Hello everyone. I hope all of you are well. Here I bring you these very curious data that I compile in a search about the doubts that many have when implementing a treatment of fertilization. I hope you can be of help and comment on your experience.
1. What is in vitro fertilization (IVF) and for what cases of infertility is indicated?
In a normal pregnancy, the sperm ascends to the tubes, where it fertilizes the oocyte that has previously been ovulated. There an embryo forms, which reaches the uterus, where it nests. In vitro fertilization stimulates the ovulation of women and oocytes are extracted, which are fertilized in the laboratory with paternal semen. A selection is made from the embryos obtained. Some are transferred to the mother's womb and the others are frozen.
This technique is the best therapy for many male and female fertility problems: males with sperm unable to ascend through the mother's womb, repeated failures of artificial insemination, couples with a history of genetic diseases ...
2. What tests are done before fertilization?
In addition to the complete clinical history, the tests include a sperm analysis to evaluate the quality of the male semen and a gynecological examination of the woman that includes a study of its ovarian response capacity and another of the tubal patency.
3. Can you choose the sex of the baby?
No. It is only possible if there is a therapeutic end. In some countries, only the genetic selection of embryos of a specific sex is carried out when this prevents X-linked diseases.
Those are the cases of hemophilia, Duchenne muscular dystrophy or Fragile X syndrome, which women can carry, but not suffer from. Therefore, female embryos are selected.
4. How is IVF carried out?
In the first phase, the ovulation of the woman is stimulated by the administration of hormones. The second phase is the extraction of the oocytes, vaginally, with local anesthesia and with a duration of 5-10 minutes. And in the third, the obtained oocytes go to the laboratory, where they are studied and inseminated so that the gametes do their fertilization process on their own, in the case of normal IVF; If IVF is used with sperm microinjection, the sperm are injected one by one into each oocyte. Afterwards, they are introduced in incubators, cultivated and evaluated every day. On the third day, the appropriate ones are selected for the transfer to the uterus, according to different criteria: morphological, genetic ... This procedure does not require anesthesia. The remaining embryos are conserved for successive cycles, in which the woman would only have to undergo this last procedure.
5. How many embryos are implanted in the uterus?
It depends on what the law allows, but it is tried to transfer one or two, to avoid the risks of a triple pregnancy. If there have been multiple failures or if the quality of the embryos is not very good, you can evaluate transferring three.
6. Do we have to rest?
On the day of the transfer, relative rest is recommended for 24 hours. From there, the woman can restart her social and work life, although it depends on the work she performs. If it is office you can return to the 24 hours.
7. How long is the whole process?
The diagnostic phase -of previous tests- has been greatly simplified and is completed, with some exceptions, in two or three visits. Then, they are 10-12 days of ovarian stimulation and another one for the extraction of oocytes. After three days the transfer is made. In total, 15 days pass. After IVF you have to wait 12-15 days to find out if the woman is pregnant.
8. When do you have to leave?
It is normal to limit attempts to four cycles, but recurrent failures are not analyzed in the same way in a young couple with good quality embryos than in a 39-40 year old woman with little ovarian reserve. After a certain age, success rates go down a lot, except that the donation of oocytes is used.
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