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.
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.
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.
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.
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.
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.
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.
Andrology and Fertility Hospital of Hanoi
? (+84) 1900 56 56 01
➡ 431 Tam Trinh Street, Hoang Mai District, Hanoi, Vietnam.