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What is IVF?

In Vitro Fertilization (IVF) Infertility Treatment

ivf  in vitro Treatment Option

Infertility is exhausting physically

Infertility is exhausting emotionally

Infertility is exhausting mentally. 

  •  What is an ‘EMBRYO’?

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…

  •  How Does the Tiny Sparkling Embryo Appear in a Natural Way?

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.

  • How Does the Embryo Appear in Case if it is IVF Infertility Treatment Cycle? 

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. 

  • Mock Embryo Transfer Increases the Chances That Your Tiny Embryo Will Be Accurately Placed Inside

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.

  • Mock Embryo Transfer is the Pre–Embryo–Transfer Procedure, and the  Actual Embryo Transfer Occurs in This Way…The Miracle for Your Tiny  Sparkling Embryo (or More Than One Tiny Sparkle…) Starts from being  taken out from the Petri Dish and Placed in the Private, Premium–Level  “Shuttle” (Catheter)! Three, two, one… GO! Imagine! Drive Through!  Launch!

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.’ 

  • If You Have at Least ONE Perfect Embryo, Don’t Burst Into Tears! This ONE Tiny Embryo Loves You and Is Waiting for You!

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’.

  • Chromosome Abnormalities Are Excluded!

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?

  • You Will Decide How Many Embryos Should Be Transferred and What Should Be Done with Those That Are Left

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.

  • Sexual Differentiation Occurs Before Fertilization! 

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].

  • Gender Selection is Possible! You may choose ‘an embryo–girl’, ‘an  embryo–boy’, two embryos (‘an embryo–girl and an embryo–boy’, or two  ‘embryo–girls’, two ‘embryo–boys’): Your Dreams Come True! 

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.

  • Multiples Are So Common (Getting Pregnant with Twins, Triplets, or Even  More Tiny Bundles is so Common)! Dreaming About Having Twins? Wondering  About Tiny Sparkling Triplets? It IS Possible!

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!

  • Extra–Embryos or Extra–Fetuses MAY VANISH…

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.

  • If There is the Mosaic Embryo: Should You Give This Little One the Chance?

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.

  • If you can see those tiny heartbeats on the ultrasound screen, your tiny embryo or fetus is alive

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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