IVF: Hope to thousands of Infertile Couples
The term IVF describes a fertilization, outside the woman’s fallopian tube, that takes place in the laboratory, and includes a wide range of techniques designed to help infertile couples have a child.
However, the eggs and sperm used in this procedure are of the couple concerned. This method is chosen when some problems in the reproductive system of the prospective parents can’t be overcome (eg blocked fallopian tubes, weak sperm or a combination of factors), as well as when other methods of assisted reproduction (eg intrauterine inseminations) have failed. In addition, an important parameter that can lead the couple to IVF is the age of the woman. If he is over 37-38 years old, IVF is immediately recommended so as not to waste valuable time with other methods. In fact, after 40, her ability to conceive decreases sharply, as the eggs are of poorer quality and fewer.
The evolution of IVF dates to 1878, when a variety of relevant experiments took place. We have reports that Pincus, Enzmann and Schenk in 1935, 1939 and 1978 respectively, attempted to achieve in vitro fertilization, using ovaries that were probably immature. The discovery of sperm maturation in 1951 was crucial. The first human birth with this technique took place in 1978 in England: a very healthy baby girl named Louise Brown.
The couple must undergo a series of examinations before proceeding to IVF. The woman should have a hormonal test on the 3rd day of the period and hysterosalpingography between the 8th and 10th day of the cycle. On the 21st or 22nd day of the cycle, progesterone is tested. It is also good to have a mammogram -especially if the woman is over 35-, as well as the classic biochemical test (for hepatitis B, C, VDRL, etc.), which is a prerequisite for the man. The main test for the man is the sperm chart, after 2-3 days of sexual abstinence which examines whether the quantity, morphology and motility of the sperm are satisfactory. If the sperm count is abnormal, it is repeated after 15 days to 3 months. When the couple finally decides to have Fertilization, the woman receives injectable hormones to stimulate the ovaries and increase egg production, and GnRH agonists or antagonists to prevent premature ovulation. Depending on the medication protocol, treatment is started on either the 1st or 21st day of the cycle. Ovarian stimulation lasts about 2 weeks. During it, the woman is monitored hormonally and with ultrasounds, to see how her ovaries respond, while it is possible from the swelling, to feel discomfort in the lower left and right abdomen. When most of the follicles reach a suitable size (over 18 mm), then follows the ovulation, the taking of the eggs that have matured in the ovaries, with a special needle transvaginal, with light anesthesia. Usually 8-10 eggs are taken. It takes 10-14 days to complete this process. On the day of ovulation, the partner gives sperm. Embryo transfer takes place 2-3 days after ovulation. The blastocyst is a special mode of embryo transfer and is selected when a pre-implantation test is to be performed or when the goal is to transfer a small number of embryos and is done 5 days after ovulation. The embryo transfer is done without anesthesia, with the help of a thin catheter. Ten to twelve days after the embryo transfer, the pregnancy test is performed. It is considered necessary for the couple to be monitored by a mental health specialist throughout the procedure. Better yet, consult someone beforehand so that they can be sure that they really want it. If the test result is negative, a second cycle can be performed after 3 or 4 months, depending on the protocol followed, while up to 4 cycles can be done in 1 year.
The method is generally quite effective. The chances of conceiving depend on many parameters, of which the age of the woman is one of the most basic, but they reach up to 40% by the age of 30. But the chances of getting pregnant after 40 falls sharply to just 3%. It is worth noting that an IVF center must be more than 20% successful to be considered reliable.
The main in vitro fertilization techniques are:
A) Classic in vitro fertilization (IVF)
B) Assisted hatching
C) Blastocyst culture
D) Micro fertilization (ICSI)
E) Cryopreservation of embryos and testicular tissue