Embrio transfer- implantacija (usadjivanje) i materica

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Embrio transfer- implantacija (usadjivanje) i materica Empty Embrio transfer- implantacija (usadjivanje) i materica

Počalji od Tinche taj 6/11/2009, 16:48

meni je ovaj tekst bio od velike pomoci da shvatim kako sve funkcionise
a i da se opustim i oslobodim preteranih briga.
nadam se da ce jos nekome biti od koristi.
ljubim vas Tina, trudnica u najavi! Embrio transfer- implantacija (usadjivanje) i materica 8326

Embryo Transfer & Embryo Implantation:
Test Tube Babies - IVF & GIFT (Page 3)
Embrio transfer- implantacija (usadjivanje) i materica Chapter25c2from the book How to Have a Baby: Overcoming Infertility
by Dr. Aniruddha Malpani, MD and Dr. Anjali Malpani, MD.

Previous page: Test Tube Babies - IVF & GIFT (Page 2)
Next page: Test Tube Babies - IVF & GIFT (Page 4)
Table of Contents

How is embryo transfer performed ?
What happens after the embryo transfer ?
Why doesn’t every embryo become a baby?
How can you maximise your chances of success after IVF ?
How much does IVF cost ?




How is embryo transfer performed ?

Embryo Transfer
Embryo
transfer is most often done on an outpatient basis. No anesthesia is
used, although some women may wish to have a mild sedative. The patient
lies on a table or bed, usually with her feet in stirrups.. Using a
vaginal speculum, the doctor exposes the cervix. One or more embryos
suspended in a drop of culture medium are drawn into a transfer
catheter, a long, thin sterile tube with a syringe on one end. Gently,
the doctor guides the tip of the loaded catheter through the cervix and
deposits the fluid containing the embryos into the uterine cavity. The
procedure should be done with great care and usually takes between 10
and 20 minutes. Some doctors perform the transfer under ultrasound
guidance, to ensure proper placement of the embryos in the uterine
cavity. Most doctors advise a few hours of bed rest after the transfer.
Embrio transfer- implantacija (usadjivanje) i materica Chapter25c
Fig 5. Schematic of the embryo transfer procedure



Most clinics today transfer 2-3 good quality embryos on Day 2 or Day 3.
Embrio transfer- implantacija (usadjivanje) i materica Chapter25c1



Embryos
are graded according to their appearance and rate of cell-division and
good quality embryos are those which have 4-8 cells, of equal size,
with clear cytoplasm, and with few fragments. These are called Grade A
embryos. Embryos with more fragments are assigned a lower grade, and
they usually have a lower chance of implanting . However, the babies
which result from these embryos are completely normal, if they do
implant successfully. You should ask the doctor to show you your
embryos under the microscope. Some times, only embryos of poor quality
are available for transfer. While the chance of getting pregnant when
only poor quality embryos are transferred, you can be reassured that if
a pregnancy results, the children will be normal !

How many
embryos to transfer is one of the most difficult decisions facing an
IVF patient today. The more the embryos transferred, the greater the
chances of getting pregnant. Since the purpose of an IVF cycle is to
achieve a pregnancy, then why not transfer as many as possible?
However, the price you pay for transferring more embryos is that the
risk of a multiple pregnancy increases as well.

In some
countries, such as the UK, doctors are allowed to replace a maximum of
only 2 embryos, to reduce the risk of high-order multiple births. Some
clinics in Scandinavia have now started transferring only one embryo (
this is called SET or single embryo transfer) in young women, in order
to reduce the risk of a multiple pregnancy. In USA and India, there are
no laws, and some clinics will transfer 4 embryos for young patients,
and upto 6 for older women – and this number is quite arbitrary.

Doctors
have tried to develop an embryo score ( based on the number of embryos
and embryo quality ) in order to predict the chances of a pregnancy
after embryo transfer, but this is still not precise. I always tell
patients that if IVF technology was perfect, and if every embryo became
a baby, we would transfer only one embryo, and I wouldn't need to
discuss this with them. Since the technology is still not perfect, and
we still cannot predict which embryo will become a baby, there is no
easy answer as to how many embryos to transfer. This is why many
clinics will allow patients to decide for themselves. This is always a
difficult decision, and you need to carefully weigh the pros and cons
before making up your mind. There is no right or wrong number – and you
need to take the path of least regret.

