26/10/2023
What is in vitro fertilization (IVF)?
IVF is a technique to treat for infertility couple that the fertilization occurs in glass instead of in the body. The woman’s eggs and the man’s sperm are fertilized in a glass (petri dish) to create embryos, at the proper time, the embryos are transferred into the woman’s uterus and luckily, embryo develops in to uterus to have baby.
Nor there are 2 kinds of IVF such as: traditional IVF and IVF/ICSI
Traditional IVF: The woman’s eggs and the man’s sperm are fertilized in a glass (petri dish) to create embryos, then embryos are incubated and cultured in Laboratory, at the proper time, the embryos are transferred into the woman’s uterus. In this technique eggs and sperm meet and integrate in a “natural” way to form embryos.
IVF/Intra cytoplasmic sperm injection (ICSI)
ICSI means injection directly one sperm into matured cytoplasm of one egg for inducing fertilization to create embryo. This technique is supported by micro manipulation systems and reverse microscope with magnification 200-300 times. Thanks to the ICSI technique, the embryo is created from one egg with on weak and immature sperm but still have high fertilization rate.
Indication of IVF
Tubal disease: Such as blocked fallopian tubes and hydrosalpinx…
Male factor. In cases with male infertility with a defect in sperm quality, sperm have difficulty penetrating the egg, very low sperm counts and no sperm (azoospermia).
Endometriosis. Patients with endometriosis, often have tubal involvement and ovarian cysts (endometrioma) and will benefit from IVF.
Ovulatory dysfunction. In patients with polycystic ovarian disease (PCOS) and other ovulatory problems, IVF can be used when other methods have failed.
Unexplained infertility. Patients with no obvious cause for their infertility (normal work up) can benefit from IVF.
Egg donor….
IVF protocol in AF hospital
Couple clinical examination and screening many tests such as: STI tests, semen analysis test, hematology tests, basical biochemical tests, reproductive hormone tests, ultrasound examination and other related tests. All the tests are completed previous cycle and on the second of the treatment cycle. The procedure and price are consulted from beginning of treatment and whenever patient require.
The patient profile will be completed when result come, and our doctors will consult together to give appropriate treatment for patient.
Long protocol
Patient undergoes follicle stimulation medicine for injection from day 21 of the previous cycle normally the injection for 12-14 days, next, patient undergo ultrasound and blood test to diagnosis the follicle development then doctor wait to see menstrual
On the second day of the treatment cycle, patients are injected with other follicle stimulation medicines after ultrasound and hormone tests on this day completed.
The injection is usually around next 10-12 days, when the follicles get enough size, patient will be injected with a trigger medicine to help the egg mature.
Egg pick up procedure is performed 36 h after the last trigger.
Sperm are taken on the same day of eggs pick up.
An embryo specialist will do IVF procedure and culture embryo in Labo for 3 to 5days
Transfer of embryos will performe into the uterus on the third day
Pregnancy test (beta-hCG) 14 days after embryo transfer.
Doing ultrasound 2 weeks later if positive pregnancy test.
Short protocol
Patients are induced follicle stimulation from the second day of the treatment cycle.
Monitor ovarian follicle development and dose adjustment of follicle stimulation medicines by ultrasonography and hormon test.
The injection time is about 10 days, when the follicles reach full size, patient are given a trigger injection.
The timing of aspiration of the eggs and transfer of embryos are the same as the long protocol
Egg pickup (oocyte retrieve)
Patient should stop eating at least 4-6h before eggs pick up procedure to avoid reflux when patient undergo anesthesia.
You have to used pian killer medicines and intravenous anesthesia medicine during the procedure.
Egg retrieve was performed under the guidance of ultrasound through vaginal delivery, usually lasting 15 minutes.
After the appointment patient should rest 2-3 hours, when the condition is stable, they can leave.
Fertilization
Eggs that retrieved will be transferred to Labo for evaluation, and performed fertilization with sperm.
The rate of fertilization on average 75-90%, some time in our hospital reached 99%. Low fertilization rates may be due to the poor quality of sperm or eggs and or boths. Occasionally, the phenomenon of unfertilization occurs is very little (about 1-2%).
