The main principle of choosing artificial insemination methods is individuality

Methods of artificial insemination, developed by reproductologists, give hope and the opportunity to feel the ecstasy of motherhood and fatherhood to those who are physiologically incapable of it. There are several treatment options and each has its own characteristics and indications.

In order to decide which of the methods should be used in each specific case, the doctor needs data from laboratory and instrumental studies. In addition, if you are going to have an artificial insemination procedure, prepare for a detailed questioning (anamnesis). During the consultation, you need to ask all the exciting questions that are better to write down in advance, and tell in detail about the diagnosis and the treatment (if any).

Exploratory survey

With the help of ultrasound diagnostics, internal inflammatory processes are detected. As all concomitant diseases are identified and appropriate treatment is prescribed, the need for artificial insemination disappears in 45% of women.

Assisted reproduction methods

Focusing on the data of the examination and the identified female or male functional disorders, the specialist will offer a treatment option - one of methods of artificial insemination suitable for your couple.

artificial insemination

If the sperm is unable to go its way and reach the egg (may be due to an obstacle - an increased concentration of cervical mucus or other reasons), a method is used. This procedure consists in introducing concentrated sperm into the uterus, purified from “weak” and incapable of fertilization spermatozoa. It is performed during ovulation (induced or natural).

Subsequently, the process of natural conception is expected. Women under the age of 30 have a higher chance of a result, without. This method can be recommended for immunological incompatibility of the couple and for low sperm motility, poor.

GIFT and ZIFT methods

Many experts consider the methods of intratubal zygote transfer (ZIFT) or gametes (GIFT) to be very effective, although in recent times, they are of little demand, despite their closer relationship to the natural process of fertilization. The essence of the GIFT method is the transfer of male and female germ cells into the lumen of the fallopian tubes, where fertilization should occur. The ZIFT method is based on the same principle, only unlike GIFT, eggs that have already been fertilized are transferred into the fallopian tubes.

Such artificial insemination program gives the female body time to prepare to accept the transplanted zygote or gamete, since the transfer of the egg and sperm occurs into the fallopian tubes, and not into the uterus itself. The only condition for such a procedure is the usefulness of at least one fallopian tube.

The use of the intratubal transfer method is shown:

• with, other pelvic organs;
• with immunological incompatibility of spouses;
• at .

IVF method

One of the most popular methods of assisted reproduction is considered. The origin of life occurs outside the female body, in a test tube, with subsequent transfer to the uterus. This process is phased and lasts for two weeks.

At the first stage, the growth of the female germ cells is stimulated to suppress the natural hormonal activity. This procedure helps to control the timing of maturation and accurately calculate the onset of ovulation.

Indications for IVF may include:

• violation of the hormonal balance in the body of a woman;
• donor eggs, ), surrogate motherhood

  Contraindications

  Artificial insemination should not be carried out if it is impossible to bear a child. Such contraindications include: pathologies of the uterus, inflammatory, infectious, as well as inherited diseases. It is in such cases that surrogate motherhood is recommended.

  Those born using assisted reproduction methods do not have distinctive features. Their behavior and appearance absolutely normal. Women who are desperate to get pregnant naturally, have a great opportunity to become a mother, and the latest medical technology and in vitro fertilization methods successfully help them in this.

  Today, about twenty percent of couples have to deal with the problem of infertility, that is, the inability to conceive a child. long time(year) with regular sexual intercourse without the use of contraceptives.

  Depending on the cause, appropriate treatment is carried out for one or both partners. In some cases, infertility cannot be eliminated. Such couples still have the opportunity to become biological parents - artificial insemination.

  Methods

  Depending on the reason for the impossibility of natural conception, experts offer one of the methods:

  • In vitro fertilization (IVF). Such artificial conception is the most common.
  • Intracytoplasmic sperm injection (ICSI). IVF type. It is used for male infertility - with a minimum number of sperm in the ejaculate, their low mobility, structural defects. Doctors select viable germ cells. Under a microscope, with special instruments, the sperm is injected into the egg, and artificial insemination occurs.
  • Artificial insemination. It is used in case of sexual weakness of a man. In a special apparatus, the seminal fluid is purified. The concentration of motile spermatozoa increases. Defective ones are removed. Sterile sperm with a high content of active cells, enriched with nutrients, is injected into the patient's uterus, ready for fertilization.
  • Sperm donation. It is used for patients in the absence of a sexual partner, with incurable infertility of the husband, if he has serious hereditary diseases.
  • Donation of eggs (oocytes). IVF type. Such artificial insemination is used for female infertility, when for some reason their own eggs do not mature.

