Damia Reproductive Health Center is constantly approached by couples who have difficulty conceiving.
There is no one-size-fits-all cause and problem: every family has a different history. But our team is specialists with many years of experience, ready to take on the treatment of infertility of any complexity and accompany you on this path side by side, from beginning to happy end.
At the initial consultations on the issues of our patients, there are usually a lot of fears, experiences, pains. Let’s try to calm the anxiety by describing all stages of the program of assisted reproductive technologies (ART). Here they are – 8 steps to achieve the desired parenthood!

 

Step 1: Get started

The problem of infertility is very personal, often provoking stress, whether you realize it or not. But we know how to help. The main thing is YOUR WISH.
As the genius writer and physician Anton Chekhov wrote: “We only need what we need!” So, if your desire is conscious, and not imposed by others, even close people, then you will successfully overcome all obstacles on the way to the dream goal.
Feel free to ask the center’s specialists for printed information or clarification of unclear details. Understanding all the nuances is extremely important for treatment. There are no trifles in our case, everything is important!

 

 

 

Step 2. Consultation

The first consultation with a reproductive specialist is possible both offline and online. You do not need to be examined before the meeting: all tests can be done at our center. However, we advise you to show the doctor the history of previous treatment, because in this case, every detail is important.
The doctor takes into account all the factors that affect infertility, and together with you chooses the optimal tactics of treatment.
What is the minimum list of examinations for a couple at the time of the initial consultation?
Spermogram of a man.
Blood test for sex hormones – follicle-stimulating (FSH), luteinizing hormone (LH), prolactin (2-3 days of the menstrual cycle), antimullerian hormone (AMG) and thyroid hormones (regardless of the day of the cycle).

If necessary, the doctor prescribes an office hysteroscopy to the patient. This procedure allows you to quickly and efficiently assess the uterine cavity.
We advise both partners to be examined, as 20% of infertility cases are a combination of female and male factors. In addition, examining a man takes much less time and effort.
It is important to know that the age and diagnosis of each member of the couple, the duration of infertility, the results of previous treatment and other factors also determine the tactics of treatment.

 

Step 3: Ovarian Stimulation

At the first stage of treatment, we individually choose drug therapy for each woman, which stimulates the growth of multiple follicles with potential eggs in the ovaries. Duration of stimulation – 8-12 days.
Several types of drugs and different methods of their administration are used in the treatment process. Each woman receives an individual scheme (protocol) in writing. All drugs you can enter yourself at home without the help of medical staff.

 

Step 4. Ultrasound monitoring

During stimulation, ultrasound of the pelvic organs is performed several times (on average, 3-4 visits) using a vaginal probe to assess the dynamics of follicle growth, endometrium and correction of appointments. Given the results obtained, the day of the puncture is assigned.

 

 

 

Step 5. Collection of eggs under anesthesia and collection of sperm

Oocytes are collected by puncture (puncture) of follicles and aspiration of their contents under the control of a vaginal ultrasound sensor. This procedure is performed under intravenous anesthesia, there is no pain.
The duration of follicle puncture is about 30 minutes. After the procedure, the patient is usually in our center for about 2 hours. Sperm are released on the day of egg collection or cryopreserved in advance. Note that the best quality sperm is after two to three days, but no more than five days, of abstinence from ejaculation.

 


 

Step 6: Fertilize eggs and cultivate embryos

The resulting eggs are placed in an incubator with a special nutrient medium to ensure proper conditions and temperature.
The next stage is fertilization of eggs. There are two types of fertilization.
During normal fertilization, a minimum number of specially treated sperm (at least 10 million actively motile sperm in the total ejaculate after sperm treatment) is added to the Petri dish with the ova.

ICSI (Intracytoplasmic Sperm Insemination) is used for male infertility. During this manipulation, one selected sperm is inserted into the egg using a special device (micromanipulator and micropipette).

There are additional indications for the ICSI procedure:
• obtaining a small number of eggs (5 or less);
• unsuccessful previous attempt at treatment;
• to ensure maximum fertilization of eggs.

The need for ICSI should be addressed at the beginning of the IVF cycle. However, the use of this procedure may be unplanned, and its need – to arise directly on the day of the puncture. Your doctor will inform you about this.
The first signs of fertilization are the presence of two pronucleos inside the egg. An egg fertilized by a sperm is called a zygote. After the zygote divides into two cells (the day after fertilization), the embryo begins to develop. Each cell of the embryo has its own development program, so the embryo may have 2, 3, 4, 5 or 6 cells the day after fertilization. Thus, the number of cells on the 2nd day is not crucial for a full pregnancy.

 

Step 7. Transfer of embryos into the uterine cavity

Embryo transfer is carried out from the 2nd to the 5th day. Blastocysts – embryos of the 5th day are considered to be the most promising for successful implantation.
The embryo transfer procedure is completely safe, painless and does not require anesthesia. The embryologist and your doctor will determine the time of transfer. After the transfer, you stay in bed in a comfortable and cozy room. Such a stay is rather psychological in nature, because convincing scientific data on the relationship between the duration of the horizontal position and the frequency of pregnancy has not been found. After embryo transfer, a normal lifestyle is recommended, but physical and sexual rest should be followed.

After the transfer of the embryos, the doctor prescribes you drugs to maintain the luteal phase. These are usually injectable and vaginal progesterone (Progesterone, Ingesta, Crinon, Lutein, Dufaston, Utrozhestan, Endometrine). In some cases, other medications are used.

 

Step 8. Diagnosis of pregnancy

The results of treatment are evaluated in two ways – a blood test for HCG (human chorionic gonadotropin) or a pregnancy test and ultrasound.
The pregnancy test is performed 14-16 days after embryo transfer. The test results show whether the embryo was implanted in the uterus. Sometimes it is necessary to do a repeat pregnancy test – you will be notified at the consultation. Note that the reliability of early pregnancy urine tests is not 100%. It is better to pass a blood test for HCG.
If the pregnancy test is positive, you need to have an ultrasound of the pelvis to make sure there is a heartbeat that confirms the progression of the pregnancy. Ultrasound examination is performed 4 weeks after embryo transfer. If you have any complaints (pain, discharge, etc.), you should tell your doctor.

In case of a negative result of the level of HG in the blood, maintenance therapy is canceled and after 3-5 days normal menstruation begins, sometimes more abundant than usual.

Believe me, almost all couples get a positive result, but sometimes it takes time and patience. And we will be with you, from the beginning of the journey until the birth of a child 💚.

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