In 1978, a female \”test-tube baby\” named Louise Brown was born in Cambridge, England, ushering in a new era in the history of human reproduction. Subsequently, the new concept of in vitro fertilization (IVF) spread throughout the world.
In vitro fertilization is a process in which eggs are removed from the body, sperm is combined with the egg, and the fertilized egg develops into blastomeres, which is artificially carried out in a test tube. When the embryo develops into 2 to 8 blastomeres, the early embryo is removed from the test tube and transplanted into the woman\’s uterus to develop and grow. Because the initial stages of sperm and egg development are in the test tube, it is called \”test tube baby\”. IVF technology mainly includes the following links: stimulating ovulation; monitoring ovulation; egg retrieval and egg search; in vitro fertilization; embryo transfer; and post-transplantation treatment.
Doctors usually give patients a drug called gonadotropin-releasing hormone analogues, which can temporarily stop the pituitary gland from secreting follicle-stimulating hormone and luteinizing hormone. Under normal circumstances, this drug Two hormones promote the development of follicles. Patients usually take a series of low-dose gonadotropin-releasing hormone analogues called peptide hormones. The two commonly used drugs are ganirelix and cetrorelix, which are usually injected 1 to 2 times. Later, when these drugs work to stimulate the follicles, follicle-stimulating hormone and luteinizing hormone are injected. This technique allows more control over the process of stimulating the ovaries and follicles, allowing multiple follicles and eggs to develop simultaneously. In this way, when retrieving eggs, doctors can find mature eggs in most follicles.
When follicles enlarge, they are easily seen via ultrasound, and the patient\’s hormone levels can also be tracked through blood tests. When ultrasound shows that the follicles have developed enough to release a mature egg, the patient is given an injection of human chorionic gonadotropin to trigger ovulation. Generally, ovulation can begin 36 hours after the injection of human chorionic gonadotropin, so the egg retrieval procedure is arranged before ovulation, so that the most mature eggs can be collected.
The egg retrieval process can be completed in an outpatient clinic and only requires intravenous anesthesia. Under anesthesia, a long hypodermic needle is inserted deep into the ovary through the vagina, and the eggs are then removed from the ovary. Under the guidance of ultrasound, the doctor inserts a needle into each mature follicle, and then gently sucks out the egg and the fluid around it. This process takes 20 to 30 minutes. It takes the patient 1 to 2 hours to recover from anesthesia, and then they can go home. You will still feel some fatigue over the next few days due to the effects of the anesthesia.You may feel a little uncomfortable when using it.
After the eggs are collected, they are immediately mixed with the other person’s sperm and placed in the laboratory for fertilization. If it is intracytoplasmic sperm injection, then the other person’s sperm needs to be injected into the egg. Keeping the fertilized egg warm and watching to see if it divides is the first step in developing into an embryo. This process usually lasts 1 to 3 days.
If the fertilized eggs divide normally, each fertilized egg will become an embryo with 4 to 8 cells after 3 days. The next step is to transfer the healthiest embryos into the uterus. This procedure does not require anesthesia. Observe the health of the embryo under a microscope to see how many cells it divides into, the more the better, and whether it is symmetrical. The doctor will put a vaginal dilator into the patient\’s vagina to clean out the dirt in the cervix, and then insert the catheter into the cervix, with the embryo and liquid contained in the catheter. A syringe slowly injects this mixture of fluid and embryo into the uterus. This process is painless. Later, the patient needs to lie down and rest for 30 to 60 minutes. Patients also need to rest for at least 1 day after returning home, and do not do any strenuous exercise or sexual intercourse for 1 to 2 weeks.
The average number of eggs collected from the ovaries is 10 (depending mainly on the age of the woman). Of these 10 eggs, six are usually fertilized in the laboratory and begin embryonic development. If the patient is under 35 years old, 2 embryos are usually transferred to the uterus. If you are older, 2 or 3 embryos are transferred. All transferred embryos have the potential to implant and develop into fetuses, so couples and their physicians should discuss how many embryos will be transferred to the uterus. However, it is possible that none of them implant. Whether an embryo can implant and develop normally depends on the quality of the embryo.
In vitro fertilization is currently the most complex, expensive and controversial method to solve infertility. However, this technology is promising and can be used by the majority of couples who have failed other fertility methods. Fallopian tube obstruction and endometriosis are the best indications for in vitro fertilization, but it is expensive, time-consuming, and has a low success rate. Any couple undergoing IVF must have a strong sense of risk. Of course, this technology is different from other clinical operations in that it is almost all done in the laboratory. To choose this assisted reproductive technology, first the woman\’s ovarian function must be normal and the man must have viable sperm. If there are scars and adhesions on the ovaries or problems with the vas deferens, it is necessary to undergo microsurgery and supplemented with progesterone treatment. Preoperative examination includes assessment of fertility, elimination of various infections and further analysis of sperm. The ovaries must be surgically accessible, and if necessary, the ovaries need to be evaluated laparoscopically. In vitro fertilization can begin only after all tests have been completed.
Many couples have more than one factor that causes infertility. Generally speaking, the more factors that cause infertility, the smaller the success rate of IVF. For example, if an infertile woman with endometriosis undergoes in vitro fertilization and the only factor causing the woman\’s infertility is endometriosis, the body willThe success rate of external fertilization is 31%. But if the other person’s sperm also shows abnormalities, the success rate drops to 16%. For women with both endometriosis and fallopian tube disease, the success rate of IVF is only 8%. This has also been confirmed in studies of women with fallopian tube disease.
Among those women who become pregnant through in vitro fertilization, about 20% will miscarry, and ectopic pregnancies account for about 5%. The proportion of babies born through in vitro fertilization with congenital malformations is slightly higher than average.
This article is provided by Baidu Reading and is excerpted from \”The Clear \”Conception\” Plan\” Author: Sun Jianqiu and Xie Yingbiao