperm count, weak sperm count and poor mobility
- Men experience ejaculation disorders such as non-ejaculation and reverse ejaculation
- Men who do not have sperm in the semen (must use sperm inside the testicles and crest)
- Women who have had cervical cancer but have not had enough children can freeze eggs and inseminate in vitro to get pregnant when they want.
- Infertility of unknown cause
- Failure of in vitro fertilization (IUI)
In vitro fertilization process
In vitro fertilization has a complicated procedure. Steps to be taken include:
Step 1: Examination and assessment of reproductive health
Before the IVF procedure, both husband and wife will be examined and evaluated for reproductive health. This is an important step for the doctor to consider whether or not to have an IVF.
– Test in the wife:
- Endocrine tests: To evaluate the activity of the wife’s hypothalamic – oat – ovarian axis, the doctor will order a hormonal test to measure the amount of hormones progesterone, estrogen, FSH, LH and evaluation quantity – quality of eggs.
- Testing for sexually transmitted diseases: Before IVF, your doctor will perform blood tests to identify potentially sexually transmitted diseases such as hepatitis B , syphilis, Chlamydia, HIV, etc. … to evaluate the health status and give appropriate solutions.
- Gynecological ultrasound : Ultrasound helps to detect gynecological diseases such as ovarian cysts, fibroids, polycystic ovary syndrome and some congenital abnormalities in the structure of the genital organs. This test helps doctors assess female reproductive health and detect the cause of infertility – infertility.
– Test in husband:
- Semen map: Assessment of semen is one of the important factors to determine the cause of infertility – infertility and provide appropriate fertility support solutions. In the case of normal or mildly abnormal semen and the wife is in good health, doctors often recommend artificial insemination instead of in vitro fertilization.
- Other tests: In addition, the husband may have to perform other tests such as a blood test to detect sexually transmitted diseases, an ultrasound of the scrotum, and quantitative measurement of sex hormones in school. semen-free semen.
Step 2: Click the eggs
Ovulation is performed continuously for 9-11 days by injecting drugs or by using oral drugs containing FSH or / and LH (luteinizing hormones). In addition, your doctor may use HCG to help follicles grow and certain medications to regulate oocyte activity with the help of ultrasound and blood testing.
After the follicle has grown to the prescribed size, the doctor will inject the last dose of ovulation stimulant (need to be injected on time) to perform aspiration.
Step 3: Poke eggs
After 36-40 hours after the last injection, the wife needs to fast and go to the hospital to perform egg extraction. To reduce pain, the doctor will use sedative and sedative during egg collection.
Procedure to remove eggs:
- An ultrasound probe is inserted inside the vagina to observe the exact location of the follicle
- Then, use a thin needle to poke eggs (take 1 or more eggs depending on the case)
- In cases where the vaginal aspiration is not possible, the doctor may perform laparoscopy to remove the eggs
- Eggs after being poked will be stored in a suitable environment and incubated to wait for fertilization
After receiving the eggs, the wife may experience angina in the lower abdomen. Therefore, doctors usually ask to stay in the hospital for 2 – 3 hours to monitor health before returning home.
Step 4: Collect sperm
Unlike egg aspiration, sperm collection is done relatively simply. For men with normal or mildly abnormal semen, sperm can be collected by masturbation. However, if the semen does not contain sperm, your doctor may recommend surgery to remove sperm from the testicles.
After taking semen, the doctor will transfer to a laboratory, select healthy sperm, remove deformed sperm, impurities and microorganisms in the semen.
Step 5: Insemination
The sperm and eggs are transported to the laboratory and incubated for fertilization. In the case of weak sperm and poor vitality, the doctor may inject sperm directly into the oocyte (also known as injecting sperm into the IC SI oocyte).
During fertilization, your doctor may perform several genetic tests on the embryo to minimize genetic disorders in the fetus. The embryo is then cultured inside a test tube for 2 to 5 days before being transferred to the womb of the wife.
Step 6: Transfer of embryos
At the right time, the doctor will report the number of embryos produced in the test tube and proceed to transfer the embryo into the uterus. In case of creating many embryos, it can be stored and used later when there is a need to give birth. Before transferring the embryo, the doctor will ask the wife to use vaginal suppositories and oral medications to facilitate the transfer process.
Process for transferring fresh embryos to the uterus:
- The wife will be given a mild sedative for the duration of the procedure
- Insert a small, soft, completely sterile tube (catheter) through the vagina and into the uterus
- A small syringe filled with fluid and embryo is attached to the catheter and injected directly into the uterine cavity
After transferring the embryo, the wife needs to stay in the hospital for 2 – 4 hours and have a medical check-up before returning home. In order for an embryo to easily nest in the uterus, it is necessary to rest, live and use drugs according to the instructions of a doctor. In the case of transferring frozen embryos, the wife will be ultrasound, use drugs within 14-18 days and the doctor will choose the appropriate time to transfer embryos.
