IVF: no undue risks
In recent years, there has been an unprecedented breakthrough in the field of infertility treatment, and one of the most important reproduction areas was the hormonal effects on the female body. To regulate menstrual cycles in which ovulation does not occur, as well as during assisted reproductive technology, a woman is injected with special medicines. In fact, these are hormones produced by the body, but in large quantities. They contribute to the accelerated growth and maturation in the ovaries of not just one, but several follicles with the egg. When it comes to in vitro fertilization, this procedure is necessary to obtain a stock of eggs for fertilization and transfer into the uterus.
During the stimulation period, a woman is going through a special state. Under the influence of medicines, the ovaries increase, each growing follicle becomes dominant, large, and in some cases, if there are a lot of follicles, this process changes into Ovarian Hyperstimulation Syndrome. To avoid side effects, the drug administration in ISIDA is chosen with great care. Fortunately, reproduction professionals accumulate knowledge about the use of hormones, and in accordance with the global trend, the amount of hormones is minimized. The Clinic professionals are increasingly about to find the middle ground: to achieve the desired result, and at the same time prefer gentler methods of exposure.
Standard protocols allow to obtain a large amount – about 20 and even more – of eggs, but such regimens are not suitable for everyone. For example, a small amount of stimulant drugs is recommended in case of Polycystic Ovary Syndrome. In this case, it is better to get a small number of follicles, but of good quality. A similar approach is needed in the event that the woman’s stock of oocytes is already low. Standard doses of hormones still will not have the desired effect. Such factors as age, hormonal state, diseases require special treatment.Gentle protocols are necessary when the patient will struggle with unwanted neoplastic processes. Earlier, oncologists feared that hormones will lead to the increase in neoplasms. Today, they know exactly with what diseases stimulation is still possible. In this case, the preliminary sampling of germ cells allows to avoid the negative effects of radiation or chemotherapy. The received oocytes or embryos are cryopreserved, and later, when the body recovers after a difficult therapy, a woman – quite possible! – will have the chance to become a mother. Currently, the number of such visits to the Clinic has increased, and it shows that more women find out that cancer is not a death sentence, not only for life but also for the future motherhood.
In special cases
Today, there are many different preparation schemes for the egg retrieval, they may be based both on the use of natural abilities of the body, and the various combinations of drugs. Here are some examples:
- “Natural” protocol or IVF in the natural cycle implies no hormonal stimulation. This scheme involves obtaining a naturally matured egg, and is used in cases, if the stimulation is strictly contraindicated, or previous IVF attempts did not provide enough eggs, they were not of very good quality, or if the patient refuses to be stimulated. The effectiveness of this method is relatively low, but it reliably allows, firstly, to avoid side effects, related to the administration of additional doses of hormones, and, secondly, to try to obtain a single egg, chosen by the body, hoping for its high quality.
- Combined protocols are based on a “simplified” scheme. At the first stage, tablets are used and only then, if necessary, we use injectable drugs. Most often, this approach allows us to stimulate the growth of small (1-5) number of follicles with good quality eggs. If the purpose of the stimulation is not the IVF, it reduces the risk of multiple pregnancies. In addition, the procedure features the lower cost of drugs. At the final stage, a drug may be administered to avoid hyperstimulation, nullifying the risk of its development. Unfortunately, once it has been performed, the chances of pregnancy with embryo transfer are somewhat reduced in this cycle. The solution is the cryopreservation of embryos and their transfer to the cavity of the uterus in the next (unstimulated) cycle. This allows a woman to recover, live a normal life without suffering from symptoms that provoke an increase of the ovaries, and attempt to become a mother at a convenient moment.
- “Shanghai” protocol is another new technology with the two-stage stimulation. Once mature follicles are ready to be retrieved, there are still a number of “kids” who only have to develop. That is why, after the first puncture, the careful hormonal stimulation continues, and, within the cycle, you can obtain almost the same number of eggs as after two cycles. Initially, such a scheme has been developed for cancer patients as well as modified for women with a small stock of eggs. In ISIDA we drew attention to another advantage of the protocol: it is good for those patients who are limited in time.