  IVF: essence, preparation

  Artificial insemination is used if infertility cannot be cured. For example, if a woman's fallopian tubes are removed or their patency is impaired, after ectopic pregnancies. It is also indicated for various forms of infertility in men.

  Contraindications for IVF are:

  • Diseases of a woman (including mental), which prevent the normal bearing of the fetus, childbirth.
  • Uterine defects that prevent the embryo from implanting.
  • Tumors of the ovaries, uterus.
  • Inflammatory diseases of a woman, regardless of the location of the focus.
  • Malignant neoplasms regardless of location, including in the past.

  At the preparatory stage, an examination is necessary. A woman takes a blood test to determine the level of hormones, as well as rubella, herpes, toxoplasmosis, chlamydia, a smear from the cervix for cytology, ultrasound of the female organs, milk and thyroid gland, colposcopy. Both partners are examined for urogenital infections, RV, viral hepatitis, HIV. A man needs to do a spermogram.

  Before donating sperm, the future father needs sexual abstinence for about 3-5 days. The material can be frozen to be used later. If viable spermatozoa cannot be obtained naturally, they are collected through surgery or puncture under anesthesia.

  The patient is prescribed hormonal drugs that stimulate the maturation of several follicles at the same time (superovulation). Their development is controlled by ultrasound, their diameter and thickness of the endometrium are measured. They are then removed from the ovaries under ultrasound guidance with a needle through the vagina. This is a safe procedure, it does not cause complications, it is done under anesthesia.

  Fertilization occurs in a special liquid in a test tube in the laboratory. After a few days, the embryo is examined, the presence of chromosomal diseases is detected. Modern technologies make it possible already at this stage to determine the sex of the unborn child. Then, to achieve the best result, not one, but 2-3 eggs are implanted into the uterine cavity using a flexible catheter under anesthesia or without it.

  Pregnancy and childbirth

  After the introduction of the egg twice a week, you need to control the level of hormones (according to a blood test). After about 14 days, they check if pregnancy has occurred. They usually do a test. In some clinics, a blood test is taken for this purpose. Three weeks after embryo transfer, an ultrasound can be performed. The probability that an artificially fertilized egg will take root is about 35%. That is, in one case out of three pregnancy occurs.

  Patients who fail the first time can try again. IVF is considered a safe procedure. Sometimes pregnancy occurs only on the tenth attempt. Unfortunately, experts cannot give a 100% guarantee that artificial insemination will be successful.

  The reasons for failure may vary. For example:

  • non-maturing of follicles (this circumstance makes it impossible to collect cells);
  • adhesions do not allow the sampling of follicle cells;
  • premature ovulation occurs;
  • lack of eggs in the follicles;
  • poor sperm quality;
  • embryos do not take root, stop in development, grow incorrectly.

  Complications with IVF occur very rarely in the form of ectopic pregnancy(up to 3% of cases), the development of infections (up to 2%), bleeding during egg collection. In 2-15% of cases, ovarian hyperstimulation syndrome occurs as a reaction to drugs that accelerate the maturation of follicles. Accompanied by poor health, bloating, pain. With timely detection, it is successfully corrected.

  

  The most common side effect of IVF is multiple pregnancy. It develops in every 3-4 patients. The reason is that in order to increase the probability of embryo attachment, several of them are planted (usually 2-3). There is a good chance they will all survive. Specialists can remove the “extra” ones, but in this case, the risk of rejection of the remaining ones (miscarriage) increases.

  9 out of 10 women who become pregnant through artificial insemination successfully bear children. Childbirth after IVF is the same as normal. The method depends on the condition of the woman, the fetus, the presence of pregnancy complications.

  Children conceived through artificial insemination are no different from other babies. There is an opinion that they are smarter, but they get sick more often. Experts conclude that this is due to special parental attention and guardianship of such children.