Two days after the eggs retrieve, fertilized eggs will divide into embryos of about 4 cells. On day 3, the embryo it will have about 6 to 10 cells. On day 5, the embryo will form a cavity, the embryo of this stage called blastocyst.
The embryo will be transferred to the uterus on each of these day: Second, third and fifth day after the egg is retrieved. At our hospital, embryo transfer is usually done on day 3 after retrieval, some cases are performed on day 5th.
Transfer of embryos
This is a procedure to insert embryos into the uterus, help embryo nest and develop into pregnancy.
Unlike eggs, when the embryo transfer you have to urinate
This procedure is light invasive. Your doctor will use a device that expose the cervix and insert the embryo into the uterus through a tiny soft catheter to prevent injury to the lining of the uterus.
This procedure is painless and lasts about 5 minutes. Some cases of embryo transfer are difficult due to abnormal cervical posture.
Frozen embryos
In some cases, after embryo transfer patient still have extra embryos, the number of embryos will be frozen for delivery next time.
Frozen embryos increase the number of embryo transfer cycles per natural ovarian cycle, increase cumulative pregnancy rates, reduceing costs and complications compared to a new fertility cycle.
The birth rate of healthy babies from frozen embryo transfer has confirmed the safety of this technique.
Before embryo transfer, patient will be prepared for endometrium, to help the endometrium to accept and facilitate embryo implantation.
After the embryo transfer, patients continue to use drugs to support the development of the pregnancy.
Support luteal phase
In vitro fertilization, due to stimulation of the ovaries, changes in the concentration and endocrine effects on the uterine lining, altering the embryo’s implantation window, thus the luteal support is indispensable, increasing the nesting ability and maintaining the development of the fetus.
There are many drugs and many protocols to support the luteal phase, patients will be using the appropriate protocol during the first 2 weeks after the embryo transfer, if you are pregnant the drug will be longer used.
Pregnancy test
Patients will be given a blood test two weeks after the embryo transfer to check the pregnancy hormone level, the most accurate determination of patient pregnancy.
The hospital can schedule an appointment for you to monitor the increase of this hormone after 2-7 days, to predict the development of fetus.
Intra uterine insemination (IUI) is an assisted reproductive procedure in which a doctor uses a small catheter to insert washed sperm into the uterus.
For infertile couples, performing IUI will help sperm pass through the vaginal environment and uterine mucus more favorably, and at the same time putting sperm in the position closest to the egg increases the chances of conception.
In Vietnam, the first artificial insemination technique was known in 1957 at the Academy of Agriculture and Forestry. After recording the positive reviews, it is applied to human experiments. Up to now, intrauterine insemination (IUI) is still evaluated as a highly effective assisted reproductive technique, suitable for many cases of infertility.
– Infertility due to ovulation disorder
– Infertility of unknown cause
– Infertility due to endometriosis
– Infertility due to cervical factor
– Cases of sperm storage for IUI
– Applicable to single women or couples whose husband does not have sperm and wishes to have children by this method.
Condition: Have at least one working oviduct
– Infertility due to weak, abnormal husband’s sperm
Condition: Normal husband’s sperm or mild deficiency
For each infertile couple, facing the decision to perform intrauterine insemination will certainly have a lot of questions and wishes to be answered. Andrology And Fertility Hospital of Hanoi sends you useful information about what to prepare before IUI.
IUI is a process that is not always easy and many couples do not succeed the first time. Therefore, keeping a good mood, psychological comfort is really a useful medicine to help couples physically as well as mentally to always be in a positive state. It is the positive thoughts that will have a great impact on the outcome of the IUI process.
Proactive financial preparation is the first step to take before starting the IUI process. Right from the beginning, couples will need to have a general examination with the indications for testing and examination by the doctor. For each medical condition that requires different treatment of the spouse, the cost also varies, in addition to the medicine cost and IUI services.
For couples living far away, transportation and accommodation costs (if necessary) will be incurred. Therefore, being well prepared financially will help families feel secure to start IUI.
