Long-term in vitro embryo culture. Cultivation of gametes and embryos - what is it?

For more than twenty years, couples who have problems with conception and the birth of a child have a chance in the form of a program of in vitro fertilization. Of course, at the moment it is quite an expensive procedure, the result of which does not always correspond to the expectations of patients, but still it is a chance for those who want their child genetically. Cultivation of embryos makes it possible to select only the most viable, as well as exclude some gene diseases.

Terminology

In vitro fertilization is the direction of reproductive technology, which involves fertilizing the mother's egg outside the womb and implanting the embryo within five to seven days.

Cultivation of embryos is the maintenance of the development and vital activity of human embryos before they are inserted into the uterine cavity.

Stages of IVF

The procedure of artificial insemination consists of several consecutive steps or steps:
1. Stimulation of superovulation, in parallel with the monitoring of folliculogenesis and the growth of the endometrium.
2. Puncture of the follicles.
3. Fertilization of the egg and embryo culture in vitro.
4. Artificial maintenance of the luteal phase of the menstrual cycle.
Embryo transfer and pregnancy diagnosis.

For young women, IVF can be performed without superovulation.

Indications and contraindications to IVF

The recommendation for this medical manipulation is the presence of a woman with infertility, which is not amenable to therapy, provided that IVF gives the greatest probability of conception.

Contraindications include:
- Extragenital pathologies threatening the interruption of pregnancy;
- malformations of the uterus;
- neoplasms of the uterus and ovaries;
- Acute inflammatory diseases (not only the reproductive system);
- the presence of oncology in the anamnesis.

Preparation for the IVF method

The first stage is the collection of analyzes and the identification of pathologies. For this, the patient must pass a blood test for sex hormones, as well as detailed general tests for biochemistry and glucose tolerance. A complex check for urogenital infections and ultrasound examination of internal reproductive organs is carried out.

The partner must make a spermogram to make sure that there is no male infertility. It is mandatory to take a smear for cytology and colposcopy, in order to exclude precancerous conditions. The future mothers are being investigated for TORCH infections (rubella, toxoplasmosis, herpes, cytomegalovirus and chlamydia), since this can affect the development of the fetus. In the end, ultrasound of the mammary gland and thyroid gland is performed.

The second stage is carried out immediately before the beginning of treatment. It consists of three points:
- spouses must pass HIV tests, viral hepatitis, syphilis, get the results of their blood type and Rh factor;
- a woman needs to take tests for blood sugar, a general blood test, urine and biochemistry, as well as to know the time of coagulation;
- The future mother must have a therapist's conclusion that there are no contraindications to pregnancy.

The order of IVF

First the doctor, after all the necessary tests, conducts the stimulation of the ovaries of a woman in order to get several healthy eggs. The introduction of drugs begins on the 21st day of the menstrual cycle, and lasts a whole month. During this time the doctor constantly monitors how the follicle ripens and the endometrium grows in the uterine cavity with the help of ultrasound. As well as a woman taking tests for hormones, in order to see the whole picture. Once the eggs mature, an outpatient procedure takes place. However, some factors may prevent this process:
- lack of ovarian response to stimulation;
- presence of adhesions in the cavity of the small pelvis;
Premature ovulation;
- Anovulatory cycle (when ripened follicles do not contain an oocyte). All these features must be considered before recommending that the couple begin the IVF procedure.

As soon as the future father or an anonymous donor donate their genetic material, it is possible to carry out the procedure of fertilization. Long-term in vitro embryo cultivation is necessary in order to select the most viable embryos. Five to six days after fertilization, several embryos are placed in the uterus to the mother. In two weeks, the future mother donates blood to the level of human chorionic gonadotropin (hCG) to determine the onset of pregnancy.

Long-term embryo cultivation

More often than not, patients who seek such specific medical care have many questions. One of them sounds like this: "Culturing gametes and embryos, what is it?", The answer is quite simple and complicated at the same time. This is the method by which the fetus remains alive before being placed in the mother's body. Long-term in vitro embryo cultivation is an expensive, high-tech procedure that requires specific knowledge and skills. Modern laboratories are constantly improving in the technique of fertilization and equipment. The latest novelty is the cultivation of embryos in the environment of Embryogen. Additional growth factors provide a high probability of embryo implantation into the uterine wall.

Earlier, cultivation of embryos was generated only up to the stage of crushing and placed in the uterus just three days after "conception", but they took root only in a quarter of all cases of IVF. But after the development of the method of embryo culture in vitro to the stage of blastocyst, the effectiveness of the method has increased. This required new nutrient media and incubators.

Pros and Cons of the procedure

This procedure leads to the cultivation of embryos to a new level.

1. Helps to select the most promising, in terms of implantation, embryos.
2. The number of chromosomal abnormalities decreases, as it can be traced and prevented at the blastocyst stage.
3. Has a more physiological approach.
4. The risk of multiple pregnancies decreases, because only two embryos are enough, instead of five, as before, pregnancy has come.
5. Ectopic pregnancy occurs at times less often than before.

However, there are disadvantages of this procedure. The first is that not all embryos can grow to the required stage. Still, the incubator systems and nutrient media still need to be improved, as close as possible to natural conditions. And if fewer than four embryos survive, the likelihood that they will be ready to be injected is extremely small. The second disadvantage, as in previous versions of IVF, is the lack of a 100% guarantee of success. No reproductive physician in the world will claim that this method is true in the last resort. Scientists still have something to strive for.

Side effects of IVF

To undesirable effects after IVF, at the time, which is used for prolonged cultivation of embryos, are:
- Multiple pregnancy, as several embryos are attached at once;
- ectopic pregnancy (it is impossible to exclude the movement of the embryo inside the uterus);
- excessive stimulation of the ovaries (ovarian hyperstimulation syndrome leads to infertility);
- infections and bleeding.