Oocyte retrieval for IVF, on what day do
Oocyte retrieval in IVF is a widely used method in the field of reproduction. The effectiveness of the methodology has identified great interest in in vitro fertilization as the only possible embodiment of the dream of motherhood. Coordinated hard work of several specialists, a clearly-established technique with the use of modern medical equipment makes a step towards the birth of new life.
What is special about this method?
Puncture of ovaries in IVF is one of the main stages of the complex surgical procedures performed by reproduction with the aim of obtaining ripe eggs.
It is the fence follicular fluid from follicles with their contained sex cells oocytes. The procedure is performed by the method of aspiration with tranceducer attached to it transvaginal transducer. Ultrasonic diagnostics allows to control all stages of the procedure.
Follicle puncture is a puncture of the vaginal wall thin aspiration needle and its further introduction into the body of the ovary. By using ultrasound Mature follicles, the fertility specialist injects a needle in him. After puncture by suction of follicular fluid from the reproductive cells oocytes are placed in a sterile vial.
Preparation for oocyte retrieval is of great importance. Compliance with gentle routines and nutrition has a direct effect on the outcome of surgical intervention. Gentle treatment involves the following activities:
- limiting sexual activity to one week before the planned date of the puncture;
- reducing physical and mental stress, frequent walks on fresh air;
- balanced nutrition with emphasis on protein foods of plant and animal origin;
- active drinking regime (at least 2 liters of water or compote of fruit in the day);
- to reduce to a minimum, stay in public places to avoid the probability of infection with viral diseases;
- the temperature conditions in carrying out hygienic water procedures (water should not exceed 40 degrees);
- taking any drugs of synthetic and plant origin must be confirmed by a physician;
- elimination of stress factor allows to stabilize the psycho-emotional condition of the woman before the procedure.
The question of how the fence material at the puncture, interested in all women. They with concern and anxiety, worry, how are you feeling after the puncture they expect, how much will hurt the operated area and what happens afterwards. No need to panic. Attending physician in the diagnosis will explain in detail the essence of the proposed operation, to determine the likelihood of possible complications, studied in detail history data.
Do not worry about the pain. Anesthesia is performed before the oocyte retrieval, a completely free woman from pain. Which method of anesthesia you choose and the doctor shall decide in each individual case.
There are two types of anesthesia used before surgery:
- Local anesthesia in anesthetic injection in the vaginal wall. Usually use 1% or 2% solution of novocaine. Some doctors prefer this type of anesthesia as an alternative to toxic systemic drugs that can impair physiological characteristics of the reproductive organs during the procedure the fence.
- General anesthesia involves intravenous short-term anesthesia. This option is more acceptable due to the provision of absolute rest, is required when carrying out the puncture.
The rationality of the use of any type of anesthesia is supported by the results of analyses and other data of the anamnesis. In any case this issue in advance discuss with the doctor.
What happens before surgery?
Before carrying out the puncture, the patient undergoes a comprehensive examination of an organism by laboratory and instrumental methods of research.
The complex of diagnostic measures includes:
- visual inspection of the reproductive organs on the gynecological chair;
- a common blood test that provides information about the General state of the organism, the presence of inflammatory processes;
- a blood test for hormones (estradiol, progesterone, prolactin, thyroxine, FSH, LH, testosterone, etc.);
- the study of the pelvis and in particular of the ovaries using ultrasound;
- the study of anamnesis.
After the diagnosis of a fertility specialist to decide on what day of cycle to do IVF. Artificial insemination is preceded by active hormonal therapy to stimulate the maturation of follicles. 36 hours before the expected date of the surgical intervention, the patient receives an injection of the hormone human chorionic gonadotropin (Pregna). From that moment on she is under strict control of the attending physician. It is very important not to miss the moment of ripening of follicles and their spontaneous rupture with the subsequent release into the abdominal cavity.
