How to maintain pregnancy after IVF

Features of in vitro fertilization

In vitro fertilization is a modern reproductive technology that is used for infertility. During the procedure, an oocyte is removed from the ovaries and fertilized under “in vitro” conditions. After this, the diploid cell is cultivated in a special incubator for 3-5 days.

The reproductive specialist decides at what point to transfer the embryo into the uterus, focusing on the degree of preparedness of the endometrium for implantation. It is believed that five-day-old embryos take root better, but not all fertilized oocytes can survive to transfer at the appointed time.

So, what preparation is done before follicle puncture?

Despite the short duration of the procedure itself, it requires careful adherence to certain rules.

• During stimulation, you must try to lead a healthy lifestyle. This refers to the ban on smoking and alcohol, abuse of spicy and fatty foods. It is advisable to limit excessive physical activity.
• Try to avoid viral and infectious diseases, and prevent exacerbation of chronic processes, if any.
• Do not take medications without the knowledge of a fertility specialist.
• Food should be rich in vitamins and minerals.
• Avoid sexual activity 3-5 days before the puncture.
• With an accuracy of no more than 10-15 minutes, enter the so-called. trigger the final maturation of the follicles, trying not to lose a drop of solution. For this purpose, human chorionic gonadotropin is usually used (there are other options), which is administered 34-36 hours before the puncture. A trigger is prescribed when the majority of follicles reach 18mm in diameter. Strict adherence to the doctor’s instructions in the stimulation protocol, especially the time of trigger introduction, is one of the most important conditions for successful egg retrieval.
• If anesthesia is required, the puncture is performed on an empty stomach, so eating before the procedure is prohibited. The need for anesthesia (pain relief) is discussed on the day of the trigger appointment.

How is the follicle puncture procedure performed during IVF?

The day and time of puncture is determined by the reproductologist when prescribing a trigger. The start time of the manipulation is selected to the nearest minute and delay in starting the procedure is undesirable. On the day of the puncture, you need to be at the clinic 30-40 minutes before the start - in order to have time to fill out documents, change clothes and “settle in” at the day hospital, and have time to discuss the type of anesthesia with the anesthesiologist. In most cases, intravenous anesthesia is chosen, so you need to come to the puncture with an empty stomach. If there are few follicles (no more than 3), it is permissible to perform the operation without anesthesia.

The duration of the operation is from several minutes to half an hour and depends on the number of punctured follicles and technical difficulties (for example, related to the location of the ovary). The patient awakens in the operating room and is transferred to the day hospital. In case of successful collection (collection) of eggs, the spouse is invited to donate sperm.

HCG analysis - rules for delivery

The concentration of hormones in the body of the expectant mother is determined by collecting venous blood. Reproductologists recommend taking tests in the morning on an empty stomach - at least 8-9 hours should pass between the last meal and blood donation. If a woman is taking over-the-counter medications, she should tell her doctor a few days before the tests.

Enzyme immunoassay must be performed not only to determine gestation. The hCG test should also be taken in the 2nd trimester of pregnancy in order to identify defects in the development of the child. Correction of maintenance therapy can prevent up to 25% of congenital pathologies and anomalies.

Follicle puncture during IVF

The IVF method, although meant as one process, consists of several stages. Follicle puncture

– one of the most important. This is the collection of mature eggs from the follicle before ovulation. The procedure is not painless and is therefore performed under general anesthesia.

Follicle puncture during IVF: preparation

For the procedure to be successful, follow these simple rules:

• maintain psychological balance before and after surgery;
• diet
  : exclude from the diet foods that can cause fermentation (white flour, fruits), increase protein intake. This will help avoid overstimulation;
• do not be late for the procedure after
  the hCG injection, otherwise spontaneous ovulation may occur, and
  puncture before IVF
  will become impossible;
• maintain sexual rest several days before egg retrieval
  ;
• Before the operation, you should only have a light dinner; you should come to the procedure on an empty stomach.

How is egg puncture done?

Follicles are collected using a special hollow needle. It is inserted into the vagina, then passes through the paracervical area and enters the ovary. From each follicle, the fluid is sucked out along with the egg it contains.

Important points

• the entire procedure is done under ultrasound control, the sensor is attached to the needle;
• Duration of the operation is about 20 minutes;
• the extracted eggs are placed in special incubators for subsequent fertilization;
• Sperm collection from the husband is carried out on the day of puncture;
• When the IVF puncture
  is completed, the woman remains under the supervision of doctors for about 2 hours, then she is sent home.

Eggs for IVF after

The punctures are fertilized, doctors observe the process of division and growth, determining the viability of the blastocytes.

After the puncture

After the puncture was performed during IVF

, and you have left the medical facility, you need to monitor your condition and sensations for a few more days.
Minor short-term pain after puncture
is considered normal; after all, this is an intervention in the internal organs. What should alert you and be a reason to call your doctor:

• the ovaries hurt
  – hyperstimulation syndrome is possible even a few days after the puncture;
• The stomach hurts
  , a feeling of fullness from the inside is another sign of hyperstimulation.

The right psychological attitude will help you cope with anxiety about the procedure. Remember, a puncture is another step towards meeting your baby. And whether you will need another IVF protocol depends on how correctly it is carried out.

