Everything you need to know about IVF

If it is not possible to conceive a child naturally, people turn to assisted reproductive technologies. IVF is the most effective method of overcoming infertility.

According to the European Society for Human Reproduction and Embryology (ESHRE [https://www.eshre.eu/]) for 2015, Spain occupies the leading position in terms of the number of artificial insemination cycles per year (119 875). Russia is in second place with (110 723), in third place is Germany (96 512), in fourth place is France (93 918), and England closes the TOP-5 (60 000).

What is IVF

In vitro fertilization (artificial insemination) is an assisted reproductive technology for overcoming infertility, in which conception occurs not in a woman’s body, but in an embryological laboratory.

Embryologists create embryos from the parents’ biomaterial (eggs, sperm). Embryos are formed not in a test tube, as is commonly believed, but in “Petri dishes”, and develop there for 5-6 days. After that, 1-2 embryos of the best quality are transferred to the uterus. If pregnancy occurs, its onset can be diagnosed after 14 days using a test for hCG, and confirmed in a month using ultrasound. Pregnancy and delivery are as if they were naturally conceived.

The IVF method in Ukraine has been practiced and improved for over 25 years. In 1991, the first child was born, conceived in this way. The girl was born healthy and received the name Catherine. At the same time, the Ukrainian Association of Reproductive Medicine was created, actively promoting ART and infertility treatment in the country.

IVF types

The procedure is carried out in the conditions of the embryological laboratory by doctors-embryologists. There are two approaches to creating an embryo:

  1. Using eggs and sperm of future parents.
  2. Using donor eggs and / or sperm.

The second type of IVF is used when, for various reasons, it is impossible to obtain healthy oocytes of the biological mother. Then the donor oocyte is fertilized with the sperm of the biological father. The resulting embryo is transferred to the future mother. Donor cells are in demand by single women without a partner. In this case, donor sperm is used for fertilization.

Depending on the medical indication, IVF is performed in one of the following ways:

  1. Classic IVF. Selected sperm is placed in a dish with a nutrient medium and eggs, which independently fertilize the eggs. Conception takes place within 2-3 hours and differs from natural only in that it does not occur in the woman’s body.
  2. IVF with ICSI. Used when semen quality is low. Embryologists select the most motile and sperm with good morphology and place it inside the egg. This method is more effective, therefore it is gradually replacing the classic IVF.
Who is IVF recommended for

IVF is a method of treating female and male infertility in the following pathologies:

  • Obstruction or absence of fallopian tubes;
  • Endometriosis;
  • Ovulation disruption;
  • Ovarian failure;
  • Antisperm antibodies produced by the female body;
  • Unexplained infertility, when, in the absence of pathologies, pregnancy does not occur;
  • Spermatogenesis failure.

There are absolute and relative contraindications for IVF. The first group includes:

  • Mental illness;
  • Congenital abnormalities of the structure of the uterus;
  • Deformities of the uterus (as a result of delivery, abortion, surgery);
  • Heart disease;
  • Pathology of the development of internal organs;
  • Stroke, cardiomyopathy;
  • Hyperparathyroidism;
  • Diabetes mellitus grade 3;
  • Multiple sclerosis;
  • Severe kidney pathology, renal failure;
  • Malignant neoplasms.

Relative (surmountable during treatment) contraindications:

  • Active tuberculosis;
  • Benign neoplasms of the female reproductive organs (if the diameter of the neoplasm does not exceed 25 mm);
  • Hepatitis, syphilis;
  • Chronic diseases;
  • Inflammatory processes;
  • Overcame oncology;
  • HIV.

Future fathers or sperm donors need to postpone participation in the procedure in the following cases:

  • For a year, if you need chemotherapy or radiation therapy for oncology;
  • For a year, after hepatitis B and C;
  • For 3 months, if treatment of inflammation of the organs of the reproductive system was required;
  • For 3 months if treatment of an infectious disease was required.

Doctors make the decision on admission to the IVF procedure after a complete medical examination.

Before IVF, you should definitely pass extended diagnostics and intensive treatment of infertility using conventional medical methods.

IVF price

The cost of IVF varies not only in different countries, but even in different clinics in the same country. This is due to different methods of IVF, the need for accompanying procedures, different lists of examinations.

The approximate cost of IVF in different countries:

  • Georgia, Greece, Spain, Russia, Ukraine – € 10,000-30,000.
  • Canada – € 15,000-35,000.
  • USA – € 22,000-45,000.

The international health insurance funds return the money spent to clients with health insurance: for example, in Germany, for citizens of the country, the reimbursement will be from 30 to 50%. In Belgium, Greece, Israel, Slovenia, France and Sweden – 100%, subject to certain criteria.

In Israel, an unlimited number of IVF procedures are available to spouses for free. The maximum number of children is two. In the UK, women under 40 years old with a diagnosis of absolute infertility are available 3 free IVF protocols, at the age of 40-41 years – one protocol.

In all countries, the decision on free IVF is made by a special medical commission after analyzing the medical situation. This is accompanied by bureaucracy, long waiting lines, and other unpleasant factors.

Meanwhile in Ukraine, reproductive technologies are available to citizens of the country and foreigners. At the same time, the legislation reliably protects the rights of future parents, the level of medicine and service is not inferior to the level of Western clinics, and prices are several times lower. Many clinics also work with health insurance, which is why the country has been attracting people who dream of becoming parents for many years.

Does IVF cause oncology?

Can IVF be done after oncology treatment? Can oncology be passed on to a future child? Let’s consider the question in more detail.

Overcame cancer is a relative contraindication. That is, if certain conditions are met, the doctor will allow IVF.

The first thing to analyze is the course of the disease and the treatment regimen. If the disease was detected at an early stage and the therapy is assigned correctly, there is a high probability of a complete cure with preservation of reproductive function.

If oncology was detected at a late stage with metastases, then in most cases, treatment is associated with the removal of the affected organ. For example, if the ovaries are removed (or the therapy has affected the quality of the oocytes), but the health is satisfactory, a woman can become a mother using donor eggs.

On the basis of examinations, a sparing IVF option is selected for a woman who has overcome oncology: without hormonal stimulation in the natural cycle (if hormones cannot be prescribed), one embryo is transferred. After a sufficient time after the treatment of oncology and with a satisfactory state of health, IVF and delivery of a healthy baby are possible.

Some cancers are indeed hereditary. Therefore, IVF for couples with oncology and other hereditary diseases in the history of clinics perform preimplantation genetic diagnosis (PGD) and offer special services of human genomics.

Based on the results of genetic testing, it is possible to identify an embryo with a normal number of chromosomes, to identify pathologies linked to the sex (then the choice of gender will help to give birth to a healthy child).

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