You should start with an assessment of how great your chances of getting pregnant. They start to decline starting from about 37 years old. After only 40 years of age, only 4-5% of attempts at fertilization result in conception. This is due to the fact that over time the amount, and most importantly - the quality of eggs decreases.
Nevertheless, doctors are sure that it is worth trying. There are cases when 60-year-old women became mother of children from a test tube. The exact forecast, how many calls will be needed, no one will give. However, practice shows that in 80% of women, pregnancy begins already with the second or third attempt at infertility treatment by IVF. It is only the doctor who can determine precisely whether this high-tech procedure is shown to you.
FIRST STEP
To begin with, the doctor will need general tests: ECG, blood on RW, HIV, hepatitis B and C, swabs on flora and oncocytology, crops (or other tests) for sexually transmitted diseases, several blood tests for hormones, th day of the cycle (estradiol, prolactin, FSH, LH, TTG - these are the necessary parameters). It is also necessary to submit an analysis for antibodies to rubella, the presence of crops from the cervical canal and bacaps sperm. All these studies are needed to determine the degree of readiness of your body for the procedure, as well as to avoid possible complications.
To the note: analyzes for IVF can be delivered in advance in the district women's consultation (free of charge), in a medical center or in a private laboratory. The main thing is when the IVF process is launched, it is necessary to observe one specialist who will lead you and answer for the result.
CHOOSING THE METHOD
After you and your doctor make sure that there are no contraindications for health reasons, you can discuss which of the ways to treat infertility is right for you. There are not so many options, and the choice of them should be approached, based on individual characteristics.
Stimulation of ovulation is if the couple is able to conceive independently, but for a number of reasons the ovarian activity is out of activity. In such cases, stimulate the ovaries, calculate the best for the conception of the day, and then everything happens naturally - as laid down by nature.
Artificial insemination with the husband's semen and donor sperm is the case when male spermatozoa are "to blame" for infertility. A specially prepared concentrated "solution" of spermatozoa is injected into the uterus, previously checked with a spermogram.
Actually, IVF helps in cases when there is obstruction of the fallopian tubes, their complete absence or damage, with endometriosis, unexplained by infertility doctors or after unsuccessful attempts at artificial insemination. Also this method is shown in the case of male infertility and if a woman has a constantly high level of antibodies to sperm. When spermatozoa do not have enough activity, ICSI will help - the introduction of the sperm into the cytoplasm of the egg with the help of special micromanipulators.
On a note. Contrary to popular belief, ICSI is not a separate method, but only an additional stage of infertility treatment by IVF, and it can not always be required.
So, the doctor recommended IVF. The program can be started immediately after the examination, on the 2-3rd day of the cycle (with a cycle duration of 28 days). From now on, you will undergo hormonal therapy to suppress the pituitary gland. Ultrasound - selection of a medicine - ultrasound - dose adjustment. In this mode, 14 days will pass.
On a note. Contrary to popular belief, such hormone therapy is not dangerous to health. Moreover, today pills are replaced with injections and no harm from them than from drugs that are used, for example, in the treatment of influenza.
After two weeks, drugs are being used to stimulate the maturation of the follicles. It is necessary to make the ovaries produce them 5 to 10 times more than usual. Within 10-12 days, every 48-72 hours the doctor will monitor the process with ultrasound and blood test. During this period it will be necessary to ensure compliance with the protein diet, drinking more than 2 liters of liquid per day and, of course, you can not drink alcohol and smoke.
This stage of infertility treatment is theoretically dangerous because in 3% of cases a hyperstimulation syndrome can develop - an excessive increase in the ovaries. Fortunately, modern treatment regimens and careful monitoring of the level of hormones in the blood reduces the risk of such complications to naught. On a note. When stimulation does not occur any unpleasant sensations, except that pain in the ovaries is possible - because now they work more intensively than usual.
Treated eggs matured and recovered, spermatozoa were surrendered. The case for small: 4-6 hours to hold eggs in a special incubator in dishes filled with nutrient medium, after which mix specially selected part of the sperm to them. The contact lasts about 20 hours. At the end of this period, it is already possible to say whether fertilization has occurred or not. You will be informed by phone when you need to appear at the final procedure
On a note. If the sperm of a husband of poor quality, there is a risk that the pregnancy will not occur. In this case, just save ICSI, when each egg is impregnated with specially selected spermatozoa. The procedure is painless and fast. With the help of a thin catheter, the "candidates" are inserted into the uterus. An hour needs to lie down in the clinic - and you can go home. Whether everything went well, it will be known after 2 weeks.
