women, single or coupled,
desire a child. Fortunately, science
has an answer for those who cannot
conceive naturally. Since fertility
treatments take time, Plenitas
has developed special programs
that enable patients to start
the procedure at home.
by Step Description of Assisted Fertilization
Treatment Processes and Possible Combinations
During the natural process of ovulation,
FSH hormone triggers the growth of
several oocytes inside their respective
follicles. Only one of the oocytes
will become ready to leave the follicle
and attach to the uterus, the rest
will die. Assisted fertilization treatments
seek to increase the chances of successful
pregnancies by stimulating the ovary
with extra hormone and making it produce
more than one oocyte. The woman is
injected the same hormone that induces
the natural development of follicles,
but in higher doses, allowing many
of the follicles that would have otherwise
died due to the growth of a dominant
follicle to continue their development.
This hormone is injected daily with
a syringe and it is such a simple
procedure that the patient can do
it by herself. The development of
the follicles induced by stimulation
is monitored with transvaginal echography.
Due to the fact that the production
of follicles varies according to each
woman, the physician will adjust the
doses according to each case.
Once the follicles have matured, the
oocytes growing inside each one of
them will be collected. The woman
is sedated and receives local anesthetics
to avoid any kind of discomfort. A
cardiologist supervises her vital
signs while the physician performs
the transvaginal echo-guided punction
of the follicles. The oocytes are
extracted from the follicles by suction,
using a hollow needle. The number
of oocytes extracted will vary according
to each woman.
The semen belonging to the woman's
partner is examined in order to establish
its quality. When there is not enough
sperm in the semen, it becomes necessary
to perform a testicular biopsy or
puncture to collect them. Once the
amount and quality of the sperm is
considered adequate, the in vitro
fertilization procedure begins.
In Vitro Fertilization
When the quality of the sperm is good,
they are incubated together with the
oocytes in a propitious medium where
fertilization will take place without
external help. But when the quality
of the sperm is not good enough or
when they are too few, the physician
must resort to a special technique
that will help the sperm penetrate
the oocyte. This technique is called
ICSI (Intra Cytoplasmic Sperm Injection),
it consists in injecting the sperm
directly inside the oocyte. Thanks
to this technique, fertilization can
take place even when the sperm is
too weak. Twenty four hours after
in vitro fertilization or ICSI, the
oocytes are examined to see if the
first signs of fertilization are already
visible, that is, two small spheres
inside the oocyte: the male and female
Once the pronucleus become visible,
the embryos are incubated during one
or two days more to monitor cell division:
first they divide into two cells,
then into four. The embryos that have
divided into 8 cells 72 hours after
they were collected will have better
chances of attaching to the uterus.
Sometimes, the embryos are placed
in another special medium and left
for a few days more until they reach
the blastocyst stage, when they are
fit for implantation in the uterus.
Sometimes, the embryo's quality is
not good enough because the pellucid
zone that covers them is too thick.
If the pellucid zone is too thick,
the embryo will not be able to break
through it and attach to the uterus.
When this occurs, a small hole is
made in the pellucid zone to help
the embryo break through; this is
called 'assisted hatching'.
The chosen embryos are transferred
to the uterus by means of a cannula.
This procedure is VERY simple and
it does not require anesthesia, it
is monitored by echography so that
the embryos will be placed properly.
Two or three embryos are usually transferred.
The number of embryos that will be
transferred is decided according to
the woman's age, the characteristics
of the embryos and the couple's background.
This allows for better chances of
achieving successful pregnancies and
lower probabilities of multiple pregnancies.
When the number of embryos exceeds
the number that will be transferred,
they may be preserved for future pregnancies
so there will be no need to repeat
the previous stages.
Corpus Luteum Stage
Once the embryo has been transferred,
the woman may return to her usual activities.
She will only have to take progesterone,
the hormone that helps the endometrium's
development, where the embryo will attach.
Approximately 14 days after the embryos
has been transferred, a test will be
carried out to see if she really is
pregnant. Two weeks later, an echography
will be made in order to see if the
gestation sack has developed and so
as to check the heart's activity. Once
the pregnancy has been confirmed, the
future mother will have to take care
of herself like every other pregnant
achieved thanks to assisted reproduction
techniques are not different from
natural pregnancies. Thousands of
couples have been benefited by these
techniques and today are very proud
and happy parents.
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