Operation of artificial miscarriage in the early stages of pregnancy. Conditions for successful insemination

Induced abortion (abortus arteficialis) - termination of pregnancy when the fetus is still not viable. This operation can be performed exclusively by a doctor and only in a hospital.
Contraindications for induced abortion:
1) gonorrhea - acute and subacute; 2) acute and subacute vulvovaginitis and bartholinitis of any origin, as well as boils on the genitals; 3) erosion if available purulent discharge from the cervix; 4) inflammatory processes of the appendages and pelvic tissue; 5) all local pyogenic and general acute infectious diseases.
Technique of operation of artificial abortion. Termination of pregnancy in terms of up to 12 weeks (and in nulliparous up to 10 weeks) is performed by the operation of curettage of the uterine mucosa (abrasio s. excochleatio mucosae uteri) with a preliminary expansion of its neck. An indispensable requirement before this operation is the examination of smears from the vagina and cervical canal. If gonococci are found in the cervix or streptococci in the vagina, the operation is postponed and appropriate treatment is prescribed.
Preparation for the operation itself: cleansing the intestines with an enema on the day of the operation, shaving off the hair from the pubis and external genitalia, emptying Bladder(the patient can urinate on their own). With a soft brush and soap, wash the lower abdomen, womb, inner thighs, perineum and buttocks. Under a stream of an aqueous solution of chloramine (1:1000) or furacilin (1:5000) from Esmarch's mug, the external genitalia are thoroughly washed, after which the vagina is douched with the same solution and then the genital slit is washed again, forcing the patient to strain.
Immediately before the operation, the obstetrician performs an internal examination to determine the position and size of the uterus and the condition of the appendages. After a bimanual examination, the genitals and adjacent parts of the body are finally treated with 5% iodine tincture.
The following instruments are needed for scraping the uterine mucosa: mirrors - spoon-shaped, short, and lateral (with anesthesia), a lift, a set of dilators, 3-4 curettes, 2 forceps, aborts, 4 pairs of bullet forceps, probes, including uterine.
Usually operated on local anesthesia novocaine or injected under the skin half an hour before the operation, a solution of morphine (1% - 1 ml) or pantopon (2% - 1 ml). AT rare cases, at very hypersensitivity pregnant, have to give general anesthesia(ether).
Local anesthesia is performed in the following way. They expose the cervix with mirrors and lower the cervix with bullet forceps; The vaults of the vagina should be well exposed, for which you should use the side mirrors and the lift.

Figure: Anesthesia for abortion. The neck is down.

After disinfection of the cervix and vaults with iodine tincture, a 0.5% solution of novocaine with the addition of adrenaline 1:1000 (1 drop per 10-20 ml of novocaine solution) is administered as superficial injections at the border of the transition of the cervix into the vaults. Such injections to a depth of up to 1 cm are made 3-4 on each side, forming a closed ring around the neck; while the needle should feel the tissue of the uterus. After these superficial injections, deep, up to 2-3 cm, injections are made with a long, thin needle. The needle is injected without a syringe (to control whether the needle has entered the vessels) and immediately immersed in the parameters.

Figure: Anesthesia for abortion. You can see the course of the needle in the parameters.

Three injections are made on each side, and enough solution of novocaine, especially at the posterolateral wall of the uterus (in the area of ganglion cervicale). With this method of anesthesia, the operation, especially its most painful moment - the expansion of the neck, proceeds painlessly, easily and almost bloodlessly. For such anesthesia, 60-80 ml of novocaine solution is required.
At the end of anesthesia, bullet forceps capture the anterior lip of the neck. For beginners, we recommend grasping the posterior lip with the second pair of bullet forceps as well. The lift is then removed. The cervical canal is lubricated with 5% iodine tincture. The spoon-shaped mirror is replaced by a short one. The cervix is brought down almost to the entrance to the vagina. Then the uterine cavity is probed and measured with a graduated probe. Probing clarifies the data of the bimanual study. The probe must be inserted freely, without violence, easily holding it with two or three fingers.
The main stages of the further course of the operation are the expansion of the cervical canal and the emptying of the uterus itself.
To expand the cervical canal, Gegar dilators are most often used. It is enough to have №№ from 4 to 15, preferably with half-numbers (numbers correspond to the thickness of the expander in millimeters). The dilators are inserted into the cervix in numerical order and each is left in the canal for half a minute and then quickly replaced by the next. Starting from # 8-9, expansion is usually more difficult, resistance is clearly felt. internal os. It is necessary to be careful at all times and follow the direction of the dilator (its direction depends on the position of the uterus) so as not to perforate the cervix. Usually, the expansion is carried out to No. 12 of the dilator during pregnancy no more than 8 weeks and to No. 14 - during pregnancy from 8 to 12 weeks. The expander should be inserted as shown in the figure.

Figure: a - Gegar expanders; b - the introduction of dilators into the cervical canal.

The expansion should not be done too quickly, as this leads to numerous neck tears, which subsequently give scars and narrowing.
At the end of the expansion of the cervical canal, a large curette is inserted into the uterine cavity, which should be held as shown in the figure.

Figure: Curettage of the uterine mucosa. The anterior lip is grasped with bullet forceps and strongly elongated until the angle between it and the uterus is straightened. A curette has been inserted into the uterus.

Figure: The position of the curette in the hand when scraping the uterine mucosa (I. L. Braude). a – introduction of a curette; held lightly between two fingers; b - removal of the curette; hold with the whole hand.

The curette is advanced to the very bottom, and by moving towards itself, the walls of the uterus are alternately scraped, while turning the curette in the right direction, but not removing it every time. Already at the first movements of the curette, parts of the fetal egg are shown from the outer opening of the neck. As the separated tissues accumulate in the uterus, the curette can be removed, while large parts of the fetal egg are removed with it. It is even better to introduce a loop-shaped forceps into the uterine cavity, open it there and grab the parts of the fetal egg that fall between the branches. It is often possible to immediately capture a large part of the fetal egg, which greatly facilitates the subsequent manipulation of the curette. The emptying of the uterus is completed by repeated scraping with a sharp curette, and then with a small curette (for control) of the corners of the uterus.
As the contents are removed, a decrease in the uterine cavity is clearly felt due to the contraction of its muscles; the surgeon feels a characteristic "crunch", indicating that the curette is sliding over these muscles. At the same time, parts of the fetal egg stop leaving the uterus and “foam” appears - the remnants of blood mixed with air. All these signs indicate the final emptying of the uterus, and the operation can be completed. The last movements of the curette check the cervical canal.
Some authors, however, believe that it is not necessary to achieve a "crunch" when scraping the uterus. K. K. Skrobansky wrote about this: “It is good enough to separate the entire chorion, but it is completely in vain and even harmful to separate the entire decidua down to the muscle.”
Some authors propose to complete the curettage of the mucous membrane of the uterus and cervix under the control of fingers inserted into posterior fornix.