The successful embryo will implant in 6 – 10 days.
Step 6: Check the results
After about 2 weeks from the time of embryo transfer, the wife needs to go to the hospital to have a blood test to determine the concentration of beta HCG. In case IVF is successful, the wife will be examined and advised by the Obstetrician about care during the pregnancy.
If there is no pregnancy but still frozen, the wife can perform embryo transfer in the following cycles without having to repeat the previous steps. For those without embryo storage, progesterone should be discontinued and rested for a while before fertility enhancement measures are restarted.
Is in vitro fertilization (IVF) dangerous?
In vitro fertilization (IVF) is an invasive procedure and a complicated procedure. Therefore, the risk of this method is also higher than that of artificial insemination.
The risks of in vitro fertilization:
1. Multiple pregnancy
Multiple pregnancy is a common risk of assisted reproductive techniques. Usually to increase the likelihood of pregnancy, a doctor sends more than 1 embryo into the uterus. As a result, it is possible in some cases to develop more than 1 pregnancy.
Multiple pregnancy comes with many risks and complications such as an increased risk of premature birth, low birth weight, sickness, weakness, difficulty in giving birth, …
2. Ovarian hyperstimulation syndrome
Human Chorionic Gonadotropin (HCG) is a common side effect of in vitro fertilization. This adverse effect was caused by the use of ovulatory drugs to mature the follicles. In addition to the effect of increasing the number of ovarian follicles, ovarian stimulants also cause ovarian enlargement, leading to lower abdominal pain, nausea, diarrhea, …
Some cases of severe ovarian hyperstimulation may face serious complications such as liver dysfunction, a lot of fluid in the abdomen leading to systemic edema, pregnant effusion, hypotension, difficulty. breathing, kidney failure, acute respiratory distress syndrome, … HCG usually occurs in women with low weight, thinness, young age and polycystic ovary syndrome.
3. Some other complications
In addition, IVF can cause a number of other complications such as:
- It is more likely to have a miscarriage than a natural pregnancy – especially in the case of frozen embryo transfer
- Damage and infection of blood vessels, intestines, bladder during egg aspiration
- Ectopic pregnancy
To minimize the risk of in vitro fertilization, both couples need to choose a reputable, quality hospital and set up a care regime according to the doctor’s instructions. In the event of an abnormal manifestation, it is necessary to immediately go to the hospital for prompt examination and treatment.
The success rate of the method of in vitro fertilization
In vitro fertilization has a higher success rate than artificial insemination. Statistics show that the success rate of IVF in the world is about 40-45% and in Vietnam it fluctuates around 25-40% in the case of the wife under 40 years old. If done when the wife is over 40 years old, the success rate will decrease from 2 to 10%.
In addition, the success rate of artificial insemination depends on many different factors such as:
- Reproductive health of husband and wife: If only husband or wife has reproductive abnormalities, the probability of pregnancy is higher than both husband and wife having fertility problems. However, this factor is more dependent on the wife.
- Age: Not only in vitro fertilization, but most of the fertility support methods are highly effective for couples under 40 years old. The success rate will decrease gradually as age gets older.
- Concomitant health status: In addition to reproductive organ problems, the success rate of IVF also depends on the overall health of both spouses – especially the wife. Normally, wives with poor health, low weight and medical conditions are less likely to become pregnant than healthy people.
- Medical facilities: IVF is a complicated assisted reproductive method that requires medical facilities to have modern machines and equipment and highly skilled doctors. Therefore, to increase the success rate, couples should choose reputable and quality establishments.
Insemination in vitro how much money?
The cost of in vitro fertilization at hospitals and centers ranges from VND 60-100,000,000. Actual costs may vary depending on the operator, the qualifications of the doctor, the couple’s health and the number of transfers.
Advantages – Limitations of in vitro fertilization
In vitro fertilization (IVF) is the solution for infertile couples – infertility. If you are planning to do it, you can weigh the advantages and disadvantages of this approach before making your choice.
- High success rate (ranging from 35-40% in the case of a wife under 40 years old)
- Can be done in men who do not have sperm in their semen
- Women who have damaged or have to completely remove the 2 ovaries are still pregnant
- High cost (about 60 – 100,000,000 VND)
- The risk is higher than in vitro fertilization
- Some couples may have to transfer embryos many times and experience psychological problems if the implementation is not successful
IVF is the most effective fertility method available today. Although there is a high success rate, this method easily incurs risks, complications, financial costs and significantly affects the wife’s psychology. Therefore, couples should consider and consult a specialist before deciding to do so.