Transferring more
embryos increases the chances of getting pregnant, and also increases
the risk of a multiple pregnancy. However, a high-order pregnancy is a
complication for which the doctor can perform a selective fetal
reduction, in order to reduce this to twins. Not getting pregnant may
be a worse outcome for some patients! If embryo freezing facilities are
available, then supernumerary embryos can be stored, and this needs to
be factored in as well.

What happens after the embryo transfer ? The terrible 2ww - 2 week wait !

The
embryo transfer completes the medical treatment in the IVF cycle and
most clinics provide "luteal phase support" after the transfer ,
usually with estrogen tablets and progesterone suppositories, to
increase the chances of implantation. However, this period is often the
hardest part of an IVF cycle for the patient, because of the agony and
suspense of waiting to find out if a pregnancy has occurred. This can
be determined by a blood test , which measures the level of the
hormone, HCG ( human chorionic gonadotropin) only 10 to 14 days after
the transfer. For many patients, these 14 days are often the longest
days of their life !

A positive beta HCG level ( of more than 10 miU/ml) means you are pregnant, and the doctor will then monitor your pregnancy to confirm it is healthy; intrauterine; and to check how many embryos have implanted.

It
is normal to blame yourself for something you may or may not have done
during this time if you do not conceive. Therefore, try not to do
anything for which you will blame yourself if you do not get pregnant.
In general the following guidelines are offered:

  • No tub baths or swimming for 48 hours after replacement
  • No douching or tampons
  • No intercourse or orgasms until the fetal heartbeat is seen on ultrasound, or the pregnancy test is negative
  • Do not undertake excessive physical activity such as jogging, aerobics, or tennis
  • No heavy lifting
  • You
    may return to "work" after 24 hours of bed rest (getting up for
    bathroom and meals only) and one to two days of light activity.


It's safe to travel 2-3 days after the transfer.

If
you are unsure whether or not to do something, take the "path of least
regret". Ask yourself - if I don't get pregnant, will I blame myself
for doing this ? And if the answer is yes, don't do it !

You
may have some vaginal spotting or bleeding prior to your blood test.
However, you must have the blood test done, even if you think your
period has started. There are no symptoms or signs which will be able
to tell you whether or not you are pregnant.

Many doctors used
to advise "strict bed rest" after an embryo transfer. However, remember
that your physical activity does not affect your chances of getting
pregnant. Resting when you are well can be very emotionally taxing, and
we encourage patients to lead as normal a life as possible. Many
patients are worried that if they cough or sneeze , the embryo will
"fall out". However, remember that this is physically impossible, and
that if the embryo is going to implant, it will, no matter how much you
exert physically. Remember that God has designed the human body with
enough sense, that coughing and sneezing will not cause the embryos to
"fall out". The uterine cavity is a "potential space", and once the
embryos are placed here, they appose to the uterine wall and are not
affect by gravitational forces. I remind patients that it's fine for
them to do whatever normal couples would do after having sex - after
all, how does it matter to the embryo that it arrives in the uterine
cavity in the normal course of events, after the couple had sex, or
after spending 2 days in the IVF laboratory and then being transferred
into the cavity with a catheter ?

Thus, there are numerous
stages to every IVF treatment cycle, each of which must be reached and
completed before moving on to the next stage:

  • more than one should egg develop
  • eggs should mature
  • ovulation should not occur before the eggs can be collected
  • eggs must be retrieved during the "pick-up"
  • sperm must fertilize at least one egg
  • fertilized eggs must divide and grow healthily,... and all this so that...
  • the embryos might get implanted in the uterus


Think of it as a series of hurdles, all of which have to be cleared , in order to win the race !

Why doesn’t every embryo become a baby?

The enigma of embryo implantation – why doesn’t every embryo become a baby?

While
modern technology is very good at making embryos in the laboratory, we
still cannot control the implantation process. We do not know which
embryo will become a baby – and this can be very frustrating, for both
patients and doctors ! Many patients who do not get pregnant after an
embryo transfer start believing that their bodies are defective, and
that they have "rejected" the embryo. They feel that if they failed to
become pregnant even after the doctor transferred 3-4 good quality
embryos, that they are flawed. However, you need to remember that
embryo implantation is a very complex process, which consists of a
series of phases in which the embryo has to appose and attach itself to
the maternal endometrium and invade into it.