  Donation

  When taking material from a patient, there may be more eggs than necessary. This circumstance makes it possible to donate female germ cells. This is very important for patients who for some reason do not have eggs, for example, after surgery to remove the ovaries, during menopause. In order for women to agree to be donors, the cost of IVF is usually reduced for them.

  Men can become sperm donors. The person who gave it away has no rights to a child conceived artificially from a cell. Donation is anonymous. They take germ cells only from absolutely healthy people.

  The cost of IVF is not available to everyone, but this is a chance to deceive nature. Modern reproductive technologies give it to infertile women, couples who dream of becoming parents. There are many options, experts select the appropriate one individually in each case.

  Many couples who are faced with the problem of conception are looking for ways to become parents, in which case the question often arises, which method to choose.

  Despite the fact that there are many ways in modern medicine, it is important to start with less radical procedures.

  Note!

  To achieve the greatest chance of conception, it is important to know the date of ovulation. You can determine its onset in various ways, for example, by keeping a schedule, tests,.

  

  Before taking action, many women do not go to the doctor, but start asking questions on the Internet search engine, for example, how is insemination done at home, experienced reviews help to gain confidence before the procedure.

  However, it is worth getting the advice of your doctor to have an accurate idea of ​​what can and cannot be done during insemination.

  What is needed for the procedure

  Before starting manipulations, it is necessary to prepare a sterile container for collecting sperm, a disposable syringe without a needle of 10 ml, if necessary, a disposable sterile vaginal dilator is purchased.

  

  The spouse or partner must collect the sperm in a container prepared in advance. You can’t use it right away, you need to wait until it becomes a little thinner.

  It takes approximately 10-20 minutes. At this time, the container can be wrapped in a towel to keep it warm, avoiding too high temperatures and shaking.

  

  You can store sperm in this way for no more than two hours.

  Step-by-step instruction

  It should be understood that it will be impossible for a person without special education to introduce sperm into the uterine cavity itself without damaging it.

  Therefore, artificial insemination at home is possible only if the syringe is inserted into the vagina as deeply as possible without damaging the cervix.

  The pressure on the plunger of the syringe must be carried out carefully, without damaging the spermatozoa.

  

  If a vaginal dilator was used or it is also called a mirror, then the scheme of actions will be slightly different. For the convenience of its introduction, it is permissible to use a lubricant, without spermicidal lubricant.

  The dilator is inserted with a downward slope, at an angle of 45°. The legs of the mirror should be moved apart by 2-3 cm so that the cervix becomes visible. With the help of the latch, the expander is fixed in this position for further actions.

  Note!

  You can not push the legs of the dilator too wide, so as not to injure the surface of the vagina.

  

  The pressure on the piston should be smooth. The contents of the syringe should not fall into the neck area, but only at its base, as this can lead to injury. After the manipulation, it is necessary to smoothly loosen the dilator and close it, only then remove it from the vagina.

  Success rate after home insemination

  Both with natural fertilization and insemination, no one can give a 100% guarantee that everything will work out the first time.

  According to statistics, if artificial insemination of a woman is carried out at home, then the chances of success are no more than 20%.

  It may take not one, but two or three attempts. If a woman has the growth of several eggs, it is best to carry out several such procedures during one cycle, this will increase the chances of a successful conception.

  As a rule, when establishing infertility with unexplained reasons for its appearance, it is recommended to first resort to such a procedure as artificial insemination without stimulation.

  That is, when the eggs are produced by the body on their own, without the need to take hormonal drugs (for example, duphaston or).

  In this case, it will be possible to carry out a similar procedure for six consecutive months no more. If pregnancy does not occur, you will have to resort to the method.

  Conclusion

  As can be seen from the article, the procedure itself is not very complicated and is quite feasible at home. The percentage of success depends not only on the physical, but also on the psychological state of the couple.

  It is possible to combine the procedure with sexual intercourse, since it is likely that when a woman has an orgasm, there are more chances for successful fertilization.

  However, do not be upset if the attempt was unsuccessful the first time, it is important to have a positive attitude and save your strength so that the body is healthy and strong before pregnancy.

