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When the world's
first IVF baby
(called a 'test
tube' baby at
the time) was
born in 1978 it
brought hope to
infertile
couples across
the world. Since
then over one
million babies
have been born
as a result of
IVF treatment.
Our IVF
laboratory at
ivfmiraclebaby
is one of the
most experienced
and best
equipped in
Thailand and has
helped thousands
of couples
achieve their
dream of having
a baby.
IVF is involved
in every
Fertility
treatment we
offer and when
other
interventions
you may have
pursued in your
home country
have proved
unsuccessful.
IVF is used in a
variety of
situations
including
standard IVF
treatment where
a patient needs
her eggs to be
fertilized in a
controlled
environment;
where PGD is
needed to
isolate genetic
diseases; where
the fallopian
tubes are
blocked; Egg
Donation when
the female
partner has no
viable eggs and
her partner's
sperm is mixed
with the donor's
eggs; when the
male partner has
low sperm volume
and ICSI is used
to inject a
single sperm
into an egg;
where the woman
is unable to
carry a
pregnancy (e.g.
after
hysterectomy)
and her
partner's sperm
is mixed with
either her or a
donor's eggs and
placed in a
Surrogate
uterus.
In Vitro
Fertilization
treatment at
ivfmiraclebaby
usually follows
these six
stages:
First Stage -
Pituitary
Suppression
In a natural
menstrual cycle,
hormones from
the pituitary
gland, LH and
FSH, stimulate
the growth of an
egg within a
follicle in the
ovary. Although
several
follicles start
to grow each
month, in a
natural cycle
only one will
become mature
enough to
ovulate.
During an IVF
cycle we want
several eggs to
mature
simultaneously.
At the same time
we do not want
an LH surge to
trigger early
release of these
eggs. We use a
medication known
as a GnRH
agonist to
temporarily turn
off your own LH
and FSH
secretion. This
medication is
usually started
around day 21 of
your menstrual
cycle and
continues
throughout the
stimulation
phase. It is
administered
daily, usually
by nasal spray
or by injection.
Second Stage
- Ovarian
Stimulation
This is when
daily injections
of FSH begin.
The injections
continue for
about 12-14 days
and the amounts
of FSH are
higher than you
would produce on
your own. This
is what
stimulates the
growth of
several
follicles,
instead of just
one. The
response of your
ovaries is
monitored with
frequent
ultrasounds and
blood tests. The
dose and
combination of
medications is
adjusted to your
individual
response and
most women learn
to give their
own injections
in order to
reduce the
number of clinic
visits.
Up to 10% of
women are
unsuccessful in
the ovarian
stimulation
phase. If your
ovaries do not
respond well
enough, with too
few follicles
developing, we
will cancel the
treatment cycle.
The reasons for
recommending
cancellation
will be
discussed with
you, along with
options for
further
treatment, such
as using an Egg
Donor.
Third Stage -
Egg Retrieval
Once your
ultrasound
indicates a
reasonable size
and number of
follicles, the
stimulation
phase ends and
the FSH
injections and
the GnRH agonist
are stopped.
That evening, an
injection of hCG
is given. This
hormone causes
the final
maturation of
the egg and
loosening of the
egg from the
wall of the
follicle. The
egg retrieval
occurs on the
second morning
after this final
injection (34-36
hours later).
Retrieval of the
egg is performed
by an ultrasound
guided needle
puncture through
the top of the
vagina. The
needle is passed
into each
follicle in the
ovary and fluid
is withdrawn
into a test
tube. The fluid
from each
follicle is
examined under a
microscope. Not
every follicle
contains an egg
and not all of
the eggs will be
mature, but
usually at least
half of the
large follicles
will yield eggs.
The procedure
itself will only
take 10 to 15
minutes, but you
will be asked to
rest in our
recovery room
for at least one
hour afterwards.
It is common to
experience some
cramping and
discomfort after
egg retrieval
which can be
alleviated with
a light
analgesic. Some
mild vaginal
spotting or
bleeding may be
present but will
usually resolve
within 24 hours.
The male role
Your male
partner will be
asked to produce
his semen sample
on the day of
your procedure.
It is
understandable
that some men
may have
experience
'performance
anxiety'. If
there is a real
concern he can
provide a sample
a few days
before the
procedure to
freeze until the
day of
fertilization.
