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IVF is a common term for in vitro fertilization-embryo transplantation (IVF-ET) technology. It refers to the whole process of removing the egg from a woman's ovary, fertilizing and cultured with sperm in vitro for 3 to 5 days, and then transplanting embryos that develop into the egg division or blastocyst stage into the uterine cavity, so that they implant and develop into a fetus. Babies produced using in vitro fertilization are called in vitro babies, which can also grow in the mother's womb.
A "test-tube baby" does not actually grow in a test tube. Instead, it involves the extraction of a few eggs from the ovaries, which are then combined with the man's sperm in a laboratory to create an embryo. This embryo is later transferred into the woman's uterus for implantation and pregnancy to occur. In natural conception, sperm and egg meet in the fallopian tubes, where they combine to form a fertilized egg. The fertilized egg then returns to the uterine cavity to continue the pregnancy. Research indicates that the pregnancy rate after one cycle of treatment is approximately 40%, with the birth rate slightly lower.
Introduction:
In vitro fertilization, commonly known as IVF, is a complex but effective method of assisted reproduction.
This guide aims to provide you with a step-by-step overview of the IVF process,
from initial testing to post-transplantation care.
Pre-IVF Testing:
Before embarking on your IVF journey, comprehensive testing is required for both partners.
Here's an overview of the testing process:
1. Testing for Women:
(1) Hormone Tests:
Follicular stimulating hormone (FSH), luteinizing hormone (LH),
lactin-promoting hormone (PRL), estradiol (E2), progesterone (PRGE), testosterone.
(2) Female Instrument Inspection:
Ultrasonography.
(3) The woman's physical examination items:
Physical Examination: Hepatitis B virus surface antigen HBsAg, hepatitis B virus surface antibody AntiHBs,
hepatitis C Anti HCV, HIV AntiHIV, Syphilis VDRL, rubella (German measles) Rubella IgG, blood group,
blood factor Rh blood group, hemoglobin typing, full blood count CBC, chickenpox Varicella Ig G;
Thalassemia, renal function, liver function, chlamydia pneumonia lgG / trachomatis IgM/ IgG,
Toxoplasma gondii (anti) - Toxoplasma IgM/IgG, anti cytomegalovirus (IgM/IgG),
anti-herpes simplex virus anti-HSV-2.
2. Testing for Men:
**Hepatitis B virus surface antigen HBsAg, hepatitis B virus surface antibody AntiHBs,
hepatitis C Anti HCV, HIV AntiHIV, syphilis VDRL, blood type, blood factor Rh blood group,
hemoglobin typing, full blood count CBC.
Semen Analysis: Semen volume, color, pH, sperm density, inflammatory cells, survival rate,
liquefaction, mobility, deformity rate.
Because the length of the menstrual cycle varies from person to person, and there are also differences in different cycles of the same patient, it is not easy to arrange the egg extraction time, and there is only one dominant follicle development in the natural cycle. After fertilization, only one embryo can be formed, and the pregnancy rate of transplanting an embryo is very low. Therefore, controlled hyperovulation is needed to enhance and improve ovarian function, so as to obtain multiple healthy eggs without the limitations of the natural cycle, provide multiple embryo transfers, and synchronize luteal development with endometrial function as much as possible. Controlled hyperovulation is generally to use GnRHa to lower the FSH and LH in the body, and then apply HMG or FSH ovulation drugs to stimulate follicle growth in the ovaries. The dosage of drug use is adjusted according to the patient's response to the drug. The age and dosage of the patient and the dosage of the drug are different, and the number of eggs obtained are also different.
When a couple preparing for pregnancy plan to have a test-tube baby, the woman needs to have ovulation promotion treatment first. This is because not every egg can be
fertilized, and not every fertilized egg can develop into a vibrant embryo. Therefore, multiple eggs need to be obtained from a woman's body to ensure that there are
transplantable embryos, which requires ovulation promotion treatment for women.
The specific method is that on the second day of the menstrual cycle, or when the results of ultrasound examination of reproductive hormones and uterine ovaries meet the
requirements, the woman begins to apply ovulation-promoting drugs. Doctors judge follicle growth based on the results of ultrasound monitoring and serum hormone
measurement, and decide whether the dosage of ovulation-promoting drugs needs to be adjusted. When the follicle matures, hCG is injected to promote the final maturity of the
egg. The eggs are usually taken 36-38 hours after the injection of hCG.
According to follicle growth, 1-2 blood tests (LH, P, E2) and B-ultrasound examinations are arranged. Generally, after 8-12 days of gonadotropin, the follicles develop and mature. When the diameter of the two dominant follicles ≥18mm and E2 meet the requirements, Dabijia (or daphilin) and gonadotropin are disabled. Generally, hCG is injected that night. Hormone blood samples should be collected promptly (around 8 a.m.) on the same day to ensure that results are available by 10-11 a.m. This allows for timely medication adjustments.
It is recommended to wash your hands before collecting the sample. Masturbation is the typical method used to obtain sperm, and a sterile cup is provided for this purpose. When handling the cup, it's important not to touch the rim or the inside of the cup. The collected semen is processed using techniques such as upstream or Percoll density gradient centrifugation.
