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In Vitro Fertilization, is
it?
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Nation in July 1980 the
first child conceived by in vitro
fertilization (IVF) and embryo transfer
(ET), which caused a lot of publicity
worldwide. From that date forward has
been born many children fathered by this
method. The technique has a relatively
low success rate and expensive,
considering that is the last recognized
method of treatment in infertile couples
with no other alternative.
The first patients treated with IVF were
those who had no permanent injury or
fallopian tubes, then your application
has been extended to blocked fallopian
tubes, fluid volume decreased sperm,
immunological infertility, unexplained
infertility, severe impairment fimbriae
(terminal segment of the fallopian tube)
Couples should undergo a study before
undergoing an IVF, with complete review
of medical records and discussion of
realistic expectations regarding the
relatively low percentage of success.
This method is not used in women over 40
years because at that age the pregnancy
rate is lower and the number of
abortions is around 50%. The choice of
stimulation method to use depends on
several factors such as age and weight
of the patient and the method used for
the extraction of the egg for IVF.
Ultrasound-guided techniques are most
successful when large follicles can be
stimulated, while laparoscopic
techniques are more useful when the
follicle (cyst where the egg) is small.
The most important step in the process
of IVF is to stimulate egg development
and maturation, so that it can be sucked
into the right moment (when ripe) Drugs
used to stimulate the woman does not
ovulate , modified in terms of dosage
and duration to produce growth
stimulation of egg and even
hyperstimulation. Should be measured
daily estradiol (female hormone) levels
and the diameter of the follicle
containing the egg, to decide whether to
continue with the administration of
stimulant medications and when to start
hormone chorionic gonadotropin (HCG)
Ovulation appear at 36 hours HCG be
administered so that the aspiration is
scheduled to occur before spontaneous
ovulation.
Initial attempts at IVF
(in vitro fertilization) used the
natural cycle, but obviously the success
of this technique can be improved if
more embryos are transferred, so
medication is used alone or in
combination to enhance the stimulation
of the egg. Although there are almost as
many protocols as researchers use them,
the general technique is to use the
stimulant drug to the top of the normal
cycle, ie the fifth day of the menstrual
cycle and started monitoring with
ultrasound and determination of
estradiol in the blood.
It has been shown that a
pattern of stimulation is better than
another, whether it has different
results in different hands.
At first he aspired to the egg by
laparoscopy under general anesthesia but
are currently being used ultrasound
guidance, either by abdominal or
vaginal.
The timing of the laparoscopy is done is
of paramount importance, although the
procedure does not change at all of
which makes for a diagnostic procedure
in the gynecological field. Laparoscopy
is performed routinely with
visualization of both ovaries with their
follicles developed (these are inside
eggs) were punctured with a long needle
and aspirate the contents of the
follicle, the fluid is immediately to
the laboratory, the same as usually
found in the operating room or close to
this.
In the laboratory the egg is identified
as quickly as possible and separating it
from surrounding blood, placing it in an
incubator during the period that depends
on their maturity. The immature eggs can
be subjected to prolonged pre-incubation
before insemination, which is done after
6 to 24 hours with semen prepared and a
known number of sperm per egg.
Fertilization should occur during the
next 15 to 18 hours. The media should be
changed more or less 18 hours after
insemination by a more rich in protein.
When the embryo is at the stage of
division between two to eight cells, is
performed embryo transfer (ET)
To carry the embryo to the uterine
cavity using a catheter system. The
embryo is taken with the catheter along
with the culture medium that surrounds
and gently inserted into the uterus
between 48 and 60 hours after
fertilization, the process is usually
not painful, does not cause cramping and
bleeding. The patient must remain
undisturbed for several hours after the
transfer. May be given antibiotics to
prevent the possibility of subclinical
intrauterine infection or mild
tranquilizers can be used for the
procedure.
