MEDICAL ASPECTS OF SURROGACY – Клініка Стефана Хміля

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MEDICAL ASPECTS OF SURROGACY

With the help of assisted reproductive technologies, you can achieve the desired result. The most famous method is – In vitro fertilisation (IVF).

IVF can help with fertility problems in women and men. For example, with fallopian tube obstruction or if there are some problems with sperm. IVF is also used in infertility of unexplained genesis, especially those couples who can not conceive a child for more than three years.

Couples, for whom the medical stimulation of ovulation and intrauterine insemination has been unsuccessful, may also use IVF.

Insemination, under normal conditions, occurs inside the female body, in the fallopian tubes.

The fertilized egg starts growing fast, dividing into many cells and move through the tube to the uterus. After it gets to the uterus, the fertilized egg attaches to the lining of the uterus, called the endometrium. This process is known as implantation. The cells keep dividing.

With the use of IVF technology, fertilization occurs outside the female body, especially in laboratory conditions. The embryo is transfered into the uterus through a special catheter  into the uterine cavity. If the embryo is well set in the uterus, then the course of pregnancy does not differ from the normal one.

Since the first time this technique has been successfully applied (in 1978), around 2 million children were born around the world with the help of IVF. The percentage of successful results from the first attempt according to world statistics is 30-35 percent.  According to the ratio, we can say that almost one in three – four couples, that uses  assisted reproductive technologies, has a baby. And it is a good probability , especially for those who are almost lost hope of being able to conceive a child on their own.

There are some recommendations in the period of preparation for IVF for future parents. The most important thing is to eliminate negative household factors that have a toxic effect on the sex cells:

  • Cut back on any alcoholic drinks, tobacco, caffeine;
  • Rationalize your food (exclude from the diet smoked foods, semi-finished goods and products with high content of food additives and preservatives – mayonnaise, canned food, sweets, etc., prefer vegetables, fruits);
  • Avoid excessive insolation, hypothermia, physical and emotional stress;
  • Change the poor working conditions (work in premises with high temperature, radiation, work with toxic substances, etc.);
  • Consume 400 micrograms of folic acid daily (at least a month before the pregnancy) to prevent birth defects;
  • Normalize your body weight if you weight less than 45 kg – increase it, and if you weight 70 kg or more – lose some weight with the help of sport activities and a diet. Do not use drugs to reduce appetite or “burn fat”.

And, of course, the main point in preparing for pregnancy is a psychological adjustment. But, at the same time, we must remember about the possibility of a negative result.

Before starting IVF, both a woman and her partner must undergo a series of surveys, which give the physician the opportunity to assess the health status of potential parents. They include:

  • blood test for HIV infection, syphilis and some types of hepatitis (usually B and C) for both partners;
  • blood group test and Rh factor for both partners;
  • specific blood test for hormones for the expectant mother (FSH, AMH, LH, prolactin, TSH, T3, T4)  in order to find the optimal dosage of stimulating drugs;
  • tests on vaginal discharge;
  • spermogram (to evaluate the concentration, structure and motility of spermatozoa);
  • ultrasound examination of the pelvic organs and mammary glands of a woman to exclude pathological conditions that may delay the IVF program.

Also, a woman who plans to become a mother with IVF should undergo a full medical examination to exclude any concomitant pathologies and after that the therapeutist confirm the absence of contraindications for pregnancy. If you have chronic diseases, you should inform the doctor about their presence and in the case of the use of any medicines or food supplements.

MORE INFORMATION ON PREPARATION TO THE IVF PROCESS

The first of these procedures is strictly on an empty stomach, on this day it is not even recommended to drink for a woman (at least a few hours before the procedure).

In order not to cause any inconvenience in this regard, transvaginal oocyte retrieval is usually carried out in the morning. The patient may leave the clinic on the same day. Particularly strict adherence to the regime in this situation is not required. You may well continue your work, unless your doctor gives you other recommendations.

On the same day, when the transvaginal oocyte retrieval is performed, her partner  donates sperm through masturbation into a special container. This sperm is used for fertilization. It is very important to follow the recommendations so that your biological material does not lose its properties and viability.

The sperm cells are immediately placed in a special sterile flask, which creates the most favorable environment for their existence, while the  length of their stay is strictly regulated and can not exceed the prescribed time.

Further, in the course of “ordinary” IVF, semen is placed in the container to the egg cells and stored in a special incubator, where the temperature, humidity, and CO2 concentration are strictly maintained. Then the embryologists find out whether fertilization and further division of the zygote took place. The transfer of embryos to the uterine cavity can be carried out at various stages, from the stage of the zygote to the blastocyst stage, which is formed 5-6 days after the fertilization. This procedure is painless and takes 3-7 minutes. On this day a woman can eat food and drink. But she must have a full bladder during the procedure .

It is recommended to carry no more than 1-2 embryos to the cavity of the uterus (according to the Order of the Ministry of Healthcare of Ukraine No. 787 dated 09.09.2013). However, with a projected reduced probability of implantation, it is possible to carry more embryos (with the consent of the patient no more than 3 embryos).

Diagnostics of pregnancy by the presence of high hCG level in blood or urine is performed 14-16 days from the day of embryo transfer.

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