Following the egg removal process, the treated sperm and eggs are placed together in the same petri dish approximately 4-5 hours after the eggs have been collected. After about 18 hours of co-cultivation, fertilization can be observed under a microscope. In cases where the sperm quality is insufficient for natural fertilization, microinjection techniques, such as single-sperm microinjection into the egg's cytoplasm, may be employed.
Fertilized eggs can develop into 8-16 cytogenes after 48-72 hours of culture in vitro. At this time, the number of transplanted embryos is determined according to the patient's age, pregnancy and the quality of the embryo, and the excess embryo can be frozen. Embryo transfer generally does not require anesthesia. At present, embryos are mostly transplanted 2-3 days after fertilization, and I use 3-5 days after fertilization. The higher the requirements for postponing the time of embryo transplantation, the higher the conditions for in vitro culture, but delaying the transplantation time is more in line with pregnancy physiology. At the same time, inferior embryos can be eliminated through natural screening, which can improve the pregnancy rate and reduce the multi-birth rate.
You must take a urine test 14 days after the transplant to determine whether you are pregnant or not. If the urine test is positive, you should contact us immediately. You must come back to draw blood to check hCG to further confirm and make a more accurate judgment, and continue to prescribe medicine to protect the fetus. Generally speaking, when you come to the center twice 4 weeks or 6 weeks after transplantation, the vaginal B-ultrasound examination to understand the condition of the intrauterine embryos (whether there are fetal sacsacs, several fetal sacs, fetal buds and fetal heart rate, and whether there are multiple fetuses). At the same time, it is as much as possible to exclude ectopic pregnancy. Once three or more births are found, the fetus must be reduced. Vaginal bleeding sometimes occurs during early pregnancy, which is not uncommon. If there are no evident abdominal cramps or pain, and if the ultrasound has shown a clear fetal heartbeat, the likelihood of a miscarriage is low.
How does a test-tube baby protect the fetus? After embryo transplantation, the "small seed" will be planted in the uterine cavity, stretching out the blood vessels and establishing
blood circulation with the mother, just like a tree rooting and rooting in the ground, also known as "embryo implantation".
Pre-treatment of the test tube will affect the function of the luteum. Progesterone and estrogen need to be added after embryo transplantation, which is conducive to embryo
implantation. Commonly used drugs include progesterone injection, diprogesterone tablets, human chorionic gonadotropin, estradiol valpronate, etc.
Within 2 hours after embryo transplantation, the doctor will arrange appropriate fetal protection treatment drugs for you. You must remember clearly. If you don't understand, ask
the nurse in time and insist on the treatment on time every day. Don't stop taking drugs rashly, otherwise it may cause bleeding.
14 days after the transplant operation, come to the hospital to draw blood on an empty stomach to determine serum HCG. Generally, it is greater than 50Miu/ml to indicate
pregnancy. Continue the fetal preservation treatment for 14-21 days and check the B-ultrasound. If you see the intrauterine gestational sac, there is fetal buds and fetal heartbeat,
you can determine the clinical pregnancy. Fetal preservation treatment generally needs to be maintained until 55 days after embryo transplantation, and the condition is stable
before the amount can be gradually reduced.
After IVF transplantation, there are several precautions for women to consider in their daily care. Following menstruation, you may choose to soak your feet or consume blood-enriching products like gelatin. Drinking soy milk or milk daily can aid in preparing your body for conception. Additionally, after eggs and transplantation, it's important to pay attention to maintaining a balanced diet and getting adequate rest. Maintaining a positive and stress-free mindset is also essential, as it can contribute to the successful implantation and development of fertilized eggs.
Women need to recuperate their bodies to the state that is most suitable for conception before surgery. You can soak your feet after menstruation, and the water should not pass the calves for 30 minutes until the night before the transplant. After menstruation is clean, eat gelatin in the morning and evening to nourish blood until transplantation, or drink soy milk and milk every day.
Take more rest. If you feel uncomfortable, contact your doctor in time. Don't lift heavy objects; don't drink alcoholic beverages; don't use drugs such as pain relief or sedation; take medicine on time as prescribed by the doctor.
Diet: You may have a balanced diet, including vegetables and protein-rich foods.
Avoid alcohol, tobacco, caffeinated drinks, and very cold foods.
Rest: In the first 48 hours after transplantation, aim to rest as much as possible.
Lie down, preferably flat, and avoid strenuous activities. Light activities at home are acceptable
after the initial 3 days, and you can engage in mild outdoor activities after 5 days.
Refrain from working until pregnancy is confirmed. Maintain a regular routine, avoid staying up
late, and prioritize adequate sleep.
Exercise: After transplantation, avoid heavy exercise, but light and moderate physical
activity is encouraged. Steer clear of heavy lifting or extreme workouts. It's advisable not to
engage in sexual activity until a successful pregnancy is confirmed.
Hygiene: Maintain good personal hygiene, adapt clothing to changing weather, and keep your
body clean and comfortable.
Emotional Well-being/Mood: Maintain a positive and relaxed mindset. Avoid excessive worry
about the results and focus on overall well-being. Keep a happy mood.
Social Activities: Minimize participation in crowded social activities to avoid exposure to
air pollution and potential stress from external factors.
Difecation: Pay attention to your diet to prevent diarrhea or constipation. Keep your stool
unobstructed. If you have constipation, don't hard relieve your stool until you have an idea.
Including more vegetables in your diet can help maintain smooth digestion.
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