To complete the IUI application, the Hospital will ask the couples to provide the necessary documents, which is also a mandatory procedure of any medical facility when performing assisted reproductive methods in general. Accordingly, the documents you need to prepare are::
– Original citizen identity card or national identity card: The hospital keeps a copy and returns the original to you after checking
– Original marriage certificate (certificate of singleness if not married): The hospital keeps a copy and returns the original to you after comparison
– Other necessary documents as prescribed by a specialist doctor
Lower cost of implementation compared to other assisted reproductive methods
Compared to in vitro fertilization (IVF) or other assisted reproductive methods, intrauterine insemination (IUI) is not too expensive to perform. With a moderate cost, many couples can realize their dream of becoming a father and mother more easily.
For those who have to use donor sperm from a sperm bank, the cost will be higher, but this is still an effective option for infertile couples.
Less invasive and affects the wife’s body
During IUI, ovarian stimulation drugs are prescribed by doctors depending on each person’s situation, but the dosage will generally be lighter than IVF stimulation. In addition, the technique of specialized doctors to insert sperm into the uterus is very quick, safe and less invasive or painful for the patient.
Reasonable cost, easy to perform, but IUI, like other assisted reproductive methods, is not 100% perfect but still has certain disadvantages. In particular, the older the wife is, the lower the success rate will be, this is a limitation of sperm injection into the uterus. In addition, this method has some other disadvantages, which are:
Risk of multiple pregnancy
Ovulation drugs are prescribed by doctors for the wife’s body to stimulate ovulation, but this can lead to more than one ovulating at the same time, thereby leading to the risk of multiple pregnancy. Women with multiple pregnancies are at high risk of preterm birth and miscarriage. In case the mother’s health is not guaranteed or the number of fetuses is more than 2, the patient will be consulted by a specialist to reduce pregnancy to ensure safety.
Risk of ovarian hyperstimulation
The use of ovulation-stimulating drugs can cause ovarian hyperstimulation with unpleasant symptoms in women such as headaches, hot flashes and insomnia, or it can also cause bloating and abdominal pain.
Most of the above symptoms will resolve on their own and subside after 10-14 days. During this period, patients need to monitor and treat symptoms to prevent possible complications. Usually, cases of severe reactions rarely occur, but if they do, the patient needs to be treated aggressively and promptly.
Risk of infection
The risk of infection occurs when the wife has an infection of the uterus and fallopian tubes due to an infected sperm sample or an infection in the vagina and cervix during treatment. The risk of infection accounts for 1% of all intrauterine insemination cases.
Signs of uterine infection: fever, vaginal bleeding, abdominal pain. In these cases, it is necessary to contact a specialist for appropriate treatment.
Couples need to perform a general examination at the Hospital for a specialist doctor to assess the situation to determine if they are eligible to perform intrauterine insemination and give appropriate advice. Each examination time must be accurate:
– For the wife, there will be 2 timelines to visit:
+ Day 2-3 menstrual cycle (hormonal test, secondary follicle count ultrasound)
+ 2-5 days after menstruation, abstain from sex (gynecological tests, Hysterosalpingography)
– For the husband who can come to the doctor at any time but need to abstain from ejaculating for 3-5 days to do semen analysis.
After having enough examination results and receiving advice from a doctor, couples need to provide the originals of the following documents to complete the medical record.:
– Identity card or citizen’s identity card
– Marriage registration
– In addition, the hospital will have an application for IUI that needs to be signed by both husband and wife
– Day 2 or day 3 of the menstrual cycle, the wife is given an ovulatory drug to stimulate the ovaries to produce good follicles.
– Day 6-7 of the menstrual cycle, the wife goes to an ultrasound to have a specialist assess the response of the ovaries, through which the doctor will adjust the medicine and schedule the next ultrasound date.
– Around day 9-10, if there is a “ripe” follicle, the wife is injected with ovulation medicine. At the same time, the husband was assigned to collect semen for the hospital to filter and select good motile sperm.
Note: Depending on each case, a specialist doctor may prescribe IUI with a natural cycle, without ovarian stimulation.
3-5 days before IUI pump, the husband needs to abstain from using drinks and stimulants, abstain from ejaculation, then proceed to collect sperm at the Hospital according to the instructions of the doctor.
