In-vitro fertilization is not done for all women suffering from infertility, but strictly according to the indications. There are a number of diseases that cause infertility and can not be eliminated with the help of conservative and surgical treatment.
IVF: indications and contraindications
Before preparing for artificial insemination, it is worthwhile to find out at what indications do IVF. The main indications for IVF:
- absolute tubal infertility (absence of both fallopian tubes after their operative removal);
- infertility in women after 30 years who underwent plasty of the fallopian tubes more than a year before IVF;
- immunological infertility;
- endometriosis;
- idiopathic infertility after a complete clinical examination of the pair;
- male factor (indications for IVF - this and male infertility in the absence of the ability of the male sperm to fertilization).
In our country, women can take advantage of free IVF, on a federal quota for which there is evidence. To receive a free IVF, the main indications are:
- female infertility (in the absence of ovulation, tubal origin and idiopathic infertility);
- male infertility (only if there is at the same time female infertility).
Only male infertility is not yet a testimony in order to conduct IVF free of charge. The conditions of it according to the OMS program are tubal infertility, weight from 50 to 100 kg, antimulylerov hormone from 0.5 ng / ml to 7 ng / ml, FSH not higher than 15 IU on the 2-3rd day of the cycle and normospermia in the sexual partner.
Contraindications to IVF:
- physical and mental diseases, in which pregnancy and childbirth are contraindicated;
- congenital malformations of female genital organs, in which the implantation and bearing of the fetus are impossible;
- benign and malignant tumors of the uterus and ovaries, any malignant tumors even in the anamnesis;
- acute inflammatory processes in the body of a woman of any localization.
If a woman has a fibromyoma, then after her prompt removal the contraindication is withdrawn and IVF can be performed if there are basic supplies to it.
Short protocol of IVF implementation
There are a number of surveys that are performed before IVF:
- A few months before IVF, a full examination of the sperm of a man is performed, vaginal smears, colposcopy, and treatment of chronic inflammatory processes.
- One month before IVF, the duration of the follicular phase is determined, blood sampling is taken for chromosomal, immunological analysis, hormone levels in the blood, presence of viral diseases, preparation of embryo culture.
- After determining the level of estrogen, stimulate ovulation under the supervision of ultrasound.
- After stimulation, the oocyte culture is taken, the eggs are identified under the microscope.
- They produce fence and prepare sperm, add 200-300 thousand spermatozoa to one egg for fertilization.
- The embryo is incubated for 40-50 hours to 4 divisions.
- Transfer the catheter embryos through the cervical canal to the bottom of the uterus.
- They support embryo implantation with progesterone therapy before the 20th week of pregnancy.