What is IVF for?
When a couple fails to conceive a child, the first step is to consult a doctor who can assess the fertility of the man and the woman. After a health assessment and a physical examination, a series of diagnostic tests can be performed.
Generally, other non-invasive methods are first tested in the couple, for example, taking drugs to stimulate egg production or artificial insemination (a technique in which sperm is injected directly into the body). Uterus).
Occasionally, in vitro fertilization is offered as a first choice for women over 40 years old with infertility. Since then, indications for IVF have been extended to endometriosis, a condition characterized by the abnormal uterine lining of the ovaries, infertility that cannot be explained by other techniques (ovarian stimulation, artificial insemination). Failed, as well as the sterility of male origin.
Why was IVF developed?
Many diseases can affect these different complex mechanisms and in vitro fertilization, or IVF, was initially developed to allow women with altered tubes to conceive children. The idea was simple: to organize the meeting spermatozoa – oocytes in the laboratory (in vitro) and thus promote fertilization, then transfer into the uterus the embryos obtained.
Stages of IVF:
The woman receives hormone therapy to trigger ovulation. Initially, the treatment will aim to develop several ovarian follicles (it is important to collect several oocytes). This step is monitored by ultrasounds and repeated hormonal assays. When the follicles mature, an injection of HCG is made to trigger ovulation.
Several days and a few hours after this injection, the oocytes must be collected. This specimen, called a follicular puncture, is performed in the operating room under local or general anaesthesia. Under ultrasound scanning, the doctor will select the mature follicles and aspirate them by puncturing the ovaries with a thin, vaginally inserted needle. The follicles collected are immediately analyzed by the biologists and the oocytes they contain are isolated.
The collection of sperm
On the day of the follicular puncture, the spouse carries out a semen collection in the laboratory. The spermatozoa are immediately examined and prepared by the biologist. A short sexual abstinence is sometimes recommended.
IVF in the laboratory
The oocytes are put in contact with the spermatozoa in a specific medium the same day of the samples.
The next day, the oocytes are examined to see if they have been fertilized. After 48 hours, the formed egg began to divide and embryos at the 2- to the 4-cell stage can be observed. These embryos can then be used for in uterus transfer. They can also be allowed to continue their division a few more days using very specific culture media, this method, called prolonged culture, thus makes it possible to obtain embryos having a better implantation rate.
It is generally decided to transfer only one or two embryos to avoid multiple pregnancies. If the couple wishes, the other embryos are frozen to serve for another attempt.
The transfer is carried out so two or three days after the puncture (or a little later in case of prolonged culture). It does not require hospitalization or anaesthesia. During a gynaecological examination, a thin catheter containing the embryo or embryos is introduced into the uterine cavity. The embryos are thus transferred. The gesture is painless. A hormonal treatment combining progesterone and HCG is prescribed to the woman the following days.
A pregnancy test must be performed on the 15th day, whether bleeding is occurring or not, to check whether a pregnancy has started. If the test is positive, an ultrasound will be performed two weeks later.