  Video: Artificial insemination. Pros and cons

  AT last years, unfortunately, there is an increase in the percentage of women who cannot become pregnant naturally. The reason for this is the deteriorating ecological situation, various inflammations of the female genital organs and many other factors. The union of a man and a woman is considered to be fruitless in the case when the partners have an active sexual life without the use of contraceptives for 1-2 years, but the long-awaited pregnancy does not occur. This problem is diagnosed in about one in five married couples. In such situations, methods of artificial insemination of the female egg come to the rescue.

  Methods of artificial insemination

  In modern medicine, today there are several methods of artificial insemination, which have been successfully used for many years. Every couple who decides to resort to one of the methods of artificial insemination should know how artificial insemination is done and what to expect during this procedure. In this article we will try to answer the most interesting questions regarding such a difficult topic. In our time, it is possible to become a full-fledged family, conceive and give birth to a healthy baby using methods such as:

  • In vitro fertilization (IVF) - the fusion of male and female cells is performed in a laboratory in a sterile test tube, after which the developing embryo is transferred to the uterus of an infertile woman.
  • Intracytoplasmic sperm injection into the egg (ICSI) - the technique of this procedure is almost identical to the previous one, however, in the case of ICSI, fertilization occurs using purified prepared male sperm (the patient's spouse or a donor).
  • Artificial insemination (AI) - to this type artificial insemination is resorted to in cases where reproductive problems have been identified in a man (insufficient sperm activity, deviations in the functioning of sexual functions, the presence of any other diseases).
  • Donation of male genetic material.
  • Conception using an egg from a professional or individual donor.

  Important! If you have been unsuccessfully trying to become parents for many years and have already used all the methods of conception available for this, you should not despair - every couple has the opportunity to resort to the services of a surrogate mother. However, if you are unable or unwilling to use this method, you can always adopt a child who is left without parents.

  Understanding the Mystery of Conception

  Fertilization itself represents the initial stage of the birth of a new life. Its beginning is considered the moment of connection of the female and male germ cells. From that moment on, the sex of the child is already randomly determined in advance. We know that the sperm and the egg contain 23 chromosomes each, one of which is responsible for the sex of the unborn baby. When an egg meets a male sperm with an X chromosome, the couple has a girl; if with a Y chromosome, you can soon be congratulated on the birth of a boy.

  As a rule, 12-14 days after the onset of menstruation, almost every representative of the weaker sex begins ovulation - the release of an egg from the follicle, which is ready for fertilization. Through the fallopian tubes, she gradually moves inward, where she will languish for some time from waiting for a meeting with a spermatozoon. The egg remains fertile for approximately 24 hours from the moment it leaves the follicle. Thousands of sperm enter the woman's vagina along with seminal fluid and begin their long and difficult journey.

  It takes 3-4 hours for the spermatozoa to cover this short distance. On their way there are a lot of obstacles, and most of them die. Only the most high-quality and mobile of them reach the cherished goal. In order for conception to occur, about 10 million male cells are required, but only one of them can merge with the egg, which will be able to penetrate through the dense protective shell. The moment of their merging is considered the moment of fertilization.

  Two merged cells eventually turn into a zygote, and then into an embryo - a prototype of the future little man. Pregnancy occurs when the fertilized egg reaches the uterus and attaches to the inner lining of the uterus, the endometrium. This happens around 7-10 days. After that, a special hormone responsible for pregnancy (hCG) begins to be produced in the woman's body, which allows you to diagnose pregnancy at home - you just need to purchase a special test at the pharmacy. After nine months, a new person is born.

  Artificial conception and its types

  If a woman or her partner has been diagnosed with infertility, then in this case they resort to the procedure of artificial insemination. But you should not be afraid of the word "artificial", because babies conceived in this way are absolutely no different from children who were born naturally.

  The most accessible and simple method of artificial insemination is considered to be artificial insemination. During this manipulation, the male sperm is placed directly into the uterine cavity through a special catheter, where the spermatozoa independently find the egg and merge with it. Of course, the sperm is pre-cleaned and prepared, only the highest quality and most mobile spermatozoa are selected.

  On the eve of the manipulation, the couple must undergo a complete examination of the body, pass the necessary tests. The woman is checked for patency of the fallopian tubes, the man takes a semen analysis, both partners pass tests for the presence of genital infections. Often, if necessary, ovulation in a woman is stimulated with the help of special hormonal injections.

