In vitro fertilization, i.e. in vitro, is currently the most effective method of infertility treatment. The indications for in vitro are, among others irreversible damage to the fallopian tubes, endometriosis, infertility, resistance to ovulation stimulation, no effects of intrauterine insemination.

Women who decide toIVF,have to undergo a lot of tests, and often also medical procedures.

  • Required tests: gynecological, cytological, vaginal pH, semen analysis, ultrasound of reproductive organs. Serological tests for infections are performed in both partners prior tofertilizationin vitro: hepatitis B and C, HIV; tests for chlamydiosis and syphilis are recommended.
  • When there are less than 5 million sperm / ml in semen, a male should undergo karyotyping and CFTR (cystic fibrosis gene) mutations.
  • Before the procedure, the woman is stimulated to multiple ovulation.
  • After fertilization, the embryos are observed to see if they divide properly and transferred to the uterus (on days 2-5). Preferably, one embryo should be transferred to the uterine cavity, and the rest should be frozen and transfers should be made in subsequent cycles. Only in exceptional circumstances is it allowed to transfer three embryos (this applies to women over 40)

Classic IVF

In the classic IVF, ova are placed in a group of 50,000. sperm and waiting for fertilization. However, the ovum may not be fertilized spontaneously in vitro. When the parameters of the sperm do not ensure that the sperm is able to do it on its own, the so-called micromanipulation (ICSI). This is the introduction of a sperm into the cytoplasm of the ovum using a micropipette. ICSI is used when the cause ofinfertilityis male, in endometriosis, in idiopathic infertility, and after failure of classical IVF. IMSI is a modification of ICSI, which consists in introducing a carefully selected sperm into the egg cell thanks to its image magnification up to 6,600 times. The IMSI procedure can be used when the sperm parameters are very bad (less than 1 million sperm / ml).

Problem

How much does IVF cost in Poland?

In many Western countries, infertility treatment is covered by he alth insurance. Also inIn Poland, in vitro reimbursement is available from July 1, 2013. As many as 15,000 will benefit from the government's IVF financing program within 3 years. Polish couples.

In vitro - intrauterine insemination

It is a procedure involving the administration of semen directly into the uterine cavity using a special catheter and syringe. Before insemination, semen is cleaned and subjected to a special procedure in the laboratory, thanks to which its parameters are improved. The chances of success are higher after mild ovarian stimulation and after reaching maturity by up to 2-3 follicles. Indications for the use of insemination: semen with slightly reduced parameters, low-stage endometriosis, unexplained infertility, ejaculation disorders. The condition for insemination is the patency of the fallopian tubes. The couple must also pass bacteriological and virological tests (HIV, hepatitis B and C, WR).

In vitro - ovulation induction

It involves the administration of drugs containing hormones that regulate the work of the ovaries, pituitary gland and hypothalamus. Hormones are given on specific days of the cycle. The treatment may take several months. Sometimes blood is taken to determine the level of sex hormones, and an ultrasound of the ovaries is regularly performed. For years, clomiphene citrate has been the drug of first choice for stimulation. Gonadotropin stimulation is used in women who fail to ovulate or conceive with clomiphene citrate, or who have pituitary or hypothalamic insufficiency. The risk of multiple pregnancy is then greater. Efficacy: in women with polycystic ovary syndrome (PCOS), the success rate is 50-60 percent.

Important

Poles with IVF

In the last few years, 5-7 thousand jobs are performed in Poland every year. cycles of treatment with the use of in vitro fertilization. It is estimated that so far from 8 to 13 thousand children have been born. children after IVF (exact data are unknown). Currently, in a year, about 1.7 thousand children are born in Poland. children after IVF, which is less than 0.5 percent. all newborns. Over 4 million children were born this way around the world.

Surgical methods of infertility treatment

In women, adhesions after inflammation of the appendages, endometriosis foci are removed, the fallopian tubes are cleared, and partitions in the uterus are removed. Cryptorchidism and varicose veins are operated on in men. The procedures are usually performed laparoscopically under general anesthesia. Efficacy: in men, surgical treatment often does not bring the expected results, in women, the operation may be effective when the patient is young, adhesionsperitubal are small and the ciliary apparatus of the fallopian tube is preserved. The removal of endometriosis foci and cauterization of the ovaries in women with PCOS, resistant to hormonal treatment, also improves fertility.

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