First, the embryo
has to undergo further development, till it reaches the blastocyst
stage, when it hatches from its shell, known as the zona.
Embrio transfer- implantacija (usadjivanje) i materica Chapter25c3



The
hatched blastocyst then needs to implant in the endometrium, and the
three phases of implantation are known as apposition, adhesion and
invasion, and occur during the period of time known as the implantation
window. Apposition, or orientation of the embryo (which is at the
blastocyst stage at this time ) within the cavity of the uterus, starts
when the cavity has become minimal due to the suction of endometrial
fluid by pynopods (small protrusions found on the surface membrane of
the cells lining the uterus). Adhesion of the blastocyst is a
progressive phenomenon that ties the embryo to the endometrium and is
the primary event initiating invasion. Many molecules, such as
cytokines, growth factors and cell adhesion proteins called integrins
play an important role in this complex process during which the
blastocyst and maternal endometrium must undergo an exquisite dialogue.
Invasion is a self-controlled proteolytic process that allows the
embryonic trophoblast to penetrate deep into the maternal decidua and
to invade the endometrial spiral arteries by producing chemicals called
proteinases. How implantation is regulated and brought about remains an
enigma, but we need to remember that the implantation process is
surprisingly inefficient in humans – Nature is not always very
competent! After IVF, it’s only about 10%, which means that only 10% of
embryos implant successfully to become a baby.

The
responsibility for this low efficiency has to be shared between the
embryo as well as a defective embryo-endometrium dialogue. We still
cannot successfully predict which patient will get pregnant after
embryo transfer . We now know that one of the major reasons for failure
of the embryo to implant is a genetically abnormal embryo. Basic
research on implantation is of great interest today, because embryonic
implantation is the major factor limiting in allowing pregnancy after
ART, but we still need to learn a lot about this "black hole" in our
knowledge, before we can learn to control it !

Many patients
blame themselves when they don’t get pregnant after an embryo transfer.
They feel that the fact that the embryo did not implant means either
that their body is defective; or that it "rejected" the embryo; or that
they did not rest enough. However, please do remember that embryo
implantation is a complex process, which you cannot influence by your
diet or physical activity – so there is no need for you to blame
yourself if the embryos do not implant.

How can you maximise your chances of success after IVF ?

Maximizing Chances For Success

Women:

  • Avoid all unnecessary medications other than paracetamol
    ( Tylenol) . If you are taking other prescription medications check with us prior to beginning your treatment cycle.
  • No
    smoking or alcohol use. Studies show both can result in lower pregnancy
    rates and a greater risk of miscarriage. Why put yourself through this
    if you are not doing everything YOU can to insure your success.
  • No more than two caffeinated beverages per day.
  • Avoid change in diet or weight loss or fad diets during IVF cycle. A healthy well balanced diet works best.
  • Refrain from intercourse following embryo replacement until the pregnancy test is done .
  • Normal exercise may continue unless enlargement of your ovaries produces discomfort.
  • Avoid hot tubs or saunas.


Men:

  • Fever
    greater than 100.4 C one to two months prior to IVF treatment may
    adversely effect sperm quality. Be sure to let us know. If you are
    sick, please take your temperature and report any febrile illnesses.
  • Sitting in hot tubs and saunas is not recommended. Please refrain from this for at least three months prior to treatment.
  • Drugs,
    alcohol, and cigarette smoking should be avoided for three months prior
    to treatment and at all times during the ongoing IVF treatment cycle to
    get the best results.
  • Abstain from intercourse for at
    least three days, but not more than seven days prior to collection of
    semen for egg collection and during treatment.


How much does IVF cost ?

The Cost of IVF
The
cost of a single IVF treatment cycle varies widely from approximately
Rs 70,000 to more than Rs 120,000 depending on the program and the
items included in the fee. It is important to get an itemized listing
from the selected program of what costs are included in the treatment
cycle. Try to find your "total" medical cost - how much you will have
to spend out of your own pocket for the entire treatment. Many clinics
do not include the cost of certain procedures ( such as ultrasound
scans) and these can then add up to quite a bit ! Other expenses to be
aware of include time missed from work and travel and lodging expenses.
The number of treatment cycles needed to achieve pregnancy will, of
course, determine the final cost.

A reduction in cost may be
obtained by using "Natural Cycle IVF." This procedure does not employ
ovulation enhancement; therefore the additional expense on the
injections used for superovulation is eliminated. However, only one
mature egg is usually obtained, and the pregnancy rate per cycle is
therefore less for this method. A newer technique called "in vitro
maturation" allows doctors to collect many immature eggs, and them
mature them in the laboratory.


