Infertility is exhausting physically
Infertility is exhausting emotionally
Infertility is exhausting mentally.
The assembly of a new life first depends on the union between a spermatozoon and an oocyte culminating in fertilization. If the In Vitro Fertilization (IVF) occurs, the EMBRYO APPEARS. Fertilization is a mysterious phenomenon that turns two cells into a tiny embryo–dude or a tiny embryo–lady, or if two oocytes are fertilized than…two tiny embryo–dudes! Or two tiny embryo–ladies! Or if three oocytes are fertilized than three tiny embryo–babies: two tiny Handsome Embryo–Dudes and one Tiny Sparkling Embryo–Lady! The Miracles Start Here… The Tiny Sparkles are here… Many versions can be inserted here…
Wondering how does In Vitro Fertilization (IVF) happen? Usually, a spermatozoon and an oocyte ‘meet’ in one of the two Fallopian tubes that connect the ovaries to the womb (uterus). Wondering how does the embryo–baby normally ‘appears’ and implants in the uterus? The tiny embryo–dude or the tiny embryo–lady (fertilized oocyte) then moves down the Fallopian tube by being wafted by fine hairs inside the tubes until it reaches the womb (uterus) two, three or four days later. Once there, this tiny embryo–bundle wonders where it should cuddle up itself in this new place. And it implants, attaching itself to the womb lining and that is where it usually continues to grow and develop.
The ability of the Fallopian tube to transfer the early embryo into the uterus is an excessive modality for a successful pregnancy. Apparently, structural abnormalities and functional abnormalities of the Fallopian tube will interfere with the embryo transfer process that can lead to tubal pregnancy.
In Vitro Fertilization (IVF) Treatment Cycle is designed to solve infertility issue and to create the Embryos in the laboratory and after that to transfer them to the mother’s uterus. In other words, FERTILIZATION [or EMBRYO ‘CREATION’] happens in the laboratory.
The Tiny Perfect Embryos Are Made Exclusively [‘DESIGNED’] For You
Fertilization (making the embryos from your oocytes and your husband’s sperm) is possible even in difficult cases. Not always the standard insemination can be used for the oocyte fertilization.
Embryologists will ‘design’ your tiny sparkling embryo–ladies and handsome embryo–dudes in the laboratory. They will take the retrieved oocytes and toss them in a Petri dish with your husband’s sperm and let them do their thing [YAY!]... Another infertility option is called intracytoplasmic sperm injection (ICSI), where the Embryologists manually fertilize the oocytes with the sperm individually, but it is for extreme cases only. The ICSI procedure is done with the aid of a microscope and fine instruments, one single sperm is taken and injected directly into every mature oocyte.
Indications for ICSI include such cases as the previous semen analysis demonstrating significant abnormalities, in situations where surgical aspiration of sperm from the vas deferens or testicle, or a previous IVF cycle with poor fertilization. You will know the next morning how many of your oocytes have been fertilized correctly. After that, you will be waiting three long days or…more. And then you have to wait. Three long days. Or...more.
On day 3, you get a Day 3 growth report, and it’s the scariest and the most exciting phone call of your life. The phone call from your Embryologist. The embryologist will tell you how many embryos Fair, Good, and Excellent quality are.
Embryo transfer is a blind procedure and some difficulties can unexpectedly arise. Therefore, many IVF programs perform a ‘mock’ embryo transfer. It is done prior to the infertility treatment cycle to determine the most suitable catheter and technique for actual embryo transfer.
In the middle of your cycle, your doctor will do a mock embryo transfer. It is a trial of the actual embryo transfer. The actual embryo transfer requires taking the embryos into a catheter and then transferring them to the uterus via the cervix. This procedure is more complicated than it appears. It’s not enough to just drop those tiny embryos anywhere inside the uterus. There is an ideal area in your uterus where they should be accurately placed.
The embryo will appear inside your uterus via the catheter. Your tiny scared embryo–lady or embryo–dude is taken out of the Petri–dish and waits for a ‘BIG TRANSFER’. If it is the time to replace this small embryo–bundle from the tube inside your uterus, it is placed inside a flexible catheter. The procedure of Embryo Transfer takes only several minutes. It takes all of three minutes to insert a weird kind of catheter, get it to where it needs to be, accurately place your little embryo inside your uterus, and that is all. YES, and it has to ‘LEARN’ so many things inside. It wonders: ‘Where am I?’ ‘What has happened?’ ‘Everything is pulsating around me…’ ‘Should I curl up here or there?’ ‘Oh, it is better on the left side?’ ‘I am scared. I will just cuddle up to that warm place and sleep there.’
Most of the embryos may stop their development... Yes, this may happen… And you will feel anger, anxiety, confusion, or even despair. You will feel like a bundle of nerves. You will burst into tears. And you shouldn’t feel this way. If you have at least ONE perfect embryo, don’t burst into tears!