Figure: Curettage of the uterine mucosa and cervical canal; control through the posterior fornix.

We use this method only for flabby uterine muscles to avoid perforation.
At the end of scraping, the uterine cavity is drained with a strip of gauze folded into 3-4 layers (1 cm wide, 12 cm long), inserted into the uterus with long tweezers.
The second same strip, moistened by one third with 5% iodine tincture, wipe the cervical canal; the strips are removed immediately. The balls on the forceps dry the vagina and cervix, remove the bullet forceps, lubricate the injection sites with iodine, and the operation is over.
Complications of an induced abortion operation can be: a) bleeding, b) perforation of the walls of the uterus, c) inflammatory and septic diseases d) amenorrhea and infertility.
Bleeding may depend on particles of the fetal egg remaining in the uterus, on insufficient contraction of the uterine muscles (hypotension), and in rare cases on low attachment placenta (chorion). In the first case, bleeding usually begins not immediately after curettage, but after a few hours or days. Treatment consists in repeated curettage; beforehand, you can try hot (40 °) douching of the vagina with iodine (½-1 teaspoon of 5% tincture of iodine per 1 liter of water).
In other cases, bleeding occurs during the operation itself, can be significant and requires immediate help. In case of hypotension during an abortion, we successfully introduce an ether tampon into the uterine cavity for 5-10 minutes, followed by injection of pituitrin into the cervix. With low attachment of the placenta and with small hypotonic bleeding, it is good to use tamponade of the cervix and lower part of the uterine cavity. At the same time, the end of the swab is moistened with ether or alcohol and left for 3-6 hours.
If, as a result of hypotension, the uterus is stretched and filled with blood clots, massage can be applied; and squeeze out the contents of it with both hands, as shown in the figure.

Figure: Squeezing out the contents of the uterus in a bimanual way.

Perforation of the walls of the uterus (perforatio uteri sub abortum) during an induced abortion is rare; but also these isolated cases should not take place: curettage of the uterus is a serious operation; it must be done carefully.
The causes of perforation may be degenerative or cicatricial changes in the uterine wall, as well as improper use of instruments during surgery. Perforation can be done with any instrument, but pointed forceps and small curettes are especially dangerous.

Figure: Perforation of the uterus with forceps. Ragged wound (I. L. Braude).

Figure: Perforation of the uterus with a small curette. Puncture wound (I. L. Braude).

Perforation of the uterus can be isolated - without damage to neighboring organs, or with damage to them. Most often, the omentum is captured through the perforation, then the intestinal loops.
In most cases, uterine perforations require laparotomy; the latter is certainly indicated for suspected trauma to neighboring organs caused by a sharp instrument. Sometimes suturing the perforation is acceptable. But if the perforation of the uterus, caused by a non-sharp instrument (probe, dilator), is noticed in time and the emptying of the uterus is completed, then the patient can be treated conservatively (ice on the stomach, antibiotics, opium inside).
If the perforation is decided to be sutured, then it is necessary to expand it, and in this way or through a special incision, the uterus should be emptied; only after that the hole is sutured. With a significant gap with crushing of the tissue, supravaginal amputation or complete extirpation of the uterus is performed.
A common complication after induced abortion - infection - can arise from pushing instruments above the internal pharynx of those pathogenic microorganisms that were in the vagina or in the lower part of the cervical canal. As you know, up to 25% of women at the beginning of pregnancy are carriers (in the vagina) of staphylococci and up to 10% of streptococci.
With gonorrheal endocervicitis, there is a danger of pushing gonococci from the cervical canal into the uterine cavity. From here they can easily penetrate the pipes and abdominal cavity, calling acute inflammation appendages (acute salpingitis), acute exudative pelvic peritonitis, or even general peritonitis. Tears of the cervix during its expansion, a large wound surface in the uterus after scraping the mucosa can be entrance gate for pyogenic infection of parametric fiber (parametritis post abortum).
More grievous septic complications after an abortion (sepsis, septicemia, pyemia), which are, however, much less common than local inflammatory diseases.
A frequent consequence of the postponed curettage of the uterus can be amenorrhea, which develops either on the basis of insufficient regeneration of the endometrium, or due to a violation of the hormonal influences of the ovary (hormonal trauma after an abortion).

With various gynecological diseases, as well as during caesarean section, injections into the uterus can be used. They pursue several goals, which depend on the specific clinical situation. In some cases, they fight the inflammatory process, in others they shrink the uterus, in others, they lyse (dissolve) adhesions.

These manipulations are quite complicated, so they must be performed by a doctor. It also determines the need for their production, depending on the clinical situation and condition. reproductive health women.

Uterine injections for caesarean section

This operation always increases the risk of bleeding, including massive ones, which represent serious danger for female body. Therefore, preventive measures have been developed given state. To avoid the development of bleeding, intrauterine contraction drugs are most often administered. Usually this agent is oxytocin. In the dosages used, it has practically no side effects. Its advantageous difference from other means is the absence of an increase in the level blood pressure. This aspect is very important in obstetrics, since during pregnancy whole line pathological processes, in which arterial hypertension develops (a condition with high blood pressure).

An injection into the uterus with oxytocin is performed in the period after the removal of the child until the separation of the placenta. The injected drug activates the contraction of smooth muscle cells, especially in the place where the placenta was attached. Therefore, against the background of its introduction, wrinkling occurs placental tissue and its prompt separation. In addition, the spiral arteries of the uterus are pinched during spasm of smooth muscle cells. This reduces the amount of blood flowing out and, accordingly, stops bleeding.