The husband’s sperm will be transferred to the Lab for washing and washing, this operation will help screen for weak, malformed, less motile sperm… from there, healthy and quality sperms will be selected to be injected into the uterus.
– After 24-48 hours from the ovulation injection, sperm injection into the wife’s uterus is conducted. Normally at Andrology and Fertility Hospital of Hanoi, in one cycle of performing IUI will be divided into 2 injections.
First injection:
– The doctor will use a specialized instrument which is a small, rounded, soft catheter that is inserted from the vagina into the wife’s uterus and directly injects sperm into the uterine cavity. This technique is quick, simple, and painless, so there is no need for anesthesia or sedation.
– The wife rests in place for about 15 minutes. At home, the wife can still work normally but limit her activities
Second injection:
The second injection will be performed 24 hours after the first injection with the same operation and procedure as the first injection..
After injecting sperm into the uterus, the patient is prescribed hormonal support drugs according to prescription. 14 days after pumping, the wife will be tested by beta hCG test to know the exact pregnancy result.
Vietnam is considered among the top countries with the lowest cost of artificial insemination (IUI) in the world. Currently, the cost of one time to perform IUI at Hanoi Hospital of Andrology and Fertility ranges from 7.000.000 VND to 10.000.000 VND including drug and IUI pump service. However, depending on the situation of each couple, the cost level will change, if the wife or husband has gynecological / male diseases, there will be additional costs to treat completely before treatment. during IUI injection.
In order to create the best conditions for you to have time to arrange your finances, when performing intrauterine insemination at AF Hanoi, proceed to any stage you pay up to that stage, not the full payment. set of costs at the same time from the very beginning
Andrology and Fertility Hospital of Hanoi has risen to be among the top quality and prestigious hospitals in the field of Assisted Reproductive Medicine. Modern facilities, a team of experienced and dedicated specialists and doctors have helped the hospital constantly develop and accompany thousands of infertile families to welcome their babies over the years. Many cases of intrauterine insemination (IUI) have been successful in the first time, every baby is born, every happy smile because of being a father and mother of families is A great source of motivation for the hospital to be more confident in carrying out its mission of bringing children’s laughter to every home.
The intensive coordination between the specialties at Andrology and Fertility Hospital of Hanoi is a highlight in the health care process for infertile couples. Customers are cared for carefully from the initial stage, to the treatment of diseases and pregnancy care for pregnant women up to 30-32 weeks. The close connection in the hospital’s medical examination and treatment system has shown professionalism to provide customers with the most comprehensive and effective services.
– Coming to Andrology and Fertility Hospital of Hanoi, out will be welcomed and examined by dedicated doctors and nurses with the enthusiastic support of hospital staffs to bring the most comfort to customers
– Security system and customer identification ensure accuracy, avoid information confusion
– Results of examination and testing are available on the same day, customers do not have to wait long
– Customer staff support from the time the customer visits until the client is pregnant and has a successful baby
– 24/7 hotline 090 222 1268 to support and answer information for dedicated and thoughtful customers
– Room system is spacious, clean and full of necessary services to help customers feel secure in treatment.
– Spa on the 9th floor creates a relaxing space to help families feel more comfortable during their visit to the hospital
After about 10 days of IUI, if favorable, you may see signs of successful IUI. In fact, these manifestations will be similar to normal conception. The hospital sends you the common signs of pregnancy 2 weeks after IUI:
Whether you are pregnant by natural or IUI method, a missed period is still the most common and important sign that you know you are pregnant or not. When you see a missed period after IUI, you can take a pregnancy test with a test strip or a beta hCG test to check.
At the beginning of pregnancy, a woman’s breasts become more sensitive to external influences, feeling pain or swelling. This is also a positive sign that you may have had a successful IUI. However, if the condition is too uncomfortable and lasts too long and is accompanied by a missed period, you should see a specialist.
This is the first symptom after successful IUI, which is commonly referred to as “blood signal” but not everyone has this symptom. When the embryo moves into the uterus and begins to implant, the cervix will bleed and the vagina will produce red mucus, the amount of blood will be small, with a light pink color.