[
_________________


_________________
Embrio transfer- implantacija (usadjivanje) i materica BwfXp2
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ja '79. neprohodni jajovodi, hipotireoza, ir
mm. '77 sve ok
nov 2009. IVF beta 156
jul 2010. rodio se Aleksandar srce 
sep 2012. prirodna trudnoca
apr 2013. rodjena Teodora srce 
Tinche
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Počalji od Orline taj 7/11/2009, 13:09

Tinche, hvala ti na korisnom tekstu Embrio transfer- implantacija (usadjivanje) i materica 237612
Orline
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Embrio transfer- implantacija (usadjivanje) i materica Empty Usadjivanje embriona i materica

Počalji od Malina taj 2/12/2009, 12:45

Pozdrav svima! Zao mi je sto sam tek sada otkrila ovaj forum jer mi se mnogo svidja. Imala bih neka pitanja, ako neko zna... Naime,posle vanmatericne sa blizancima i uradjene operacije(jajovodi nisu odstranjeni,ocisceni od priraslica, dr rekao sve je sad super, 6 mes. pauze i onda moze trudnoca opet) na zalost 5 godina nisam mogla da zatrudnim, sve kao u redu, opustite se i sl. Medjutim tada vec imam 39 god i odlucujem se za ivf. Prvi ivf mi je bio uspesan, mojoj sreci nema kraja, na zalost spontani. Radjena kiretaza i dr onako usput prokomentarise, bas me je iznenadilo kako vam je meka materica. Ja ga pitam sta to znaci, a on nista, takvi ste. Ja i zaboravim na to. Posle slede jos 4 pokusaja sto sa zamrznutim, sto ovako-neuspesna. Uvek dovoljno jc(kazu mi da ih imam kao da sam 10 god. mladja) embrioni odlicni i nista. Sada vec postajem ocajna, ne znam sta da radim. Problem je izgleda do tog usadjivanja embriona u matericu. Nesto razmisljam ovih dana da li mozda ima to neke veze sa tom mekom matericom? Pila bih neke cajeve ili bilo sta ako neko zna da preporuci. Zanima me da li neko ima slican problem i sta bi moglo povodom toga da se uradi?Vise sam luda od straha i brige, a ne zelim nikoga da opterecujem, jer iskreno i ne verujem da do shvata bilo ko, ko ne prolazi kroz to.
Malina
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Počalji od nena beba taj 2/12/2009, 12:52

dobro dosla Malina, i naravno, sto pre otisla na trudnicke!
prvi put cujem za izraz meka materica, ali ako mislis da ti je problem implantacaija embriona, dobro dosla u klub Very Happy
na zalost, to je najneistrazenija oblast i tu ti niko ne moze mnogo toga reci, a posebno ne dr. tj retko koji da hoce da prica o tome cak i ako zna ponesto...
zao mi je sto te docekah ovako pesimisticki...
nena beba
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Počalji od Orline taj 2/12/2009, 12:54

Uhh, kakva prica... Embrio transfer- implantacija (usadjivanje) i materica Kopfschuettel
Zao mi je malina, ali u svakom slucaju, dobrodosla na nas Kutak

Materica je normalno meksa u trudnoci, sto veca trudnoca, to meksa materica, bar u prvim mesecima. U kojoj nedelji je tebi radjena kiretaza?
Gde si radila IVF?
Jesi li sad u postupku?
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Počalji od Malina taj 2/12/2009, 13:45

Hvala na dobrodoslici!
Trenutno se oporavljam od poslednjeg neuspesnog pokusaja pre 10 dana. Imam jos malo godisnjeg, pa sam odlucila da ne idem odmah na posao ovako bezvoljna.
Kiretaza mi je radjena u 8 nedelji.
Malina
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Počalji od Orline taj 2/12/2009, 13:54

A na kojoj klinici?
Orline
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Počalji od Masha UK taj 2/12/2009, 14:23

Dobro dosla Malina.

Ja bih ti preporucila da probas akupunkturu mozda u kombinaciji sa kineskim cajevima. Ako mozes da priustis probaj, nemas sta da izgubis. Osim toga ja bih na tvom mestu u postupku pila aspirin i steroide kao prevenciju. Ti vec imas istoriju pobacaja i neuspelih pokusaja, pa mislim da bi bila savrsen kandidat da ti se prepisu aspirini i steroidi.

Prosvrljaj malo po internetu pa sama razmisli.