Some clinics may use enzaprost, which also shrinks the uterine wall, to achieve the same therapeutic result. This drug belongs to the group of prostaglandins (a special class of cells synthesized human body substances with different biological effects). However, there are reported cases of complications with its use. The most formidable of them is a pronounced rise in blood pressure, which most often occurs in women with an increased risk of developing hypertension. In this regard, modern obstetrics with the introduction of uterine injections during cesarean section recommends using only oxytocin, a drug with proven efficacy and high safety.

You can learn more about caesarean section from this video:

Treatment of endometritis with uterine injections

Endometritis is a reaction of the uterus to the introduction of pathogenic microorganisms into it. Therefore, their destruction will allow to cope with the developed inflammatory process. The best way to do this is to inject the drug directly into the lesion. With endometritis, it is the uterus. Therefore, with this disease, injections into the uterus are widely used. The essence of this procedure is the introduction of the drug directly into the uterine cavity. It looks like this:

The cervix is exposed with the help of mirrors;
A special polyvinyl chloride conductor (catheter), which has a small diameter, is inserted into its channel;
Injected through the catheter with a syringe medicinal solution. This must be done slowly so that the drug is evenly distributed in the tissues.

For injections into the uterus with endometritis, drugs from several groups can be used. On the one hand, these are antibiotics that disrupt the vital activity of microorganisms, leading to their death. On the other hand, for the treatment of endometritis, it is recommended to use anti-inflammatory injections into the uterus ( nonsteroidal drugs). Such therapy can be used for both acute and chronic damage to the uterus. The duration of treatment will depend on clinical improvement. Usually it is from 3 to 7 weeks.

It should be borne in mind that starting such treatment, you must first make the vagina clean. If it is inflamed, then there is a possibility of introducing an additional infection into the uterine cavity, which will negatively affect its condition. Therefore, intrauterine injections are always preceded by a stage microbiological research vagina, and if a pathology is detected, it must be treated (suppositories with antibiotics are administered).

For more information about endometritis, watch this video:

Treatment of adhesions with intrauterine injections

One form of infertility is uterine (Asherman's syndrome). Its cause is the formation of adhesions in the uterine cavity, which disrupt the process of moving sperm to the fallopian tube, where fertilization normally occurs. Injections into the uterus allow you to eliminate the adhesions that have formed. For this, lysing agents are used. enzyme preparations. Them active ingredients dissolve connective tissue from which adhesions are formed. In addition, uterine receptors become more susceptible to hormonal influences.

With infertility, such injections are performed on days when there is no menstruation. It is best to do this before the onset of menstruation, so that the lysed residues are removed from the uterus. The number of procedures is determined by the severity of the underlying disease. Monitoring the effectiveness of the treatment is carried out with the help of hysteroscopic examination (visualization of the uterine cavity using endoscopic techniques). If its results are unsatisfactory, then in the next menstrual cycle, a new introduction of lysing drugs into the uterine cavity is carried out.

Non-developing pregnancy and intrauterine injections

It has now been proven that in non-developing pregnancy there is always an inflammatory process with varying degrees activity. In some cases, it is a consequence of an interrupted pregnancy, and in others it is the cause of its termination. In these situations for full recovery reproductive function is required to eliminate the inflammatory process. The best result can be achieved if you use an injection in the uterus. Dioxidin, an antibiotic and an anti-inflammatory agent, can be administered. One course of treatment includes 10 procedures. Their technique is no different from those that were carried out with endometritis.

You can learn more about non-developing pregnancy from this video:

The first injection of the uterine injection is performed immediately after the removal of the frozen fetal egg. In the process of its removal, damage to the integrity of the vessels occurs. Therefore, introduced medications immediately penetrate into vascular system and with blood flow evenly distributed throughout the uterus. When comparing the further reproductive ability of such women with patients who did not receive drugs into the uterine cavity, it was found positive impact this procedure. This was expressed as follows:

Rapid onset of pregnancy after an episode of non-developing;
The course of pregnancy with minimal complications or their complete absence;
Large percentage physiological childbirth(complications in childbirth did not differ from the general population).

Therefore, this method of treatment using injections into the uterus is the most effective. It is used in their practice by many obstetric and gynecological clinics.

Uterine injection as a stage of IVF in infertility

Non-standard uterine injection is the transfer of embryos as a stage of artificial insemination. After studying the genetic material of the cells that are supposed to be transferred, proceed directly to this stage. Fertilized eggs are collected from a plastic container with a special sterile syringe. The cervix is exposed with mirrors and a special catheter is inserted through the cervical canal. The doctor presses the syringe plunger slowly so that there is no injury to the embryos.

After the procedure, the woman should continue to lie on the gynecological chair for 30-45 minutes. This is necessary for the adaptation of transplanted embryos to new conditions. If blastocysts remain in the syringe after replanting, they can be frozen for possible next attempts. All these actions are discussed with the woman, and she makes a decision, which the doctor then implements.

Frozen embryos are transferred in a similar manner. The procedure is performed after laboratory or ultrasound detection of ovulation. Wherein optimum time replanting is the interval from the 7th to the 10th day of the cycle. This avoids other steps that precede embryo transfer.

Thus, intrauterine injections can serve various purposes. But in all cases, they are designed to maintain or improve reproductive function. The procedure practically does not lead to pain and is highly effective, therefore it is used within the framework of complex treatment obstetric and gynecological pathology, as well as a stage of in vitro fertilization.

INTRAUTERINE DEVICES (IUD), contraceptives introduced into the cavity.

One of the most effective and acceptable methods of contraception for women who live a regular sexual life. Even in ancient times, nomadic tribes prevented pregnancy in camels before long journeys by introducing small foreign bodies- pebbles. Attempts to extend this method of contraception to humans for a long time hampered by a significant number of complications. Foreign bodies made of bone, gold, silver caused inflammation in the uterus, disrupted the menstrual cycle and often caused perforation of the uterus. The problem was resolved with the advent of synthetic materials that are biologically inert to human tissues.

Types of intrauterine devices

There are over 50 varieties inside uterine funds(spirals, arcs, loops, springs, etc.), among which the most commonly used polyethylene Lipps loop, T-shaped contraceptives containing copper (Cu T-200) or copper and silver, and T-shaped contraceptive Alza-T containing progesterone. Copper-containing and progesterone-containing products can also have the form of the number 7. All of them reliably protect against conception and give a 95 - 98% guarantee of preventing pregnancy, do not cause anxiety, can be left in the uterus for a long time (different for each contraceptive depending on the materials and inclusions ) without frequent and special medical supervision and do not require other precautions.

