Contact a reproductive specialist on time: when artificial insemination (IVF) gives hope of becoming a mother

• What is IVF and in which cases is it prescribed
• Why factors such as time and the specialization of the doctor are important
• What a couple should be prepared for
• IVF algorithm
• Peculiarities of pregnancy thanks to IVF

What do we know about artificial fertilization? Many people consider it a 100% method of getting pregnant. And many couples are convinced that problems with conception are treated by an ordinary gynecologist, and because of this they lose precious time. After all, he — or rather, the woman’s age — plays an important role in the ability to become a mother. Both naturally and with the help of IVF.

Accessible and most important about in vitro fertilization is explained by reproductive specialist, obstetrician-gynecologist of the highest category of the capital’s clinic “Oxford Medical” Venera Doroshenko.

What is IVF and in which cases is it prescribed

More than 30 years ago in Ukraine, the IVF method began to be used. This is a treatment for infertility, in which the main stage of fertilization takes place not in the woman’s body but in a test tube. In other words, the fusion of the male and female gametes (sperm and egg cell) is carried out under laboratory conditions. That is why the method is called extracorporeal, that is, the one that is performed outside the woman’s body.

There are clear medical indications for the IVF program. They can be divided into the following main groups:

• problems with the fallopian tubes. They are either obstructed, or absent as a result of surgical intervention due to ectopic pregnancy or inflammation;

• if other methods, such as surgery on the woman, ovulation stimulation, treatment of the man, do not help;

• critical decrease in the number of egg cells or their absence in the woman (in this case, egg donation is foreseen);

• absence of the uterus, which is an indication for a surrogacy program;

• genetic diseases in the couple. Then IVF is done to examine the zygote for chromosomal or genetic abnormalities in order to prevent pregnancy with fetal defects. Such pathologies are often the cause of embryo arrest or inability to carry the child. Thus, the method makes it possible to select and transfer healthy studied cells in order to reduce the risk of giving birth to a baby with chromosomal abnormalities;

• in case of male infertility, when sperm activity is low.

Sometimes, when a woman does not have a partner and insemination (donor fertilization) does not help, IVF with donor sperm is also used.

According to world statistics, 50–60% of women who undergo the IVF program become pregnant. The success of this method mainly depends on the age of the patient and the number of embryos obtained. It is clear that women at 30 and at 44 will show different results.

Before starting the IVF program, it is very important to find out the reasons that prevent pregnancy. It is the reproductive specialist who knows how to determine infertility in women: prescribes a comprehensive examination, which includes analysis of the hormonal background, ultrasound of the pelvic organs, checking the patency of the fallopian tubes, laboratory tests, and consultations of related specialists.

Why factors such as time and the specialization of the doctor are important

The expert notes that the probability of pregnancy depends on the supply of egg cells, the number of which decreases with age. Therefore, the statistics for 30- and 40-year-old women differ greatly. For the first, it can be 60% successful pregnancy, and for the second — only 15–20%!

More mature couples, of course, have a chance to become parents with the help of IVF, but it is much more difficult. They must be prepared for unsuccessful attempts, since very few egg cells remain for fertilization.

The foresighted approach of modern 30-year-old women, who due to career, war, or other reasons freeze their egg cells to give birth to children at an older age, is very wise.

But one of the main factors of success is timely consultation with a specialist. In order not to lose the chance for pregnancy in the future, it is worth consulting a reproductive specialist as early as possible. If within six months the desired pregnancy does not occur, do not waste time, undergo screening in the appropriate department of a multidisciplinary or specialized clinic. It is there that the doctor will correctly establish the diagnosis and direct the couple quickly towards parenthood.

Out of ignorance, a woman may go to a gynecologist for 5, 6, 10 years and wait for pregnancy, hoping that this specialist will cure her. However, the gynecologist has limited resources, he often does not have the technical capabilities and knowledge to provide timely help. But in specialized institutions or departments of multidisciplinary clinics, the couple — I note, not only the woman — will undergo a full examination. But first you need to turn specifically to a reproductive specialist.

What a couple should be prepared for

Before IVF, the protocol provides for a thorough examination of both the woman and the man. The couple undergoes clinical and laboratory tests and consultations with a therapist and related doctors if they have chronic diseases. This makes it possible to determine the causes of infertility and identify contraindications for pregnancy and carrying a child.

In particular, the woman is checked for infections, undergoes hormonal testing, ultrasound of the pelvic organs, mammary glands and thyroid gland, visits a therapist and endocrinologist. The man is required to provide a spermogram and tests for syphilis, HIV, hepatitis B and C.

Only after comprehensive examination, absence of contraindications, and treatment of chronic diseases, stimulation is carried out for the woman and the IVF procedure is performed. Therefore, the time of pregnancy onset can vary from 1.5 months with good indicators to several months or more if infections or general pathologies of the body are detected.

Contraindications for IVF include:

• from the side of infections the most common are syphilis and hepatitis;

• from the side of the therapist — diseases in which pregnancy can threaten the life and health of the woman. For example, hypertension, heart defects, tumors, neoplasms, renal failure. The list of pathologies is actually large.

IVF algorithm

Depending on the hormonal background, ovulation stimulation is prescribed for the woman. This is a course of injections with gonadotropins in order to obtain several egg cells. It lasts about 12–14 days. During stimulation, which takes place under ultrasound monitoring in the clinic, the doctor observes how the follicles grow.

When the follicles increase to a certain diameter, their puncture is prescribed. The woman comes to the procedure together with the man, everything is done in the operating room under intravenous anesthesia. During the retrieval of follicles, the specialist obtains egg cells. On the same day, the man provides sperm.

After that follows the period of embryo cultivation under laboratory conditions — 5–6 days.

After 5 days the woman comes for embryo transfer into the uterus. She is prescribed hormonal support.

When 2 weeks pass, the woman takes a blood test for hCG (chorionic gonadotropin) and thus finds out whether the desired pregnancy has occurred.

Peculiarities of pregnancy thanks to IVF

The Ministry of Health limits the IVF procedure to 1–2 embryos, so the probability of forming triplets is very low. Although very rarely there are cases when an embryo divides.

Apart from hormonal support and more attentive monitoring of well-being, the management of pregnancy that occurred through artificial fertilization does not differ from usual.

Of course, preference will be given to a multidisciplinary clinic, where a pregnant woman without unnecessary hassle can take all the necessary tests in certain trimesters. And it is better to be monitored by a doctor who has experience in managing pregnancy after IVF.

In conclusion, the expert emphasized that the IVF program should not be perceived as a panacea. This method of treatment is carried out only for medical indications. However, it is precisely it that makes it possible to find out the causes of infertility and come to motherhood fully examined, when the couple knows everything about their health condition, reproductive system, and chronic diseases that prevent pregnancy or threaten fetal developmental abnormalities.

Trust the experience of the reproductive specialist and overcome problems together without unnecessary loss of time, effort, and money.