Embrio transfer- implantacija (usadjivanje) i materica 543728 Embrio transfer- implantacija (usadjivanje) i materica 543728 Embrio transfer- implantacija (usadjivanje) i materica 543728
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Počalji od Malina taj 2/12/2009, 14:46

Orline, u Jevremovoj.
Masha,za aspirin sam cula, a ne znam na kakve steroide mislis, cemu to sluzi?
Malina
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Počalji od Masha UK taj 2/12/2009, 14:53

Pa ja sam uzimala Prednison, a verujem da ih ima jos na ponudi. Steroidi sluze da pomogne telu da ne odbaci plod kod vestacke oplodnje. Slicni steroidi se koriste i kod presadjivanja organa.
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Počalji od Orline taj 2/12/2009, 14:59

Koji lekar? Vlaisavljevic?
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Počalji od Malina taj 2/12/2009, 15:06

Orline-ne, Ljubic. Da li si ti kod Vlaisavljevica?
Masha, dali su mi poslednji put deksazon, ne znam da li je to nesto slicno, mada mislim da ima neku tu svrhu.
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Počalji od Orline taj 2/12/2009, 15:35

Nisam, ja sam kod Z. Stankovica
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Počalji od Kamilica taj 14/11/2011, 08:20

Šta znači kad je enbrion feagmentovan. Čitam gore prvi post, pa mi nije jasno.
Kamilica
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Počalji od dr mali pariz taj 14/11/2011, 17:20

Kami, takav embrion nije sjajan...ima kao "mrvice " oko sebe-fragmente sebe.

_________________
ja '78.g.
m.m. '71.g.
2x IVF beta 0
1x ICSI  beta 1,87
4. postupak ICSI+PICSI+hatching PFC dr Sonja
16. dan beta 1931

ispod maminog , kucaju još Embrio transfer- implantacija (usadjivanje) i materica 0913 Embrio transfer- implantacija (usadjivanje) i materica 0913
Bog će nam dati sve u svoje vreme ; onako i onoliko, kako i koliko nam je nužno , za naše spasenje.
16.jul, Zvezde su rodjene!
Lilypie Fifth Birthday tickers
dr mali pariz
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Počalji od Kamilica taj 14/11/2011, 18:16

Tako znači Pariz.. onda sam ja imala 1 takav što nije sjajan, i to onaj najveći, ali i iz tame kadkad nikne divan cvet...
Kamilica
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Počalji od dr mali pariz taj 14/11/2011, 19:24

Very Happy
i meni su šestoćelijski fragmentisan vratili,i ubeđivali me da nije strašno,jer sam ih ja pogledala i upitala za fragmente kad sam ih videla.

_________________
ja '78.g.
m.m. '71.g.
2x IVF beta 0
1x ICSI  beta 1,87
4. postupak ICSI+PICSI+hatching PFC dr Sonja
16. dan beta 1931

ispod maminog , kucaju još Embrio transfer- implantacija (usadjivanje) i materica 0913 Embrio transfer- implantacija (usadjivanje) i materica 0913
Bog će nam dati sve u svoje vreme ; onako i onoliko, kako i koliko nam je nužno , za naše spasenje.
16.jul, Zvezde su rodjene!
Lilypie Fifth Birthday tickers
dr mali pariz
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Počalji od Kamilica taj 15/11/2011, 14:16

Sad sam čitala o tome na temi Kvalitet embriona. To kad su tebi vratili fragmentovan, je bilo na Betaniji?
PS Može reći na koracima ili clubu da ne zatrpavamo.
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Počalji od najdi10 taj 25/3/2014, 07:52

Dobro jutro Very Happy .

Nova sam na forumu pa ako nesto pogresim vi me ispravite. Naime ja sam pre 8 dana bila na embriotransferu. Dobro spavam, imam malo bolne grudi, ponekad ziganje u donjem delu stomaka, ali mislim da je to sve posledica Utrogestana. Kako ste se vi osecale?

najdi10
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Počalji od Sofija Veks taj 25/3/2014, 10:21

Dobrodosla, Najdi!  cvet 

Ja sam lose spavala (i sada ne spavam najsrecnije), takodje malo bolne grudi, osetljivije sa ziganjem mestimicnem u donjem delu stomaka, kao blagi PMS, i to je otprilike to. Juce sam radila betu, na 12 dan nakon transfera, i beta 3300, tako da sam presrecna, sto i tebi zelim kada za koji dan budes radila betu!  igra igra 

Pridruzi nam se na temi "koraci", tu caskamo o svemu tome...

 ljubav 
Sofija Veks
Sofija Veks

Broj poruka : 2743
Location : Beograd
Datum upisa : 05.11.2012

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