  This type of artificial insemination is used in cases where:

  • a woman does not ovulate;
  • fallopian tubes are impassable or absent altogether;
  • a woman experiences spasms and muscle contractions during intercourse;
  • the woman's body produces antisperm bodies that deprive sperm of the viability;
  • a man is diagnosed with impotence or other disorders in the genital area;
  • age factor;
  • a woman has endometriosis or other diseases in the genital area;
  • spermogram analysis has an unsatisfactory result.

  With primary infertility (infertility of the 1st degree), married couples prefer this particular method of artificial insemination.

  Important! The effectiveness of this type of artificial insemination is approximately 25%. However, the degree of effectiveness is also determined by a number of factors: the age of the partners, the degree and duration of infertility, the quality of the ejaculate, and some others.

  In vitro fertilization (IVF) is a more expensive, complicated and time-consuming procedure. It is resorted to in situations where there are many unsuccessful attempts to conceive naturally and artificially, but the long-awaited pregnancy never happened. The couple must pass a series of tests together, the woman is given an ultrasound diagnosis, the fallopian tubes are checked for patency, and the man takes a spermogram. After a long preparatory stage, they go directly to the process of artificial conception.

  The male biomaterial is pre-processed and cleaned, after which it is placed in a favorable nutrient medium in an incubator. In a sterile test tube, the most active and high-quality spermatozoa are mixed with female cells. After about a day, it can be ascertained whether fertilization has occurred. And after 2-3 days, the developing embryos are transferred to the uterus of an infertile patient for further development.

  During IVF, several embryos are usually placed in the uterus at once, in order to increase the effectiveness of the procedure. If desired, the couple can freeze the remaining embryos so that they do not go through all the previous stages of IVF in the future. The chance of pregnancy when using this method is approximately 20-30%.

  Itroplasmic sperm injection (ICSI) is usually used in cases of male infertility. In most cases, the reason for this is insufficient sperm motility, or their complete absence in the ejaculate. The procedure is quite simple - the selected spermatozoon is delivered directly into the egg using a very thin needle. This happens not in the body of a woman, but in a laboratory using a pre-extracted and processed egg. The course of manipulation is controlled by a microscope.

  Preparation for ICSI is about the same as for IVF. The only difference is that with IVF, spermatozoa are given the opportunity to independently reach the egg, and with ICSI, this task is taken on by an experienced specialist. The chance of pregnancy with this artificial insemination technique is approximately 30%. To be more precise and turn to statistics, the probability also depends on the age of the woman:

  • the chance of getting pregnant with IVF in women under 35 is approximately 40%;
  • at the age of 35 to 37 - 30%;
  • at the age of 38-40 years - 20%;
  • women over 40 years old are given about 10%, and at 45 years old - about 1%.

  Alternative methods of conception

  It should be noted that in especially severe cases, there are also ways for childless couples to become happy parents:

  • using the services of a surrogate mother (your unborn child is being carried and given birth by another woman);
  • in vitro fertilization using donor biomaterials;
  • use of frozen embryos;
  • adoption of a child without real parents.

  Curious facts

  There is an opinion that artificially conceived children develop several times more actively than their peers, but at the same time they are more susceptible to various diseases. However, these are just assumptions, and in fact, test-tube babies are no different from naturally conceived babies. Perhaps such opinions are based on the fact that usually a child conceived with the help of IVF is born to elderly parents, thereby becoming even more desirable, long-awaited and loved. In addition, the opportunity to carry out this procedure is mainly available to people whose financial component is quite reliable and stable, and such parents in the future are able to give their child a decent education and excellent living conditions.

  Difficulties of choice

  In the vast majority of cases, almost any form of both female and male infertility can be successfully treated, and the spouses eventually manage to experience the joy of having a child. However, sometimes it happens that the cause of infertility has been established, but it is not possible to eliminate it either with the help of medications or by surgery.

  What is the method of artificial insemination to choose? There is no definite answer to this question. Each of them has its own merits and demerits. For example, the artificial insemination procedure is financially accessible to almost everyone and easy to perform. But you can not vouch for its very high efficiency. While in vitro fertilization has a rather high price, and its implementation can take more than one year, but the probability of obtaining the desired result is quite high.