There will be twins, triplets or one baby, it is impossible to predict. According to statistics, one child is born only in half the cases. Approximately every third IVF-patient is destined to become the mother of twins, one in five gives birth to triplets.
On a note. Do not try to detect pregnancy by yourself earlier than 14 days using tests: because of hormonal therapy, any answer will be accurate only by 30%.
LONG-AWAY FINAL
The entire cycle of IVF takes about a month. Unfortunately, after the long-awaited "yes", many relax: it would seem that everything depends on nature. But in most cases, without additional medicinal support in the first months, adherence to diet and regimen matched by a doctor, it is not easy to keep a future child. Absolutely all for the whole ECO period it is better to give up cigarettes, coffee, alcohol, sweets in large quantities. But you need to drink more water (more than 2 liters per day) and to attend a disciplined doctor.
QUESTIONS WHICH WILL EXPLOIT ALL
1. How many attempts? Is it harmful to carry out hormonal stimulation several times?
After the transfer of embryos, only 35-40% of women become pregnant. It's better to be ready to take 3-4 or more attempts. Long-term intake of hormones is not dangerous - today use the drugs of the latest generation and take into account all the features of the future mother's organism.
2. Do not have to do a cleaning if the embryo does not get accustomed?
Unsuccessful IVF does not affect the body in any way: there is no need to wait for miscarriage or complications threatening with operational cleaning. But it's also not necessary to start the second call at once - the break must be at least 3-4 months.
3. I'm not ready to give birth to twins, let alone triplets. In the case of infertility treatment by IVF, this possibility is great. What to do?
The more embryos are planted, the higher the probability of pregnancy. But the risk of being a large mother is also high. Therefore, usually only 2-3 embryos are planted, the rest are frozen. If required, it is possible to reduce - one or more "unnecessary" embryos. The method is controversial from the ethical point of view, however, technology exists, and it can be resorted to if necessary.
4. How big is the risk that a child will be born with a congenital malformation?
ECO-children do not differ from the conceived in the natural way. They even have the advantage: modern technology makes it possible to prevent the development of many diseases. Confidence that the baby will be all right will be given pre-implantation genetic diagnosis (PGD). It allows to reveal deviations in the development of the embryo, the presence of genetic diseases. And for an additional 60 thousand rubles you can choose the gender of the future baby.
5. Is there a way to carry out IVF with minimal use of hormones?
Yes, this method is called IVF in the natural cycle. Drugs that stimulate the growth of follicles, in this case do not apply. But this is possible only if at least one egg ripens. This method is more "friendly" to the body, but also less effective (pregnancy occurs only in 16% of cases). Among the minuses and the high complexity of the program: because if the follicle is the only one, any errors (for example, in calculating the time for medication at the time of ovulation) are unacceptable.
HOW TO CHOOSE ECO-CENTER?
1. First of all, the institution must have an appropriate license for IVF (on the basis of the "Certificate of Embryology and Clinician").
2. Ensure that the clinic has the necessary minimum staff for successful procedures:
obstetrician-gynecologist (reproductive specialist);
embryologist;
andrologist (this is important if you need additional research on partner's health);
anesthetist;
nurse and nurse.
3. Try to get on a mini-excursion and evaluate the level and quality of equipment: modern ultrasound machine and gynecological chairs, thermostats, sperm analyzers, incubators ... If you are far from medicine, at least ask questions when the equipment was last updated, how to improve the methods of diagnosis and procedures.
4. Specify, whether there is a possibility in this clinic if necessary to carry out additional researches.
5. The institution should be conveniently located - you will often have to visit the clinic.
ECO FOR FREE
Few people know that since recently, Russian women have the opportunity to undergo the procedure without paying a penny, free ECO-programs in Moscow implements the CPPS. The program includes:
two attempts of IVF + PE;
freezing and storage of embryos during the year;
cryoperation of embryos;
necessary medicines.
To use the right to free IVF, you need to get a referral from the Federal Health Agency. It is best to go for paper fully armed: with extracts, analyzes, spermogram and the conclusion that you have infertility and the only method of solution can be only IVF. In addition, you must meet certain criteria:
age - 22-38 years at the time of inclusion in the program;
the fact of permanent residence in Moscow;
the presence of a registered marriage and the absence of common children;
the presence of infertility for more than 2 years in the absence of the effectiveness of other treatments, or absolute tubal infertility, or combined forms of infertility;
absence of effect from surgical methods of treatment, classical induction of ovulation for 6 months and treatment of the spouse;
absence of somatic and mental diseases.