All the procedures of IVF?

1. Controlled superovulation:

Because the length of the natural menstrual cycle varies from person to person, and there are differences in different cycles of the same patient, it is not easy to arrange the time of egg retrieval, and only one dominant follicle develops in the natural cycle. After fertilization, only one embryo can be formed, and the pregnancy of one embryo is transferred rate is very low.

Therefore, it is necessary to use controlled superovulation to enhance and improve ovarian function, in order to achieve the purpose of obtaining multiple healthy eggs without being restricted by the natural cycle, providing multiple embryo transfers, and synchronizing corpus luteum development with endometrial function as much as possible.

Controlled ovarian hyperstimulation generally uses GnRHa to down-regulate FSH and LH in the body, and then administer HMG or FSH ovulation drugs to stimulate follicle growth in the ovary. The number of eggs obtained differs depending on the dose used.

2. Monitoring follicles:

In order to evaluate the effect of ovarian stimulation and determine the time of egg retrieval, the size of the follicles must be monitored by vaginal ultrasound, and the E2 value (estrogen) should be checked with blood to adjust the dosage. When two to three or more follicles are larger than 1.8cm in diameter, and the number of follicles over 1.4cm is equivalent to the E2 value, human chorionic gonadotropin (hCG) can be injected to promote follicle maturation. Egg retrieval was performed 34 to 36 hours after hCG injection.

3. Egg retrieval:

The most commonly used method of oocyte retrieval is under local anesthesia, guided by transvaginal B-ultrasound, the oocyte retrieval needle is passed through the vaginal fornix, directly to the ovary to absorb the ovum, and immediately transfer the ovum to a petri dish containing embryo culture medium under the microscope. , and cultured in a 37°C incubator.

4. Sperm extraction:

The sperm retrieval time is the same day as the egg retrieval day. Wash your hands before semen collection, and use masturbation to collect semen. The small cups given are sterile, do not touch the rim and the inside of the cup when saving. The removed semen was processed by upstream method or Percoll density gradient centrifugation.

5. In vitro fertilization:

The treated sperm and eggs are placed in the same petri dish 4 to 5 hours after egg retrieval, and after co-cultivation for 18 hours, the fertilization can be observed under a microscope. If the sperm quality is too poor for natural fertilization, forced fertilization by microinjection must be performed (see intracytoplasmic spermatozoa microinsemination).

6. Embryo transfer:

Fertilized eggs can develop to 8-16-cell stage embryos in vitro for 48-72 hours. At this time, the number of embryos to be transferred is determined according to the patient's age, whether it has been pregnant or not, and the quality of the embryos. The excess embryos can be cryopreserved.

Embryo transfer generally does not require anesthesia. At present, embryos are usually transferred 2 to 3 days after fertilization. What I use is embryo transfer 3 to 5 days after fertilization. Delaying the time of embryo transfer requires higher conditions for in vitro culture, but delaying the transfer time is more in line with pregnancy physiology. At the same time, it can also eliminate inferior embryos through natural screening, which can improve the pregnancy rate and reduce the multiple birth rate.

7. Hormone supplementation after embryo transfer:

At present, we use the injection method to give progesterone to support the corpus luteum. If pregnancy is confirmed, switch to hCG and continue supplementation until 10 weeks of pregnancy.

8. Check after transplantation:

On the 7th day after transplantation, the patient was taken to the hospital to check the pregnant carcass, estradiol, HCG and pregnant carcass on the 14th day, and estradiol to determine whether the pregnancy was pregnant. For some people, the results on the 7th day may not be very ideal. It may be late in implantation, so they cannot give up. Usually, the doctor will strengthen the dose of the drug, and the final result will be 14 days.

The process of IVF may vary slightly from person to person. The specific process of IVF needs to be determined after going to the hospital for relevant examinations.

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