How is the extracororal fertilization cycle taken place?
Treatment of each pair is individual, but any program of assisted reproductive technology includes several successive steps - click on the chosen site for an explanation. Although we successfully conducted hundreds of couples through this process. It can still be very intensive, so we guarantee you any pieces of advice and support at every step of the way.
Step 1. Getting Started
We understand that the problem of infertility is very personal and causing great concern. As experts specialized in fertility problems we are pleased to help all patients who look for our help as soon as they faced with the problems of infertility, and those people who have been treated for infertility and need a new approach.
If you need additional information or assistance at any time, we will be happy to help. Please feel free to request a brochure or a more specific explanation of obscure points. All stuff of our center "Damia”is open to dialogue and willing to help you! (Permitted with link to contacts).
Step 2. Consultation
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At the initial consultation with the doctor the couple makes a decision on treatment strategy. We study your medical and surgical history, history of previous treatment and discuss possible options available to you treatment. If you require further examination, we will try to execute them on the spot. We want to minimize your travel time and waiting, not doing unnecessary tests to you, we'll try to use any actual information you own.
For the initial consultation the couple should take along all the statements about the manipulations and procedures which have been made and the results of surveys.
The need for ART cycle is taken together with the doctor and the married couple based on a combination of factors:
- age of each member of the couple;
- wife and husband's diagnosis,
- duration of infertility;
- results of previous treatment.
Step 3. Ovarian stimulation
In order to get the optimal number of eggs we produce pharmacological ovarian stimulation. Several types of drugs and the different ways of inputting are used in the treatment. For each woman individual treatment protocol is selected. Each woman receives individual scheme (protocol) in writing form. You can input all the medication yourself at home without the help of medical staff.
Step 4. Ultrasound monitoring
During thestimulation pelvic ultrasound with using vaginal probe is repeatedly performed, in order to assess the dynamics of growth of follicles,to endometria and to correct assignments. Based on the results the day for puncture is appointed .
Step 5. Collecting the eggs and sperm (sperm)
Collecting eggs is made by puncture (puncture) follicles and aspiration of their contents is controlled by vaginal ultrasound. This procedure is performed under intravenous anesthesia. You do not feel anything. The duration of follicle puncture is about 30 minutes. After the procedure, you will be in our center for 2 hours, in order to make sure that your state of health is normal. A sample of sperm is usually required at the time of taking of eggs. Please note that the most optimal sperm quality is after 2-3 days of abstinence from eyakolyatsiyi.
Step 6. Fertilization and Embryo Cultivation
The resulting egg is set in a special growth environment and then it is placed in an incubator for ensuring appropriate conditions and temperature conditions. The next step is fertilization. There are two types of fertilization:
Thus in the culture cup with eggs is added the minimum number of specially treated sperm. For the normal fertilization it is necessary to have at least 10 million actively motile sperm in the ejaculate total sperm after special treatment.
ICSI (intracytoplasmic sperm entry)
It is used even when it is the minimal change in sperm. In carrying out this manipulation one selected sperm with a special device (micromanipulators) and micropipette is inset into the egg. There are also additional indications for this manipulation - getting small amounts of eggs (5 or less), failure in the previous cycle and so on. In any case, doctors sometimes reinsured in order to achieve the maximum amount of fertilized eggs. Naturally, the need of ICSI is desirable to decide early on IVF cycle, but sometimes there is a need in the appointment of procedure on the day of puncture. You will be informed about that by your doctor.
The first signs of fertilization is the presence of two pronukleosiv inside the egg. Sperm fertilized ovum is called zygote. After the zygote divides into two cells (the day after fertilization) embryo development begins. Segmentation (fragmentation) is a term used to describe the cell division in the embryo (the first five days, while increasing the number of cells, but the weight does not change because it is the product of segmentation initial mass of the fertilized egg). Each cell embryo has its own development program because the embryo can have 2, 3, 4, 5 or 6 cells the day after fertilization. Thus, the number of cells on day 2 is not crucial to the creation of a full pregnancy.
Step 7. Embryos transfer
Embryo transfer is performed from 2nd to 5th day. Embryo transfer procedure is absolutely safe, painless and requires no anesthesia. Embryologist together with your doctor determines the time of embryo transfer. After embryo transfer you should lie in bed in a comfortable and cozy chamber for a while. Your stay is more psychological, because there is no scientific evidence of dependency horizontal length and frequency of pregnancy . After the transfer of embryos normal life is recommended , but you must adhere to physical and sexual rest.
After embryo transfer your doctor prescribes you medication for luteal phase support. Of course, they are injectable drugs and vaginal progesterone (Progesterone Inzhesta, Krynon, lutein, dufaston, Utrozhestan, Endometryn). In certain situations, other medicines can be applied.
8. Step Pregnancy Test
Evaluation of treatment is made in two ways by a pregnancy test and ultrasound. Pregnancy Test is performed within 14 - 16 days after embryo transfer. The test result shows whether there was embryo implantation in the uterus. Sometimes you need to make a second pregnancy test, you will be said about it on the consultation.
Please note that the reliability of urinary pregnancy tests in such a small period is not 100%.
If the pregnancy test is positive, you must have first pelvic ultrasound to make sure there is a heartbeat that confirms your pregnancy. Ultrasound study is carried out in four weeks after embryo transfer. If there are complaints (pain, discharge or other.) you should inform the doctor.
In case of a negative outcome of hCG the blood and supportive therapy is canceled and in 3-5 days regular monthly allocation s begin , sometimes more abundant. Later on we will discuss future ways of treatment.It is always available support and advice of our experts and foreign colleagues.