IVF with stimulation
In Vitro Fertilization (IVF) has been used in reproduction for more than a decade. The most relevant state of art is the method of IVF with ovarian stimulation. This method allows to achieve maximum results in the treatment of infertility, due to obstruction of the fallopian tubes, hormonal disorders and some diseases of the uterus.
Before in vitro fertilization, the couple undergoes an examination aiming to obtain information about the reproductive organs condition, identify contraindications, and determine the cause of infertility. The procedure itself is performed in several stages:
- Stimulation with IVF. The purpose of this step is to start the process of several ovocytes maturation. For this purpose are applied the different hormonal medications. The choice of the exact medication for stimulation and its dosage is performed on the individual basis. For example, with low AMH (anti-Muller hormone) a woman produces few ovocytes and a higher dose of hormonal medications is prescribed for stimulation.
- Mature ovocytes retrieval. The puncture of the follicles is performed using a special needle under the ultrasound control. For maximum comfort, the procedure is performed under the intravenous anesthesia, which allows to exclude painful and unpleasant feelings during the procedure. At the same time at this step, the husband delivers sperm.
- Fertilization of the ovocyte. It is performed in conditions that best match to the internal environment of the body. After a few days, the viable embryos are selected and need to be transferred into the uterine.
- Embryo transfer is a painless procedure, so it is performed without anesthesia. The doctor places two or more embryos in the uterus using the catheter. The remaining material is cryopreserved. It can be used in subsequent attempts if this attempt will be unsuccessful.
- Pregnancy support. After embryo transfer, woman takes medications necessary for the normal start of pregnancy for several weeks. If the level of a human chorionic gonadotropin (hCG) rises, it means the successful IVF procedure.
Despite the high efficiency of the method, the first attempts are not always successful. World statistics show that the probability of pregnancy after the first attempt of in vitro fertilization is about 30%. This indicator strongly depends from the woman age, the cause of infertility, concomitant diseases, the medications used, etc. For example, according to the American Society for Reproductive Medicine, the likelihood of pregnancy after IVF with stimulation drops from 48% in women younger than 30 years to a level of 6% in 45-year-old women. However, each subsequent attempt has a higher chance of success; after four attempts, the probability of successful pregnancy is about 80%. Therefore, a natural question arises for women: how often can IVF be done with stimulation? Experts say that the number of attempts is unlimited, provided there are no contraindications. In addition, it is necessary to understand that between procedures should take some time, in average 2-3 months.
IVF with minimal stimulation
This type of method implies a reduction of hormonal medications dosages, and at the same time, the risks of adverse reactions. However, this option has certain disadvantages. Firstly, the less number of ovocytes that are suitable for fertilization. Secondly, loss of the ability to perform cryopreservation of the obtained material. Thirdly, it is very likely that intracytoplasmic sperm cell injection should be performed. Therefore, IVF with minimal stimulation is performed only if there are specific indications, among them are the following:
- Ovarian hyperstimulation syndrome in the past.
- Age over the 40 years.
- Polycystic ovary.
- The presence of contraindications to hormonal medications.
- Weak ovarian response to previous IVF attempts.
The choice of the exact option of the procedure is always performed on the individual basis. Stimulation with IVF does not affect the processes that occur in the female body. In each case, upon the pregnancy occurrence, it will be performed according to physiological norms, and the child will have no difference from the peers.