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In Vitro Fertilization (IVF)

The birth of Louse Brown in 1978 conceived with the help of in vitro fertilization (IVF) became a huge breakthrough in the infertility treatment. The technology of fertilization in the test tube (in vitro) has fundamentally changes the capacities of treatment of infertile couples and resulted in the establishment of different auxiliary reproductive technologies (ART). 20 year late in vitro fertilization became the keystone to reproductive medicine and today IVF clinic uses the technology, which the senior generation considered something from the science fiction. With IVF many infertile couples, which had unsuccessfully tried to cure with other methods, did have healthy children.

At this moment more than four million children were born worldwide conceived with the IVF method.

The phases of the infertility treatment with the IVF method:

1. Examination of the married couple during IVF is conducted in accordance with the appropriate standards.

2. Stimulating ovulation of ovaries (stimulating the maturing of oocytes in the follicles of ovaries). For that purpose starting from 2-3 day of the menstrual (medicinal) cycle the woman receives injestions of special medicines containing gonadotropins (“Menopur”, “Purogen”, “Gonal-F”). As a result of injections several oocytes mature in ovaries (not one oocyte as in case of natural menstruation) which considerably increase possibilities for pregnancy. During the stimulation proves hormonal and ultrasound monitoring of ovaries is conducted. 10-11 days after the start of stimulation the maturing of oocytes takes place. The given process is optimized through injection of the trigger dose of human chrorial gonadotropin (HCG).

3. The procedure of extracting oocytes from the follicles is conducted 34-36 hours after the injection of the chorial gonadotropin through the puncture of ovaries with the special thin needle under ultrasound control. During the puncture of ovaries, as a rule, a short-term phlebonarcosis is applied. In cases when it’s impossible to get own oocytes of good quality the procedure of IVF is conducted with donor oocytes.

4. At the same time the husband’s sperm is selected and processed. In a series of cases (e.g. in case of absolute male factor of infertility) patients may apply for the donor sperm bank.

5. Embryological phase. Fertlization of oocytes with husband’s/donor sperm and cultivation of received embryos takes place in the laboratory conditions during the next 3-5 days. 16-18 hours after the fertilization the a zygote – fertilized oocytes with male and female pronucleuses – is formed. The first fragmentation of the fertilized oocyte takes place 20-22 hours later. In case of right fragmentation on the second day of the fertilization the embryo will consist of 4 cells (blastomeres). On the fourth day a morula – a cell mass generated by merged blastomeres – is formed. On the fifth day after the fertilization the morula is transformed into a blastocyst, accumulation of trophoblast and embryoblast cells forming a small cavity filled in with liquid.

6. The transfer of embryos to the uterine cavity is made on 3-5^th day of the puncture of ovaries. As a rule no more than 2 embryos are placed in the uterine cavity. The procedure is conducted in ambulatory conditions on the gynecological chair without cervical dilatation. The procedure doesn’t need anesthesia.

7. Post-transfer period. To ensure pregnancy after the transfer of embryos the doctor prescribes medicines containing chorial gonadotropin, progesterone or its analogue. 10-14 days after the transfer of embryos the pregnancy is tested to identify the level of chorial gonadotropin (HCG) in the blood. Ultraasound diagnosis of the pregnancy is conducted 21 days after the transfer of embryos.