IVF - in vitro fertilization

Apr 15, 2012 , Michaela Knollová

ivf-in-vitro-fertilizace.jpg - kopie
ivf-in-vitro-fertilizace.jpg - kopie
In vitro fertilization (IVF) is a method of assisted reproduction. In vitro fertilization is fertilization of an egg outside the patient's body in a laboratory. It is used during the occlusion of both fallopian tubes or if there are any risks associated with hereditary diseases and donation of the egg is not an exception. In IVF sperms and patient's or donor's eggs are taken, and afterwards fertilized.Already fertilized ovum is then inserted into the patient's uterus. IVF is relatively efficient method, however, it has certain risks especially due to hormonal stimulation patients.

IVF - in vitro fertilization

If the couple fails to conceive within two years with regular unprotected sexual intercourse, it is advisable to talk about methods of assisted reproduction with an expert. One of them is the so-called in vitro fertilization (IVF). This method is based on the fertilization of the woman’s eggs or donor ones with partner's or donor's sperms outside the woman's body. It is necessary to take the sample of healthy eggs and sperms. The eggs are obtained by hyperovulation in which the woman takes sex hormones from the beginning of the ovulatory cycle. These hormones cause that it does not mature only one egg in the uterus but several of them. Growth and maturation of eggs is regularly checked by ultrasound examination. When the eggs are matured, they are extracted. The collection of eggs or oocytes is a procedure that is performed under general anaesthesia, it takes 15 - 20 minutes and it is done ambulatory. When the intervention is finished, the woman rests for about two hours on cot, and then, if everything is in order, she can go home. After the collection, the eggs are left in the laboratory to be fertilized by sperms, they are cultivated for three days and then injected back into the woman's uterus.

Fertilization

For conception of a child is fusion of sperm and the egg necessary. Ideally, one egg matures once a month in the woman's ovaries. When the egg is matured, the ovulation during which is the egg released into the fallopian tube occurs. The egg remains for about 24 hours in the fallopian tube in order to be fertilized. According to this are male sperm needed. Sperms develop in the testes in which they have the ideal temperature and environment for their growth. During sexual intercourse, it leads to ejaculation or erection of semen into the woman's vagina, afterwards sperms move through the uterus into the fallopian tube. After the fertilization of egg by sperm a complex process of development occurs. The fertilized egg migrates from the fallopian tube into the uterus which is already hormonally prepared for his nidation, growth and development. If the egg is not nidated in the womb, it is eliminated together with blood during the menstruation. If there is an error in any step of the fertilization, reproduction disorders develop.

Course of IVF

Firstly, during in vitro fertilization (IVF) the woman is stimulated with female sex hormones to induce so-called hyperovulation in which matures more eggs at once in the ovary. Into the woman's vagina is at first introduced ultrasound probe which allows doctors to see the ovaries and eggs. Afterwards, puncture with needle through the vaginal wall is made and matured eggs are extracted. This way, the eggs are collected directly from the patient or donor.  Furthermore, it is necessary to obtain male sex cells, i.e. sperms, by masturbation. Sperms can be provided in two ways, by the partner or from the donor.

Corse of IVF in laboratory

After the collection of sperms, the semen is analysed by various tests. Sperm count and tests for infectious diseases such as HIV or hepatitis B and C are performed. The sperm count is laboratory examination of male fertility in which is quality and quantity of sperms examined under the microscope. It is a non-invasive, painless examination, so there is no need to worry about it. Collected sperms and eggs are placed together into the reaction vessel with the proper temperature in incubators. Ideally, it comes to natural fertilization of ova and thus to the development of embryos. However, if the sperm can not penetrate the protective cover of eggs, there is a possibility to help them. It is the method called intracytoplasmic sperm injection (ICSI). In this method, with the special needle is healthy sperm injected into the egg under the microscope and the egg is fertilized. Fertilized eggs or embryos are tested for various genetic defects and only the healthy ones are chosen.

The final phase of IVF

Woman must be also specially prepared for implantation of the embryo. During the preparation, the woman takes another hormone called progesterone. These hormones cause changes in the uterine lining and improve the conditions for the adoption of the fetus. Insertion or implantation of the embryo into the uterus is performed with long needle called implantation window. This is performed between 2 and 6 day after administration of progesterone. The proper attachment of the embryo is checked by ultrasound and regular monitoring of hormone levels. Normally, not all of the embryos are implanted, the woman always agrees the number with the doctor. Nowadays, implantation of fewer embryos is preferred. If all of the embryos adapts, it is necessary to remove some of them. Maintaining them in the womb and also their removal from the uterus is risky for the selected embryo. The remaining embryos can be preserved by deep freeze

Risks of IVF

Even in vitro fertilization (IVF) has its associated risks. The greatest risk is during the support of hyperovulation because ovarian hyperstimulation syndrome may manifest in the woman. It is basically the response of woman's body to high doses of hormones. Therefore, the woman is during the whole process of IVF intensively monitored. Feeling of pressure in the lower abdomen or low pressure is very common. If you are undergoing this treatment and have some difficulties, it is necessary to inform your doctor about them.

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