Many of you will have a feeling of fullness during early pregnancy, which is caused by the increase of the hormone progesterone, which slows down the digestive process, causing the stomach to become bloated. This phenomenon is less common but is a sign that you have successfully fertilized after IUI.
In the early stages of pregnancy, many people will begin to have morning sickness, fear of a certain smell or food because the nose becomes more sensitive than usual, leading to nausea. You may experience some dizziness at this time. This phenomenon is caused by an increase in the hormone estrogen, which makes the sensitive organs, especially the sense of smell, more sensitive.
Progesterone levels will rise above the normal threshold during pregnancy, leading to lower blood sugar, less blood production and slower oxygen to the brain. The body expends a lot of energy, making the body in a state of fatigue with a feeling of sleepiness.
Hormonal changes in a woman’s body at the beginning of pregnancy. You will suddenly crave food that you have never eaten or can’t eat before. Hunger attacks come in close frequency and often come at different times of the day.
At Andrology and Fertility Hospital of Hanoi, the current average IUI success rate is 20%. However, the success rate of IUI depends on some factors below:
– Age of performing IUI: For women under 35 years of age, the level of success will be higher than for those over 40 years old. When entering the age of over 40, natural fertility will be reduced, especially in women of older age, the ovarian reserve and egg quality decline markedly. This makes it more difficult to implement assisted reproductive methods.
– Long-term infertility: In cases of infertility, long-term infertility, have tried many treatments but still can’t conceive, the success rate of IUI injection is very low, because each year passes the pregnancy rate. can all be further reduced. Therefore, when treating infertility for too long without any results, it will still be difficult to perform IUI.
– Sperm are too weak, the number is too small: in a healthy man, every 1ml can contain up to 10 million sperm, but if the sperm count is too low, If the quality is not high, the chances of successful fertilization will decrease.
Actively seeking information about IUI will provide a lot of useful knowledge to help couples have an effective IUI cycle. Here are some questions commonly asked by Andrology and Fertility Hospital of Hanoi during examination and treatment:
According to MSc, Dr. Le Thi Thu Hien – Deputy Director and Head of the Assisted Reproductive Department – Andrology and Fertility Hospital of Hanoi, the fallopian tube has a very important function in the fertilization process. The fallopian tube is the tube that carries the ovum from the ovary to the uterus and is also the place where the fertilized egg travels to the uterus. The speaker of the fallopian tube has a structure of 10-12 tentacles, these tend to catch and capture the ovum and put it into the fallopian tube.
Therefore, the fallopian tubes need to be open and at the same time soft and easy to move to be able to catch the ovum, move the ovum, sperm and fertilized egg into the uterus. There are a number of medical conditions such as pelvic endometriosis, pelvic inflammatory disease caused by Chlamydia … causing adhesions, blocked fallopian tubes.
With limited fallopian tubes, to get pregnant naturally, as well as to evaluate the success rate of IUI technique depends on a lot of factors, the basic needs to be met are: Quality of eggs and sperm must ensure, ensure factors for the egg and sperm to meet, ensure that the egg after conception moves to the uterus for implantation and development. After assessing all these factors in combination with your health status, pregnancy history, age … the clinician just recommend which method to proceed, or how IUI estimates the success rate…
MSc, Dr. Le Thi Thu Hien said that if the husband has a normal semen analysis, the wife is examined and tested only with two blocked fallopian tubes, which affects the spermatogenesis process. For eggs and fertilized eggs to move into the uterus for implantation, there is still the possibility of natural pregnancy. Therefore, couples who find it difficult to conceive, infertile… need to go to the doctor soon, so that depending on the specific case, the doctor will give appropriate treatment methods.
Normally, the process of injecting sperm into the uterus takes only a few minutes and is performed by experienced specialists of the Hospital, so you can be completely assured of the doctor’s skill. During the sperm injection process, the doctor will insert a specialized instrument through the vagina into the client’s uterus, so the private area will feel more sensitive and a little uncomfortable in the lower abdomen. However, most of the customers who have done this technique feel very safe, with little pain. Therefore, you do not need to worry too much when performing this method and trust the advice of the doctor.
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