In the same few cases where an unwanted conception did occur, IUDs do not have harmful effects on pregnancy, childbirth and the health of the child. IUDs have significant advantages over other contraceptives: their use does not require burdensome, sometimes special, preparation before and after sexual intercourse; the female body receives biologically active substances found in semen; the high reliability of the method dramatically increases the sexuality of a woman. Most scientists consider the basis of the Navy's actions to be providing fast track eggs through the fallopian tubes into the uterine cavity (about 5-7 times faster than usual), as a result of which the egg does not have time to acquire those qualities that would allow it to penetrate the uterine wall for further development. In addition, the walls of the uterus themselves are not yet prepared for such implantation.

Insertion of intrauterine devices

IUDs are inserted by an obstetrician-gynecologist after a preliminary examination of a woman (bacterioscopy of smears from the cervical canal, vagina and urethra is performed for flora and purity, clinical analysis blood and urine) on the 5th - 7th day of the menstrual cycle; after uncomplicated artificial termination of pregnancy (see Abortion) - immediately or after the next menstruation; after uncomplicated childbirth - after 2 - 3 months. The introduction of the IUD to women who have undergone inflammatory diseases of the uterus and appendages is performed 6-10 months after treatment, provided there is no exacerbation, for women with a scar on the uterus after cesarean section - 3-6 months after the operation, taking into account the course of the postoperative period. IUD insertion is contraindicated in acute and subacute inflammatory diseases female genital organs (see Inflammatory diseases of the genital organs), the presence benign tumors and neoplasms of the female genital organs, malformations of the uterus, isthmicocervical insufficiency, erosion of the cervix, in violation of the menstrual cycle, blood coagulation.

After the introduction of the IUD, it is necessary to observe sexual rest for 7-10 days. Control examinations are carried out one week after the introduction, after the first, after 3 months, then 1 time in 6 months. In some women, immediately after the introduction of a contraceptive, pain in the lower abdomen may appear, which stops after a few hours or days on its own, in 9-16% spontaneous expulsion (expulsion) of the contraceptive is possible. At possible complications (constant pain, bleeding, inflammatory diseases of the female genital organs, extremely rarely perforation of the uterus) it is necessary to urgently consult a doctor. In the absence of complications, IUDs can be in the uterine cavity long time depending on the spiral and the substances included in it. With their longer use, the property of the material from which they are made changes, their contraceptive ability decreases. Progesterone-containing products are removed after one year, because by this time progesterone ceases to be released. Before reintroduction IUD is recommended to take a break for 2 - 4 months, during which it is desirable to use other contraceptives.

Contraindications for the use of intrauterine devices

Navy cannot be applied in the following cases:

if the risk of infection is too high various infections and their subsequent sexual transmission;
women suffering from diseases inflammatory nature various organs of the small pelvis, as well as with post-abortion or post-natal endometritis ;
with purulent acute cervicitis , at chlamydial or gonorrhea infection ;
pregnant women, as well as persons who may be suspected of having a pregnancy.

In this case, intrauterine devices can be used as postcoital contraceptive within five days after unprotected intercourse. However, VMV is forbidden to be used by women who are diagnosed with endometrial cancer, occur vaginal bleeding pathological, as well as persons who have been identified uterine cancer.

The choice of an IUD should be especially careful for women suffering from leukorrhea without cervicitis or severe vaginal infection in the stage of relapse purulent infectious cervicitis . Also, intrauterine contraceptives are not recommended for childless women who are prone to big risk become infected with a sexually transmitted infectious diseases. Other relative contraindication for the use of the Navy - availability AIDS or other diseases leading to immune system in an unstable state, as well as disease anemia, although IUDs that include progestins can significantly reduce menstrual blood loss. IUDs are not recommended for women with painful or heavy periods, a small uterus, cervical stenosis, or those who have had one before. .

Before the introduction of intrauterine contraceptives, it is desirable to gynecological examination, which may reveal contraindications for the use of the IUD, such as the pathological structure of the uterus or the presence biomes.

Principles for the introduction of intrauterine devices

If the presence of pregnancy is excluded, then intrauterine devices can be administered at any time during the menstrual cycle. In cases where pregnancy is suspected, it is recommended to wait until the next menstrual cycle. Most often, intrauterine devices are inserted into the woman's uterus for 3-8 days, at the very beginning of the menstrual cycle or after a certain period after. After giving birth, it is recommended to wait a few months, and only then introduce intrauterine contraceptives.

The Navy is inserted into the following situations in the absence of pregnancy:

In the first ten minutes after the delivery has occurred, since subsequently inserting the IUD is already risky due to uterine contraction and there is a significant risk of expulsion
Six months after childbirth, if a new pregnancy is excluded, and the woman either refused sexual intercourse during the entire period, or was used during contacts condom or the woman used vaginal spermicides
Immediately after the abortion, if it was done earlier than 12 weeks after the conception of the fetus, if the artificial legal or spontaneous abortion is not characterized by complications
Any day menstrual period if the presence of pregnancy is completely excluded, and the woman has previously constantly used any contraceptives

IUD insertion and prophylactic antibiotic therapy

Currently antibiotics for prophylactic purposes are prescribed in cases where a woman is at high risk of contracting sexually transmitted infections. If antibiotic therapy is prescribed, the following factors must be considered:

A woman during this period should not suffer from infectious diseases of an acute nature, and also have no contraindications to the use of antibiotics and the introduction of an IUD
Internal reception recommended doxycycline
During the period of breastfeeding, a woman is recommended to take erythromycin

As a rule, intrauterine devices are inserted immediately after physiological childbirth, if they passed without complications, and uterine contractions are normal character, while the risk of uterine bleeding should be absent. After delivery of the placenta, intrauterine devices are sequentially inserted manually, their introduction is a convenient and safe method, while there is no risk of infection. To prevent development inflammatory complications, you must strictly follow the rules of asepsis, which include the mandatory use of long sterile gloves.