Even if 6 of your oocytes were fertilized correctly, you know the odds of all 6 of them making it to day 5, may slim to none. If you are lucky, you will have one, and if you are super lucky, you will end up with 2 or 3 of them. Two or three perfect embryos would have meant the chance that maybe; just maybe, one of them would grow to full term. The responsible Embryologist closely monitors the development of the tiny embryos. If the embryos continue their development, then the embryo transfer may be prescheduled. BUT there is still one BUT… If you will be too nervous, the embryo transfer may be cancelled. Give this tiny one embryo the chance. Do not play the scenario ‘It took so long’.
The great challenge for Reproductive Endocrinologists handling infertility treatment is to correctly identify the most viable embryos and prioritize them for further transfer to the uterus. Especially it should be done in cases when it is vital to exclude the embryos with chromosome abnormalities. And there is a GREAT OPTION for this.
Preimplantation genetic screening (PGS) is currently applied to evaluate the presence of aneuploidies in embryos of couples at risk of occurrence the chromosome abnormalities, for example, advanced maternal age, recurrent miscarriage, recurrent IVF failure or severe male factor.
If your doctor insists on this procedure, do not say ‘NO’. First glance through two next lines. Embryos are prone to chromosomal abnormalities. The consequences of chromosomal abnormalities could cause miscarriage (early pregnancy loss) or severe chromosomal diseases. Have they changed your mind about preimplantation genetic screening?
Surely this decision will be based on your doctor’s recommendations. Before the time of the actual embryo transfer, your doctor will review the fertilization results and the development of the embryos. A decision will be made regarding the number of embryos that will be transferred. You will have to sign the papers before the embryo transfer. The questions in these papers vary from clinic to clinic, but there are three most important which remain the same. How many embryos should be transferred? What should be done with those embryos that left? Will you undergo the embryo reduction procedure in case of multiple pregnancy? Or will you try to save all those tiny ones?
You can ask to transfer two, three or even more embryos. But you should understand the risks which will follow your decision. Increasing the number of embryos transferred will increase the chances of pregnancy. But it will also increase the risk of a multiple pregnancy (twins, triplets, etc.). Remaining embryos that are not transferred will be accurately examined. If they are of suitable quality, they may be frozen, stored and transferred in the future. Alternatively, these ‘extra’ embryos can be discarded.
Thrilled by this news? Yes, the gender is PREDETERMINED. Inspired and nervous? Yes, it can be even chosen. During the embryo development, sexual differentiation occurs BEFORE FERTILIZATION. It is determined by the genetic material contributed by the sperm of the baby’s father.
The father’s genes are responsible for the baby’s gender. Sperm cells [spermatozoa] carry either X or Y sex chromosomes. Every spermatozoon [every father’s sperm cell] carries either X or Y sex chromosome. Given that mother’s cells [oocytes] always have an X sex chromosome, two chromosome variations are possible:
If the father’s spermatozoon carries an X–chromosome the embryo–baby will be ‘XX’ –– an embryo–lady [a girl].
If the father’s spermatozoon carries a Y–chromosome the embryo–baby will be ‘XY’ –– an embryo–dude [a boy].
Wondering is it possible to have the embryo–baby with the desired gender? YES, it is possible! If you would love to choose the gender of your future baby or babies, you have this option. These embryo–babies will be exclusively ‘designed’ for you! If you do want to have ‘an embryo–girl’, ‘an embryo–boy’, two embryos (‘an embryo–girl and an embryo–boy’, or two ‘embryo–girls’, two ‘embryo–boys’, or three ‘embryo–girls’, or two ‘embryo–girls’ and one ‘embryo–boy’, IT IS POSSIBLE!
Amused by these facts? What may be done by the reproductive specialists to ‘DESIGN’ the embryo–baby’s gender? They must know which chromosomes prevail in the sperm. If the sperm sample will contain mostly ‘X’ chromosome spermatozoa, a tiny gorgeous embryo–lady will be waiting for you. If the sperm sample will contain mostly ‘Y’ chromosome spermatozoa, a tiny handsome embryo–dude will be warmly welcomed. And if you want more tiny embryos with the desired gender…They will be cute and beautiful, just make a wish–list ‘WHO’ they should be. Caught the hidden idea?
And if the ICSI (intracytoplasmic sperm injection) technique is chosen for fertilization, that means that the ONE single spermatozoon will be INJECTED inside the oocyte. So…They just need the utter accuracy to choose that ONE spermatozoon and to inject it inside the oocyte. And the divine ‘embryo–[insert your version]’ anticipates the ‘romantic date’ with you!
OR… the other intimidating option – to produce the embryos and to ‘glance inside’ their GENETIC CODE to find the one which suits your desires. The technique which is used is called PGD (preimplantation genetic diagnosis). They screen the entire genomes of the embryos for the desired characteristics.
Twins, triplets, or YAY…That also may happen, quadruplets, quintuplets, sextuplets, septuplets, octuplets… Fetuses of all shapes and sizes are everywhere! At present, multifetal pregnancies are closely associated with infertility treatment. And (IVF infertility treatment) is responsible for multifetal pregnancies and adverse neonatal outcomes. IVF treatment cycle is designed to stimulate excess follicles and transfer excess embryos to achieve pregnancy. So?