How to maintain pregnancy after IVF

Pregnancy after IVF often occurs with complications. This happens because women with diseases of the endocrine system and reproductive system resort to in vitro fertilization. They often experience miscarriage, toxicosis and other problems that put pregnancy at risk. To prevent this and maintain pregnancy after IVF, you need to be observed in a clinic that has the necessary equipment and qualified specialists working with IVF mothers.

Hormonal disorders during pregnancy after IVF

These problems are caused by the introduction of large doses of hormones during the preparation for IVF, if hormonal stimulation of the ovaries was carried out. For many women, this is a necessity and the only opportunity to become pregnant, since stimulation of the ovaries leads to the maturation of several follicles at once. At the same time, the concentration of estrogen in the blood increases sharply. Hormonal imbalance can cause disturbances in vascular permeability and accumulation of fluid in the lungs and abdominal cavity. Excess moisture prevents a woman from breathing, causes nausea, vomiting and loss of appetite.

Another possible consequence of HS is a slow increase in hCG levels (human chorionic gonadotropin), which is called the “pregnancy hormone”. This hormone should:

• preserve the corpus luteum;
• prepare the woman’s immune system for the upcoming pregnancy;
• stimulate fetal development

With a lack of hCG, fetal growth slows down, which leads to miscarriage and fading of pregnancy.

In this case, pregnancy support after IVF When observed in a specialized clinic, doctors will be able to correct hormonal levels in time, remove swelling and eliminate the threat of miscarriage.

Infectious and inflammatory processes

Women who become pregnant after IVF often suffer from chronic inflammation of the genital organs, which leads to the impossibility of natural conception. Although women are treated as much as possible during the period of preparation for pregnancy, the disease often worsens again. All this affects the functioning of the immune system and reduces the production of hormones responsible for the normal course of pregnancy.

A woman develops a bloody “spot,” indicating a threat of miscarriage. Under these conditions, it is not easy for the fetus to stay in the uterus, so medical support for pregnancy after IVF is required. Medical supervision helps eliminate dangerous inflammatory processes, maintaining pregnancy after IVF.

Maternal problems

IVF is mainly used by women aged 30 years and older. A large percentage of them have various diseases of internal organs (kidneys, heart, liver, gall bladder) and metabolic disorders. All these “sores” are prone to exacerbation during pregnancy, which negatively affects the intrauterine development of the child.

Women who already have health problems may develop gestational diabetes, caused by the pancreas not working properly. The level of glucose in the blood rises, which causes oxygen starvation of the fetus. This complication occurs more often if a woman is carrying twins, which often happens after artificial insemination. If the problems that arise are not treated in time, the pregnancy can be lost. To do this, women, being observed in the clinic after IVF, regularly donate blood for biochemistry and sugar.

Fetoplacental insufficiency

This condition occurs as a result of malformation and or insufficiency of the placenta. Since women who become pregnant after IVF often have problems in the sexual sphere, fetoplacental disorders are not uncommon.

As a result, the fetus suffers, which receives few nutrients and oxygen, which can lead to miscarriage or the birth of a sick child. Periodic Doppler testing, which shows the state of the feto-placental blood flow, can help with this condition. If a pathology is suspected, supporting pregnancy after IVF involves prescribing medications that improve blood circulation in the placenta and help the pregnancy proceed properly.

Multiple pregnancy

During IVF, a woman is often implanted with several embryos at once. If they all take root, a multiple pregnancy occurs. Sometimes twins develop from one egg, as in a normal pregnancy; a woman gives birth to identical twins. Many people consider twins or triplets to be an excellent result after IVF, forgetting that several babies are harder to bear and easier to lose.

Sometimes nature itself regulates the process, and extra embryos stop developing, but often all implanted eggs grow equally. It is possible, of course, to reduce (remove) excess embryos, but parents rarely agree to this.

In women pregnant with twins, toxicosis occurs more often and is more severe. The uterus, growing much faster, puts pressure on the legs, causing them to swell. Pressure on the diaphragm in recent months interferes with the mother’s ability to breathe properly. In the later stages of pregnancy with twins or triplets, an increase in blood pressure is more often observed, which can lead to convulsive syndrome (eclampsia) and premature birth. Since twins are already born with low weight, this can lead to extreme prematurity and death of newborns.

Overstretching of the uterus and increased stress on the body cause:

• bleeding;
• oxygen starvation of the fruits;
• anemia caused by a high load on the mother’s hematopoietic system;
• feto-fetal transfusion syndrome, when one fetus takes more nutrients, inhibiting the development of the second;
• thrombosis of placental vessels. During multiple pregnancies, one or both “baby places” are located incorrectly, which causes premature placental abruption;
• oblique, transverse or pelvic location in the uterus of one or all babies

A woman who has developed a multiple pregnancy as a result of IVF needs special observation and strict control, so she often undergoes an ultrasound to find out how the children are developing.

The condition of babies carried by IVF mothers is monitored using ultrasound and Doppler. Competent doctors working at the Life Line clinic will provide full support for pregnancy after IVF and will help you successfully endure multiple pregnancies and give birth to healthy children. The conscious attitude of a woman and the supervision of experienced specialists allows us to save the majority of pregnancies that occur after IVF.