This method of insertion of the IUD has a side effect - an overestimated frequency of expulsion of intrauterine contraceptives. At the same time, the probability of occurrence of expulsion frequency in copper-containing IUDs is significantly lower than the same indicator when using the Lipps loop, therefore, further explanations concern only the means of Sorre r -T 380A.

Probability of Expulsion Occurrence decreases in the following cases:

if intrauterine devices are inserted into the uterus within the first ten minutes after exit placenta ;
it is necessary to manually free the uterine cavity from the blood clots accumulated in it;
intrauterine devices must be manually inserted into the uterine cavity;
The IUD should be placed at the bottom of the uterus, high in its cavity;
The Navy must enter experienced doctor;
it is necessary to inject intravenously a drug that causes uterine contractions.

If the Sorré r-T 380A threads are inserted immediately after childbirth, it is recommended to leave them directly in the uterine cavity. If a woman, one month after the introduction, cannot palpate independently, then the position of the IUD of the name Sorre r -T 380A is determined by the method of probing the intrauterine cavity. It should be borne in mind that within a month after the last birth, the onset of a new pregnancy is considered an unlikely fact. If the threads of the IUD can be palpated during probing, the doctor can easily quickly remove them from the intrauterine cavity, and subsequently from the cervix. In all other cases, intrauterine devices, the presence of which is confirmed by probing, can already be left in the uterine cavity without any fear.

Many women immediately after the introduction of intrauterine devices note nausea or significant pain so it is recommended to come to medical clinic together with a spouse or partner who can accompany the woman home after the procedure.

After the introduction of uterine means, it is necessary to check the position of their threads even before you are about to leave the doctor's office. Learn to determine the length of the threads yourself, while they usually protrude two centimeters from the external os in the cervix. If, during palpation of already inserted IUDs, you can feel their plastic parts, or palpation becomes impossible, the risk of an unwanted pregnancy increases significantly. The threads are recommended to be checked regularly for several months after the IUD is inserted into the uterine cavity, and if a violation of their position is detected, it is recommended to use additional contraceptives until the next visit to the doctor.

Do not forget about the possibility of developing various inflammatory processes and the risk of infection. With pain in the lower abdomen, fever, various secretions from the vagina, contact a specialist immediately. Remember that such inflammatory diseases are a direct path to or chronic pelvic pain.

Be sure to keep track of all changes in menstruation and irregularities in the menstrual cycle, contact a gynecologist in a timely manner at the slightest concern due to a violation of well-being. Pay attention to symptoms such as the appearance of profuse vaginal mucous or spotting , increased pain during menstruation, the occurrence menstrual bleeding . Remember that the IUD can be removed at any time, you just need to see a doctor. Do not forget that unpleasant symptoms when using this method of birth control appear, as a rule, in the first two to three months after the introduction of intrauterine devices, and then in many women they disappear.

Do not try remove the IUD yourself, since the removal of an intrauterine contraceptive that is safe for you is possible only by an experienced doctor and only in sterile clinical setting. Always watch for the following signs:

delayed menstruation- this fact may indicate the onset of pregnancy;
the occurrence of bleeding or spotting;
the appearance of pain in the lower abdomen, as well as pain during intercourse;
Availability pathological discharge, infections and inflammatory processes;
general malaise, including symptoms such as chills, fever, weakness;
the impossibility of palpation of the threads of the IUD, their lengthening or shortening.

Complications when using intrauterine devices

Among all cases of extraction of the IUD in 5-15%, the direct cause of this fact is the appearance of spotting or the occurrence of bleeding, especially in the first year of using these means to prevent unwanted pregnancy. Symptoms for removal of the IUD may include general weakness, skin pallor, discharge blood clots between two periods, persistent and prolonged bleeding. In any case, when bleeding, the intrauterine contraceptive is recommended to be removed, even if its introduction is not the cause of this problem.

If there are problems different nature please adhere to the following guidelines:

even before the introduction of intrauterine contraception, it is necessary to carry out probing with the utmost care, it is important to choose the right probe of the right size;
if severe pain occurs during the insertion of the IUD in or a subsequent two-day period, as well as during menstruation, this intrauterine device is recommended to be removed; if the pain is not very strong, then you can remove them with the help of aspirin ;
if there is a partial expulsion of the intrauterine device, it must be removed, and then in the absence of pregnancy, if inflammatory processes are not observed, it is recommended to install a new IUD;
in case of inflammatory diseases in a woman of the pelvic organs, it is necessary to remove the IUD, carry out appropriate treatment, the duration of which is at least three months, and then introduce a new contraceptive intrauterine device into the uterus;
in case of occurrence severe pain immediately after administration, with loss of consciousness, cardiac arrest, convulsions, vaso-vagal reactions must be administered intramuscularly atropine and any pain reliever to maintain the tone of the heart, in severe cases, the IUD must be removed;
if the presence of an IUD in the uterine cavity causes discomfort due to big size, it can be safely removed and replaced with a smaller intrauterine contraceptive;
in case of spontaneous abortion, you must first diagnose pregnancy, then remove the IUD, then evacuate the uterine cavity, excluding ectopic pregnancy; if an ectopic pregnancy is diagnosed, the woman should be referred for urgent operation;
if the intrauterine contraceptive does not open correctly, the IUD must be removed, and then it is easy to introduce a new agent.

Complications when using the IUD are spontaneous expulsion of the intrauterine device, which is observed in approximately 2-8% of cases. this usually happens in the first year of use. Its symptoms are: unusual discharge from the vagina , the occurrence of pain in the lower abdomen, the appearance of intermenstrual bleeding. After sexual intercourse during expulsion, there may be observed bloody issues, signs dyspareunia , you should pay attention to the elongation of the threads, as well as the feeling of the intrauterine device in the cervix or in the uterine cavity. Remember that expulsion can not only cause discomfort to a woman, but also be the direct cause of irritation of her partner's penis.

If you do not observe direct symptoms of expulsion, pay attention to its possible indirect consequences, including the inability to palpate the internal threads, the onset of pregnancy, the delay in menstruation.

The following objective signs of expulsion can be distinguished:

the location of the IUD in the vagina or in the cervical canal;
in the case of partial expulsion, an elongation of the IUD threads is observed;
at full expulsion, the IUD threads are not visualized;
during probing, X-ray or ultrasound examination of the abdomen and pelvic organs, the IUDs are not detected.