If two or more perfect tiny embryos were transferred into your uterus, you may expect the multiple. But sometimes spontaneous twinning/tripling occurs from fertilization of two separate oocytes [dizygotic twinning] or from a single fertilized oocyte that subsequently divides into two identical structures [monozygotic twinning]. So… it may happen! If there are no limitations according to your doctor’s recommendations and you are dreaming about Two Tiny Sparkling Bundles, surely, you will hold them in your hands soon! A little bit patience here!
Worrying about having triplet after IVF infertility treatment? Multiple embryo implantation can’t guarantee that absolutely all embryos would develop normally into fetuses. On the contrary, discovering more than one gestational sac before the eighth week should not be considered as definitive because vanishing embryo phenomenon may occur.
Interested and nervous? You shouldn’t feel this way because spontaneous vanishing mainly occurs between 8 and 9 weeks of gestation. Vanishing embryo is a phenomenon, which occurs before the ninth gestational week. The intricacy of this phenomenon can be shown through the percentage: between 10% and 20% of viable twin fetuses disappear. And not only twins are in danger. Embryo vanishing phenomenon was defined as the spontaneous loss of one or more embryos after identifying their heart activity via external ultrasound.
Where do the embryos VANISH? The scientists don’t know yet. They just have some tips what to do. Accurate early ultrasound monitoring is highly recommended to precisely identify the occurrence of a vanished embryo and the time when the vanishing occurred. We do hope that in the nearest future they will REVEAL this Vanishing MYSTERY.
Many preimplantation embryos designed during infertility IVF treatment cycles contain two or more cytogenetically distinct cell lines. This phenomenon, known as chromosomal mosaicism, can involve the presence of cells with different types of abnormality [aneuploidy], the absence of any normal embryonic cells or a mixture of normal [euploid] and abnormal [aneuploid] embryonic cells.
Recent studies have represented that among tiny mosaic embryo–dudes and embryo–ladies, or embryos with a mix of normal (euploid) and abnormal (aneuploid) cells, many still have the potential to implant in the womb and develop into chromosomally healthy newborns.
What does the Mosaic Embryo look like inside? Metaphorically saying, have you ever seen the pearl rondelle beads accurately covered ‘curled up’ in translucent package or envelope? If you have never even envisioned that, Google the rondelle pearl beads ‘curled up’ in translucent package or envelope. This is how your handsome embryo–dude or gorgeous embryo–lady looks like inside. If we are talking about normal [healthy] embryo, this pearl content is accurately shaped, ivory–colored and has no ‘dark–blue’ [abnormal] pearls.
The mosaic embryo is a phenomenon. This tiny BUNDLE can be envisioned as mixed pearls: ivory and dark–blue pears in the same line accurately covered ‘curled up’ in translucent package or envelope. It doesn’t have the pure chromosomal content. It has the affected [or even mixed] chromosomal content. But this affected content has its own categories as, in future, if the mosaic embryo corrects itself, the affected mosaic cells can be ‘TRANSFERRED’ to the placenta and won’t affect the tiny fetus, or, in the other case, they can turn the tiny embryo in ‘MOSAIC FETUS’ with many abnormalities. And the hardest question is should you give this little one the chance?
The interpretation of mosaicism among preimplantation embryos is complicated thing both for doctors and couples. Doctors should identify those mosaic embryos that won’t have the developmental abnormalities. Couples should make the serious decision concerning the preimplantation genetic screening (PGS) testing that reveals the abnormalities in the genetic content. And this decision should be made only after the counselling.
The mosaic embryo is a phenomenon as it contains both normal and abnormal embryonic cells. And it is difficult to say, which embryonic cells will prevail. This mystery hides either miracle or frustration. Therefore, prior to transfer the tiny mosaic embryo, it should be accurately validated.
Genetic Counselling is exclusively designed for giving the couples the most transparent and inclusive information about whether or not to pursue PGS. The pre–test (pre–PGS) counseling should include a discussion about the frequency of mosaic results, the challenges associated with the interpretation of these results, the possibility of a false positive diagnosis of embryonic mosaicism, and the limited predictive data available. The Genetic Counsellor should also say that the priority for embryo transfer should be given to mosaic embryos with low mosaicism level.
You will go through many things before this UNIQUE MOMENT. Your doctor will perform the first external ultrasound to determine how does your little one spend its time inside. It’ll be painful and uncomfortable and terrifying, but you will keep your focus on the black and white screen by your side. And if you can see those tiny heartbeats (that glittering red spot) on the ultrasound screen, your tiny embryo or fetus is with you. Amused? Just curl a smile!
IVF is a new world! The world of Hope... The world of Miracles... The world of Wonders! Never give up! Even the tiny chance may be YOUR CHANCE!
Wondering what every infertility option noted in this list means? Worrying about the advantages and disadvantages certain infertility treatment has? Not sure that this option is good for you? Feeling like a bundle of nerves because you have no idea what best infertility option should be chosen because there are several ones that may be proposed for you? No worries here! We will navigate you in this Complex Ecosystem and will show you what is “inside” every infertility treatment option! Why Waiting? All the Options are at your Fingertips! Just Bundle Up and Glance Through!
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