Fourth Stage -
Fertilization
In some clinics
natural
fertilization is
used where the
sperm sample is
washed and
concentrated,
then added to
the eggs a few
hours after
retrieval. The
dishes are
placed in an
incubator and
eggs are
examined the
next day for
signs of
fertilization.
We expect about
70 to 80% of
eggs to
fertilize if the
sperm sample is
normal. The
fertilized eggs
are then kept in
the incubator
for an
additional 48
hours. Not every
follicle will
contain an egg,
not every egg
will fertilize,
and not every
egg that
fertilizes will
become a good
quality embryo
Fifth Stage -
Embryo Transfer
Three days after
egg retrieval,
the fertilized
eggs, now called
embryos, are
transferred to
the uterus using
a small
catheter. The
exact number
transferred will
depend on your
age and your
embryo quality.
Generally we
recommend
transferring two
embryos for as
it is important
to understand
that the risk of
multiple
pregnancy
increases with
the number of
good quality
embryos
transferred.
The embryos are
placed in the
transfer
catheter which
is passed
through your
cervix into your
uterus where the
embryos are
gently released.
The catheter is
then slowly
removed and
checked under a
microscope to
ensure that the
embryos have
been transferred
successfully.
You and your
partner will be
able to watch
the procedure on
the display
screen in our
transfer room.
The transfer
takes around
fifteen minutes
and you will
experience only
mild discomfort.
Prior to
transfer we will
have selected
your two best
embryos and will
re-confirm the
number with you
on the day of
the transfer.
Some of your
remaining
embryos may be
suitable for
freezing,
depending on
their quality.
You will be
prescribed
Progesterone and
Estrogen that
you will need to
take at the same
time each day
until you reach
your 12thweek.
These will help
keep your
endometrium (the
lining of your
uterus) in
optimal
condition for
implantation and
maintenance of
the pregnancy.
The dosages and
timings will be
explained to you
by Dr Wiwat and
our nursing
staff.
You will need to
rest for 2 days
after the
transfer but on
the third day
you will be able
to travel home
or continue your
usual activities
while you wait
for your result.
Things to be
aware of after
embryo transfer
that must be
maintained until
the 12th week.
- After
embryo
transfer, it
is important
that you
keep to a
healthy
lifestyle.
- Do
not walk up
steps in the
first 3 days
and be aware
of not
exerting
yourself
until your
pregnancy
test, 10 day
post
transfer.
- If you
have been
taking folic
acid
tablets, you
should
continue to
do so.
- Do not
smoke, take
drugs, drink
alcohol,
coffee or
strong tea
- It is
important
that your
core
temperature
does not
increase so
definitely
No
sunbathing,
spas,
saunas,
jogging or
aerobics.
- No
Sexual
intercourse
until the
doctor
advises
otherwise.
- Drink a
lot of fluid
and eat
plenty of
vegetables
and
proteins.
Foods that
are simple
and easily
digested are
best.
-
Sometimes
headaches
can be the
result of
the hormone
supplements
so a mild
analgesia
such as
Paracetamol
may be taken
if
necessary.
- Please
contact our
IVF nurse or
the Doctor
if you have
any worries
or concerns,
or if you
experience
symptoms
such as
cramping or
discomfort.
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Embryo
Development |
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Stage Six
- Luteal Phase
and
Pregnancy The
Luteal Phase is
the 10-day
period between
the embryo
transfer and the
pregnancy test.
You may
experience
vaginal bleeding
before you are
due for your
pregnancy test.
Although this
may be worrying,
it does not
always mean that
the treatment
was unsuccessful
however, check
with the doctor
if you are
concerned . Some
bleeding can
occur as a
result of
implantation of
the embryo in
the endometrium
and is a normal
part of the
process. You
should continue
using the
progesterone and
estrogen until
the blood test
results are
known 10 days
after the
transfer. Keep
in mind that the
progesterone you
are taking may
delay your
period so not
having your
period does not
necessarily mean
that you are
pregnant.
Waiting for
results can feel
like 10-months
rather than
10-days and is
often
emotionally
charged with
expectation and
anxiety. We
understand this
is a difficult
time for couples
and encourage
you to call our
centre for
support if you
need
reassurance.
Your luteal
phase is a time
to spend sharing
with your
partner or
friends doing
activities that
are pleasurable,
relaxing but not
taxing. Gentle
walking,
shopping,
movies, and
candlelit
dinners together
can help allay
anxiety and help
make it a
positive time.
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