If partial expulsion is diagnosed, then the intrauterine contraceptive must be removed, then if there is no inflammatory process and pregnancy has not occurred, then a new IUD can be inserted immediately after the removal of the old one, or wait for the next menstrual period. If full expulsion is observed and no contraindications have been identified, another uterine contraceptive can be introduced. Statistics show that expulsion of intrauterine devices containing progestins is the least common.

Often women complain about the gradual shortening of the threads, the impossibility of palpation, as well as the fact that an increase in the length of the threads leads to irritation spouse or partner. These facts indicate either the expulsion of the IUD, or their transition into the abdominal cavity, so an examination is necessary in order to determine the position of the threads. Best Practice - ultrasound procedure, which allows you to view the location of the threads with great accuracy.

To restore the normal position of the displaced threads of the IUD, a spiral is often used. In rare cases, the cervical canal is examined using narrow forceps, thanks to which an experienced doctor can easily locate the threads of the intrauterine contraceptive. Such funds can not only be groped, but also quickly removed with various medical instruments, including hooks and forceps used in hysteroscopy .

In the case when the threads of the IUD are in the inner space of the uterus, it is recommended to remove this contraceptive, and then introduce a new one - of this variety or another type.

About 30% of cases of unwanted pregnancies during the period of use of intrauterine contraceptives are directly related to the expulsion of the IUD, but pregnancy occurs even if such an agent is present in the uterine cavity. If pregnancy does occur, an urgent removal of the intrauterine contraceptive is required, by pulling on the threads, or by careful traction .

in this case, the risk is doubled miscarriage ;
increased risk of developing ectopic pregnancy;
in the case of spontaneous miscarriage, the risk of subsequent infection is significantly increased.

In the case of the introduction of the IUD, the frequency of uterine perforation fluctuates at the level of 0.04-1.2%, and this indicator is directly related to the form and type of intrauterine contraceptives, the technique of their introduction, anatomical features the uterine cavity, the position of the IUD, as well as the competence of the doctor. With perforation of the uterus, pain occurs during the introduction of intrauterine contraceptives, then there is a gradual disappearance of threads, regular uterine bleeding followed by a possible pregnancy.

Quite often, the diagnosis is significantly difficult, because external signs uterine perforation may be completely absent. The development of this fact may be indicated by such objective reasons as the absence of threads inside the cervical canal, the inability to remove this intrauterine contraceptive even if it is detected, the detection of a displaced IUD during a hysteroscopic, ultrasound or x-ray examination.

The cause of perforation of the neck of the shirt is often the expulsion of the IUD. During a gynecological examination, the gynecologist discovers a contraceptive in any of the vaginal vaults. If perforation of the cervix develops, then the IUD must first be transferred into the intrauterine space, and then removed this remedy narrow forceps from the cervix. In the case when an intrauterine contraceptive is implanted into the cervix, the IUD is removed using conventional techniques. When this contraceptive is located outside the uterine cavity, it is removed by laparotomy or laparoscopic method . A diagnosed pregnancy can be saved if desired, even if the exact location of the IUD has not been established.

Complications with IUD use include exacerbations chronic diseases uterine cavity. Acute inflammatory processes in women giving birth occur in 1.5-7% among women giving birth, and among nulliparous this indicator is approximately 10%. The presence of inflammatory processes during the use of the IUD is quite often the result of various infections that are usually sexually transmitted, including gonorrhea and chlamydia . The risk of infection when using intrauterine contraceptives is much higher than when using other methods of contraception. In any case, when diagnosing various inflammatory diseases, the intrauterine contraceptive should be removed immediately, then treated with suitable medications for two weeks. antibacterial drugs followed by follow-up examination.

If the IUD is in the uterine cavity, the treatment of inflammatory processes in the organs located in the pelvic area is not recommended, since the intrauterine contraceptive must first be removed. Otherwise, the likelihood of developing abscesses, sepsis, peritonitis, and obstruction of the fallopian tubes is very high. Before the introduction of a new intrauterine contraceptive after the elimination of the inflammatory process and its cause, it is recommended to wait three months.

Method of insertion of intrauterine devices

Modern technique IUD insertion is quite simple, it is performed only in aseptic conditions of the outpatient clinic. The doctor must first perform a thorough gynecological examination in order to accurately exclude the possibility of the patient's pregnancy and make sure that there are no inflammatory processes, as well as to identify the presence of uterine perforation. If the uterus is located retrograde , a more precise study is required.

The cervix and vagina should be treated with an antiseptic solution, including a solution of iodine or benzalkonium chloride. Sensitive women will require intracervical anesthesia, after which the cervical forceps must be placed on the cervix, on its upper lip and then close them slowly. Next, a uterine probe is carefully inserted into the uterine cavity, when it reaches the bottom of the uterine cavity, a sterile cotton swab is applied to the cervix, which is removed simultaneously with the probe itself.

An intrauterine contraceptive is inserted into the conductor, and then the prepared structure is inserted through the cervical canal into the uterine cavity. Each action the gynecologist must perform very slowly, observing maximum care. When the intrauterine contraceptive is inserted, all that remains is to cut its threads, and the patient can be advised to palpate the threads of the IUD immediately in order to know the standard for the location of this contraceptive. In this case, it will be easier for a woman to later determine the expulsion, if it occurs.

Method of extraction of intrauterine devices

The term for removing the IUD depends on the type and type of intrauterine contraceptive, but, as a rule, this tool must be removed after three to four years. It is easiest to remove the IUD during the onset of menstruation, since in this case such a procedure is relatively easy and as painless as possible. Remove the IUD slowly permanent light traction, if natural resistance occurs, it is necessary to probe the uterine cavity, then correctly rotate the probe 90 ° to dilate the cervix.

