The fertilization in vitro (IVF) it is recommended especially in the case of total occlusion or partially; or the absence of the trumps. In the case of infertility, for unknown reason, or for bad quality of the sperms, IVF has been applied with success. IVF has a great diagnostic value as treatment of the infertility. If they end up fertilizing the mature ova well although the patient is not pregnant, the future treatments make sense. If on the contrary the fertilization of the mature ovum doesn't happen, the only treatment of it is, in most of the cases, it is the injection spermatic intracytoplasmic (ICSI).
In most of the cases, the treatment with IVF requires hormonal stimulation, beginning the day 1 to 3 of the cycle.
With the help of a sanguine analysis and ultrasounds to observe the maturation of the ova, the time of the injection is determined with HCG (hormone that causes the ovulation) and the day and the hour of the puncture to obtain the ova (36 hrs. after the application of HCG). The ova are obtained with the help of an ultrasound and of a thin needle. In general, the patient receives a light anesthesia. With a suction system the liquid of the follicles is obtained with the ova. Soon after, the liquid is examined to detect the ova. If they are ova, these are introduced in a means of they remain until they are introduced in the womb (transfer of embryos). This process lasts approximately from 40 to 70 hours.
After the transfer, the patient rests and she can go to her house. At the same time that is carried out the puncture: or little time later, the husband gives a fresh sample of sperm. Before the procedure, it is examined and a sample of sperm freezes; in the case of not obtaining a sample, sperms should exist with what to work.
After the preparation of the sperms, they are deposited 100,000 sperms approximately with the ova in the means of cultivation. In some cases, it is expected up to 24 hours post-puncture to join the ova with the sperms so that the ova have this way a bigger maturity. The fertilization can observe up to 18 hours after the procedure; and 40 - 48 hours later, the ova in division state, are transferred with the help of a small return catheter to the woman's womb (embryo transfer). Later on, the patient rests some hours in the hospital and later she can go home, keeping rest in a bed during next three days. The quantity of embryos that the doctor implant depends on the quality of the same ones; and the doctor, together with the couple, they make the decision about how many embryos they are transferred. The possibility to achieve a pregnancy is bigger when they are increased the quantity of embryos, in the same way it increases the possibility that it happens a multiple pregnancy.
The embryos left, can be conserved freezing in liquid nitrogen to temperatures of 196º Celsius under zero.
The success of the IVF depends on many factors: it influences the quality of the sperm, the quantity of mature ova, the quantity of transferred embryos and the process of anidation of the embryo in the internal layer of the womb (the endometrium). The bad quantity of the sperm that is identified usually by poor mortality impedes in many cases a successful fertilization. The fertilization in these cases doesn't usually exceed 30% (if quality of normal sperm, the fertilization exists it arrives to 80%).
In occasions, in women with serious hormonal dysfunctions, they are only obtained non mature ova. These immature ova or post mature don't fertilize in the same level. In these cases, the moment of union of the sperm with ova is of supreme importance. In occasions, the dysfunction in the maturation of the ova is possible to correct through a protocol adapted in a next treatment cycle. The anidation of the embryos in the internal layer of the womb (the endometrium) he/she leans on with hormones. A great part of these embryos gets lost for bad conditions for the anidation of the same endometrium. Another part of the embryos stops to probably be developed because genetic damage exists. In these cases, the lack of a pregnancy is a mechanism of protection of the nature to avoid a malformation.