  For couples with similar difficulties, artificial insemination techniques come to the rescue, which have been successfully carried out for several years by Dr. Lazarev Alexander Pavlovich, PhD, author of more than 30 scientific papers in the field of various forms of infertility. Remember that without exception, all couples who managed to get pregnant and give birth to a long-awaited baby with the help of modern achievements in the field of reproduction experience great parental happiness. The same cannot be said about infertile men and women who still have doubts and have not yet been able to make this decision. However, it should be borne in mind that after thirty years it is much more difficult for any woman to become a mother, even with the help of artificial insemination. Weigh all the pros and cons, make the right decision and experience the joy of having a baby!

  How does artificial insemination work?

  The artificial insemination procedure, regardless of the chosen protocol, methodology, requires careful preparation, patience, accurate and well-coordinated work, laboratory staff, related specialists and a married couple.

  • Preparation for in vitro fertilization
  • Ovarian puncture during artificial insemination
  • How artificial insemination works in the embryology laboratory
  • Embryo cultivation
  • Embryo Transfer

  How is the preparation for artificial insemination

  Artificial insemination in the embryological laboratory

  Embryologists, being under sterile conditions, search for eggs in the follicular fluid under a microscope, transfer them to a test tube or Perty dish filled with a nutrient medium, and send them to an incubator for 4-6 hours.

  In parallel, the preparation of sperm takes place: washed, cleaned. Sperm becomes concentrated.

  After the specified period, “improved” sperm is added to the eggs and sent back to the incubator. For the fertilization of one egg, 100-200 thousand live spermatozoa are needed. One penetrates inside, all the rest serve to melt the shell of the egg at the entry point of the "main" spermatozoon.

  Observation is carried out within 48 hours. Then they look at which eggs are fertilized. And two more days observe the development of embryos. Only the best will be placed in the uterus: those that develop in a timely manner and do not have anomalies.

  • the number of cells;
  • fragmentation percentage;
  • division rate;
  • the presence of deviations in the process of division;
  • the presence or absence of inclusions in the cytoplasm;
  • lack of multinuclear blastomeres;
  • regularity of form;
  • equal size, etc.

  With a repeated process, after and for a number of other reasons, a more subtle artificial insemination procedure can be used - (, or) intracytoplasmic injection of a spermatozoon into an egg. With a thin needle under an electron microscope, the shell is pierced and the selected male germ cell is introduced into the cytoplasm. Such a development of events is agreed in advance with the doctor. One of the undoubted advantages of the ICSI technique is the possibility and prevention of possible deformities.

  

  cultivation

  Depending on the quality and pace of development within 2-4 days. There is an option for long-term cultivation for 5–6 days, in which the percentage increases. allows you to reduce the likelihood, since the need to transfer a large number embryos are lost. In this case, the likelihood of pregnancy increases. If the embryos good quality a lot, then after the completion of the process of artificial insemination, the "extra" offer to send to.

  Embryo transfer day

  The main recommendation on the eve and on the day of the transfer is not to worry. Be patient and have a positive attitude. often prescribed in the morning. Therefore, breakfast should be light, with limited fluid intake.

  Before the procedure, the couple has a conversation with the embryologist. The doctor shows pictures of embryos taken under multiple magnification. It characterizes the development and degree of their maturity, gives recommendations on the choice and answers questions. Together with the doctor, the couple decides which ones.

  Embryo transfer technique

  Then proceed to the procedure on the gynecological chair. It only takes 10-15 minutes. The embryologist collects embryos in a long sterile plastic tube - a catheter attached to a syringe. The attending physician, having previously exposed the cervix in the mirrors, inserts a catheter through the cervical canal into the uterine cavity and performs the transfer. To make sure that all the embryos from the tube have entered the uterus, the catheter is examined under a microscope.

  Sensations during manipulation are likely to be slightly unpleasant, but the discomfort quickly passes. The woman remains in a horizontal position for 20 to 45 minutes, after which she is invited to the doctor's office, where the doctor will prescribe further treatment - hormonal support, antispasmodics, vitamins, give recommendations, appoint the next consultation and date of delivery.

  The effectiveness of artificial insemination

  The efficiency of IVF ranges from 25 to 33%. Continuous scientific work is carried out to increase positive results. Since its inception, the procedure and technology of artificial insemination have not stood still, but have continued to improve.