AT difficult cases will be required special expanders and preliminary paracervical blockade , often the expansion is also performed using kelp . Cervical forceps can be placed on the cervix to hold it securely so that the uterus can align. Narrow forceps will help to identify the threads of the IUD if it is impossible to visualize them; special instruments can be used to examine the internal cavity of the uterus hooks , alligator tongs or Nowak's curette . If the patient used the IUD for longer than the prescribed period, it is necessary to take into account the possibility of the intrauterine contraceptive growing into the wall of the cavity itself, as well as a significant narrowing of the cervical canal. The modern technique for extracting the IUD includes anesthesia. First, the gynecologist must perform paracervical anesthesia by injecting the patient with a solution of lidocaine. This action must be performed only in the treatment room, where, in a difficult case, it will be possible to provide the patient with emergency care at any time, if necessary. Paracervical anesthesia is currently used in the removal of intrauterine contraceptives from previously nulliparous women, as well as at the risk of vaso-vagal reactions.

The following stages of paracervical blockade are recommended to doctors in this way:

before the procedure, it is necessary to perform an examination of the patient with the help of special mirrors and then examine it bimanual way;
the mucous membrane of the cervix and vagina must be cleaned with an antiseptic solution;
during the procedure, it is recommended to ask the patient if she has complaints of dizziness, nausea, tingling in the labia, ringing in the ears;
treat the cervix, put forceps on the upper lip, injecting the patient directly into the lip with a solution of lidocaine in the required proportions;
after injecting a local anesthetic, you need to insert a needle into the connective tissue under the mucous membrane;
five minutes after the implementation of the blockade, you can proceed directly to the removal of the IUD.

: use knowledge for health

The choice of contraceptive method often belongs to the woman. After analyzing the effectiveness, safety, ease of use, many stop at the intrauterine device. This method has an ancient history, but has long ceased to be traumatic and dangerous for the female body.

An intrauterine device is a small medical device containing copper, gold, silver, or a hormone that is designed to be inserted into the uterus.

How does a spiral work and look like?

To understand the principle of the spiral, it is necessary to turn to the physiology of conception. During sexual intercourse, sperm is poured onto the cervix, spermatozoa rush into its cavity.

If a woman has ovulated shortly before, then a mature egg moves towards the male germ cells. In the uterine cavity, spermatozoa enter the left and right fallopian tubes, and it is there that fertilization occurs. The fertilized egg goes back into the uterine cavity and attaches to its loose wall.

If fertilization does not occur, then menstruation begins. The egg, together with the inner lining of the uterus, is released with menstrual blood.

The IUD, depending on the type, affects several stages of fertilization at once. modern medicine offers several types of spirals:

Metal-containing.
Hormone-containing.

In the first version, there is a small amount of metal in the spiral - copper, gold or silver. Ions of these metals deactivate spermatozoa or cause their death, and in the egg cell, they reduce the lifespan. A small inflammatory response which prevents the egg from attaching.

IUDs with hormones contain progestogen, which is continuously released into the uterine cavity. It does not allow you to get pregnant and has therapeutic effect. The hormone increases the viscosity of cervical mucus and prevents sperm from entering the uterus. Spermatozoa become less mobile. Some women do not ovulate. The therapeutic effect is to reduce the thickness of the endometrium. This is useful for long heavy menstruation and endometrial hyperplasia, myoma.

IUDs come in the following forms:

Ring-shaped.
Spiral.
T-shaped.

The latter type is more popular. The T-shaped helix looks like a plastic stick with copper wire. At the upper end there are hangers for fixation in the uterus. Bottom - special threads to extract. Length without them up to 3.5 cm.

The spiral is enclosed in a special conductor tube, the hangers are folded along the central part. When inserted, they straighten out to the sides and the IUD is fixed in the uterine cavity.

If the installation went correctly, the shoulders rest against the fallopian tubes, the body of the spiral is located in the center of the uterus, the antennae come out of the cervix.

Advantages of intrauterine contraception, insertion and removal

The IUD has a number of advantages over other methods of contraception:

Before the installation of the IUD, a woman undergoes an examination. A vaginal swab is required to rule out infection. If there is inflammation, a course of anti-inflammatory suppositories is prescribed.

An ultrasound of the uterus and appendages is performed to determine their shape, the presence of nodes, inflammation. A general blood and urine test, a blood test for HIV and syphilis are prescribed.

They put a spiral on the 4-6th day of menstruation, when the cervix is not yet tightly closed. The doctor determines the length of the body of the uterus by introducing a special probe. After it, a conductor tube with a spiral inside is inserted. The conductor is carefully removed, the hangers straighten out and securely fix the spiral inside. The doctor cuts the threads, forming antennae up to 2 cm long.

The IUD can be placed for up to 5 years, after which it is removed. Sometimes it is removed ahead of time at the request of the woman or for certain indications, they can be:

pregnancy;
helix shift;
myoma growth;
inflammation of the uterus or appendages.

The doctor removes the IUD after gynecological examination, 1-5 days of the menstrual cycle. Normally, it is pulled out by the antennae, without causing discomfort. In some situations, the spiral is removed only during hysteroscopy under anesthesia. This happens with long-term wearing and its ingrowth into the uterus, with a significant increase in myomatous nodes that prevent extraction.

Contraindications for installation

The spiral is placed in healthy women giving birth who do not plan pregnancy in the next 1.5-5 years. It can be put after an abortion, if there is no inflammation, for nursing mothers, after childbirth at 6 weeks. If there are contraindications for admission hormonal contraceptives, then the spiral is the way out.

The World Health Organization identifies relative and absolute contraindications for the insertion of an IUD.

Absolute contraindications completely exclude the possibility of placing a spiral:

inflammatory diseases of the genital organs;
pregnancy;
bleeding from the uterus of an unknown nature;
cancer of the uterus or cervix;
for hormonal spirals - thrombophlebitis, hepatitis.

Relative contraindications allow the possibility of wearing a spiral after their elimination:

transferred inflammation of the genital organs, the spiral is placed no earlier than after 6 months;
prolonged and heavy menstruation, uterine bleeding, endometrial hyperplasia;
painful periods;
uterine fibroids with many nodes that deform the uterine cavity;
endometriosis;
previous ectopic pregnancies;
malformations of the uterus;
anemia, diseases of the blood coagulation system;
repeated fallout of the spiral;
carried over Last year venereal diseases, infected abortion.

But some contraindications do not apply to the installation of a hormonal coil. The hormone progesterone it contains healing effect with prolonged and heavy menstruation, endometrial hyperplasia, endometriosis, uterine myoma. The thickness of the inner layer of the uterus - the endometrium - decreases, blood loss decreases. In women with normal menses they may become scarce or stop altogether.

