In our country, “in vitro fertilization and embryo transfer” (IVF-ET) is often called “test-tube baby”. In fact, in vitro fertilization is a special technique that takes eggs and sperm outside the body, allows them to complete the fertilization process in an artificially controlled environment outside the body, and then transfers the early embryos to the woman’s uterus. Conceived as a child. The babies produced by in vitro fertilization are called test-tube babies, and these babies are also grown in the mother's womb. It can be said that "test-tube baby technology" is equivalent to "in vitro fertilization".
1. Patients with fallopian tube obstruction;
2. Patients with unexplained infertility, and those who failed to get pregnant through treatments such as IUI;
3. The man is severely weak and weak in sperm, or the man is azoospermic, who needs to obtain sperm through testicular or epididymal puncture;
4. Women with endometriosis and infertility can use IVF as appropriate;
5. In patients with ovulation disorders, no mature follicles will grow after general ovulation stimulation treatment.
1. Conventional in vitro fertilization and embryo transfer technology;
2. Intracytoplasmic sperm injection technology;
3. Preimplantation embryo genetic diagnosis technology.
1. Ovulation stimulation treatment
Since not every egg can be fertilized, and not every fertilized egg can develop into a viable embryo, it is necessary to obtain multiple eggs from a woman to ensure that there are embryos that can be transferred, which requires ovulation induction therapy for women.
2. Egg retrieval
Under the guidance of B-ultrasound, the doctor applies a special egg retrieval needle to puncture mature follicles through the vagina and suck out the eggs. Egg retrieval is usually performed under intravenous anesthesia, so women will not feel the pain caused by the puncture process.
3. In vitro fertilization
Sperm retrieval: When the female retrieves the eggs, the male retrieves the sperm. After the semen undergoes a special washing process, the sperm and eggs are placed in a special culture medium in order to combine naturally. This is the so-called conventional fertilization method.
4. Embryo transfer
A few days after fertilization, use a very thin embryo transfer tube to transfer the best embryos into the maternal uterus through the cervix. According to age, embryo quality and previous IVF outcome, determine the number of embryos to be transferred, usually, 2 to 3 embryos will be transferred Embryo. In recent years, in order to reduce the rate of multiple pregnancies, some centers have opted for single embryo transfer or up to 2 embryos. Because the embryo transfer tube is very thin and the doctor moves gently, the patient usually does not have any pain.
5. Corpus luteum support
Due to the application of GnRH agonists/antagonists and ovulation-stimulating drugs, as well as the loss of follicular granulosa cells caused by egg retrieval, women usually have insufficient corpus luteum function during the egg retrieval cycle and need to use progesterone and/or chorionic gonadotropin for corpus luteum Supplement/support. If there is no pregnancy, stop progesterone and wait for menstruation. If you are pregnant, continue to use progesterone, usually 3 weeks after the fetal heart rate is seen by B ultrasound.
6. Determination of pregnancy
Serum HCG was measured 14 days after embryo transfer to determine if pregnancy. Serum HCG was measured again 21 days after embryo transfer to understand embryo development. Transvaginal ultrasound examination 30 days after embryo transfer to determine whether there is an intrauterine pregnancy and whether there is a fetal heartbeat.
The success rate of IVF-ET treatment is generally judged by the clinical pregnancy rate, that is, the proportion of the clinical pregnancy cycle to the embryo transfer cycle, and clinical pregnancy refers to the vaginal ultrasound observation of the intrauterine gestation sac 28 to 30 days after the embryo transfer. Different IVF centers have different success rates. Most centers have a success rate of 30% to 50% per transplant cycle. Some centers report a success rate of 60% to 70% per transplant cycle. The clinical treatment success rate is affected by many factors. Impact, such as patient choice, clinical treatment methods, laboratory technology, etc.
Factors affecting the success rate of IVF
There are many factors that affect the success rate of IVF. Women's age, the cause of infertility, and the quality of the IVF central laboratory are all factors that affect the success rate.
It is an important factor affecting the success rate of IVF. As age increases, the number of eggs decreases, the quality decreases, the fertilization rate decreases, the pregnancy rate decreases significantly, and the abortion rate increases. The IVF pregnancy rate for women aged 41 to 42 years is 12%, the live birth rate per embryo transferred for women over 42 years old is only 5.9%, and the abortion rate for women over 43 years old is 50%.
Significantly reduce the embryo implantation rate and pregnancy rate, so that the pregnancy rate is reduced by 50%. Therefore, women with hydrosalpinx should remove the hydrosalpinx before IVF.
3. Uterine abnormalities
Such as endometrial polyps, endometritis, previous surgery or inflammation (tuberculosis is the most common) leading to endometrial damage, which can affect embryo implantation.
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