To prevent premature rupture of the follicles, the probability of which stimulate your own hormones from the pituitary gland, use leaks. The gonadotropins affect the production of female sex hormones, also participate in the maturation process of the oocytes. Among the most commonly used drugs by reproduction release: Decapeptyl-Daly (Diferelin daily), Orgalutran, Cetrotide, Menopur and others. Hormonal injections start to apply from the 6th day from the beginning of the process of stimulation of the follicles. Therapeutic course the average does not exceed 5 injections.
Ultrasound examination of the ovaries allows us to identify suitable for fertilization the follicles. The number of Mature follicles should not exceed 18 – 20 pieces. The rapid growth of the follicles is threatened by their lack of sexual maturity. An experienced specialist accurately determines which follicles to take. The size of the follicles, their appearance does not always meet the expectations of reproduction. A larger size may indicate the presence of a follicle with two oocytes. The more female germ cells will be subsequently identified, the higher the chances of successful fertilization. You should have at least 3 eggs.
The follicular fluid collected by aspiration, transferred to the embryologist for further study in:
- maturity of reproductive cells;
- the absence of genetic abnormalities;
- the presence of pathogens (bacteria, viruses).
The egg retrieval can be done using laparoscopy. This technique is practiced in case of impossibility of surgical manipulation through the wall of the vagina. The use of laparoscopy rationally when many adhesions in the ovaries and in the case of individual reproductive organs.
While produce taking genetic material from a woman, her sexual partner (husband) prepares seed ejaculate for further research by the embryologist. Sperm quality depends on the physiological characteristics of sperm.
The quality of sperm is influenced by such factors:
- Mobility. For fertilization to choose the most active individuals.
- Number. For the procedure you need to have as many sperm as there are eggs, but the bigger the number is, the higher the chances of a successful outcome.
- Appearance. An experienced specialist can easily identify the sperm for artificial insemination. Damage to the structure and shape may indicate the presence of chromosomal anomalies.
- Bacteriological examination will determine the presence of pathogenic flora. Infected sperm for the IVF.
Seed can be frozen and later use if necessary.
After the adaptation process of male and female cells are combined in vitro and observe further developments.
Peculiarities of postoperative period
Active hormonal therapy is not lost on the female body. The greatest risk is hyperstimulation of the ovaries, when we celebrate the growth of many follicles with a threat of breaking the body.
For hyperstimulation syndrome is characterized by:
- the change of the circumference of the abdomen due to ovarian enlargement;
- pain of strong intensity, increasing by changing the position of the body;
- the appearance of migraines, uncontrollable vomiting;
- violation of psycho-emotional state;
- bleeding (possibly internal);
- impaired urination and defecation.
Despite the fact that these symptoms represent a real threat to the life of the patient, do not panic. Qualified staff will provide the necessary medical care. In this case you will need a longer time of stay of the patient in hospital (as many days, decides physician).
Any surgical intervention in the body has the probable consequences. The puncture of follicles are doing in a sterile environment in compliance with all precautions. But the risk is always present.
The severity of clinical symptoms indicates normal or pathological changes in the reproductive system.
|Pain of low intensity aching, appeared after the procedure fence (stomach hurts, but not much)||Pain of strong intensity in the pelvis and lower back|
|Slight vaginal discharge mixed with blood and mucus (pink)||The bleeding (can occur immediately or after some time)|
|Decreased physical activity, libido||Abnormal discharge (change in color, consistency, smell)|
|Weakness, dizziness||The increase in body temperature for 2 to 4 days after puncture|
|Violation of the General condition, the unpleasant symptoms of the stomach and intestines (nausea, vomiting, diarrhea)|
Symptomatic treatment is strictly individual, depends on the nature of the pathology.
After the fence follicles in their place formed a yellow body. Its main task is to produce progesterone, contributing to the creation of favorable conditions for transplantation of embryo in the uterus. To balance the hormones by using drug therapy (antiseptic, cough medicine, a Progestin). Prescribed by a doctor the drug is used topically in the form of vaginal suppositories or systemically (in pill form or by injection).
To determine the puncture is in advance impossible. Each organism reacts individually to the performed manipulations. It’s safe to say that a further stage of IVF largely depends on the given genetic material and painstaking work of specialists in reproduction.