With the help of progesterone, you can act on uterine myoma, under its action, the nodes decrease within 6 months - one and a half years, often there is no need for surgery.

Possible Complications

The first complications may arise during installation. It can be partial or complete perforation of the uterine wall.

Normally, the uterus is elastic, but with frequent inflammatory diseases, its walls change and become more loose. With excessive pressure during the installation of the spiral, a puncture can be made. With a partial puncture, the IUD is removed from the vagina, cold is applied to the abdomen, and antibiotics are given to prevent infection. With a complete puncture, surgery is necessary to suture the uterine wall.

The appearance of severe bleeding during the installation of the spiral is an indication to stop the procedure!

In the process of wearing a spiral, the following complications may develop:

Increased blood loss during menstruation. Copper-containing IUDs increase blood loss by up to 50%. There may be spotting in the middle of the cycle during the first 3 months.
Inflammatory diseases of the vagina, uterus, appendages. The IUD can serve as an entry gate for infection. With the development of inflammation, the spiral is removed.
Spiral drop. In the first week after the procedure, limit physical exercise and weight lifting. After this period, you can return to normal life and sports. But during menstruation it is recommended to avoid excessive loads. Those women who used sanitary tampons should switch to pads, because. it is possible to extract the spiral along with the tampon.
Pregnancy. The IUD does not provide 100% protection against pregnancy. An ectopic pregnancy often develops, tk. the passage of the egg through the fallopian tubes slows down. She does not have time to enter the uterine cavity and is attached in the appendages. A normal pregnancy may develop, but with highly likely miscarriage. If a woman is interested in preserving the fetus, the non-hormonal coil is not removed until the moment of delivery. Hormonal can cause malformations of the child, it is better to terminate such a pregnancy.

signs of ectopic and normal pregnancy the same, but an ectopic can end with a rupture of the tube and bleeding into the abdominal cavity. With delayed menstruation and positive test If you are pregnant, you need to see a doctor immediately!

After removing the spiral, complications are possible in the form of chronic inflammation of the genital organs, the risk of ectopic pregnancy, and infertility. If you use a spiral longer than the prescribed period, endometrial hyperplasia or polyps may develop.

It should be remembered that the coil is a one-sided protection, it protects against pregnancy, but does not protect against sexually transmitted infections. Therefore, for women who often change sexual partners, it is better to choose a condom for contraception.

It is also recommended to independently control the presence of a contraceptive once a month. To do this, in a squatting position, insert a finger into the vagina and feel for the antennae. If neither are present, then there is a possibility of loss of the spiral.

In cases where there are no contraindications, the IUD serves effective way prevention of unwanted pregnancy and reproductive health.

Artificial insemination is a real chance infertile couples to find parental happiness or an unnatural procedure, the chances of success of which are negligible?

Motherhood is the greatest happiness and joy for a woman, her vocation and the most natural state. When, for some objective reasons, a woman cannot become a mother, then artificial insemination comes to the rescue. What is it, what methods of artificial insemination exist, what are the features of the procedure, as well as other issues of concern to women, we will consider in this article.

Importance of artificial insemination

Artificial insemination is modern method solutions to the problem of infertility, when the conception of a child cannot occur naturally. The artificial insemination procedure can be performed for a number of reasons, in which both one of the partners and both are ill with infertility.

The main indications for artificial insemination are:

polycystic ovaries
endometriosis
low quality of the partner's sperm, which can manifest itself in sperm immobility, low concentration and a large number of pathological units
hormonal infertility
tubal infertility
infertility, the causes of which are not established

Thanks to progress in medicine, hundreds of thousands of infertile couples can finally experience the joy of motherhood and fatherhood, because artificial insemination gives the opportunity to have children with forms of infertility that in the past put an end to reproductive function.

Video: Conception in vitro

Methods of artificial insemination

When it comes to artificial insemination, many people think of the common and popular IVF procedure. In fact, there are several methods of artificially solving the problem of infertility:

ISM is a method in which the sperm of her husband is transferred into the uterus of a woman. This technique is used in cases where the reproductive functions of a woman are not impaired and she cannot become a mother due to Low quality husband's sperm or when the mucus in the woman's vagina is an aggressive environment for the existence of spermatozoa and they die without reaching the egg

ISD - if the husband's sperm is unsuitable for conception or he is completely infertile, then the spouses are offered a method of artificial insemination with donor sperm. The procedure itself this method practically does not differ from the previous one: a woman is also injected with spermatozoa into the uterus, but only her husband is not a sperm donor

GIFT - when the cause of infertility lies in the fact that the woman's egg is not released into fallopian tube for fertilization, then the method of intratubal gamete transfer is effective. It consists in the transfer into the fallopian tube of an egg previously taken from a woman, connected by artificial means With male spermatozoa. Male germ cells can belong to both the spouse and the donor

ZIPT is a method in which a fertilized egg is injected into the uterus prepared by hormones. Previously, a healthy, fertile egg is taken from a woman by ovarian puncture and fertilized outside the female body with sperm. The embryo is then inserted through the cervix

ICSI - effective method artificial insemination, which involves the fertilization of an egg with a sperm using the thinnest needle. Through the puncture of the testicles, the most active spermatozoon is removed and introduced into the egg

IVF is the most common type of artificial insemination of an egg outside the body of a woman, after which the embryo is implanted in the uterus

IVF fertilization method

in vitro fertilization is a modern reproductive technology, which is most often used not only in our country, but throughout the world. What explains this popularity of the method? First, this technique gives the most high results; secondly, with the help of IVF, pregnancy can be achieved even in very difficult cases of infertility, when both partners have serious problems reproductive function.

artificial insemination procedure

IVF requires multiple eggs. But since only one egg can be formed in a woman's body in one cycle, the amount of egg production is stimulated by hormones.

When, using ultrasound, it is determined that the ovary is enlarged and eggs have formed in it, they are removed. After that, the oocytes are washed from the follicular fluid and placed in an incubator, where the eggs are until the moment of artificial insemination.

If it is not possible to obtain eggs from a woman, then donor eggs are used.

On the same day, spermatozoa are taken, which are obtained by masturbation or coitus interruptus. In the resulting semen, spermatozoa are isolated and the most active of them are selected. After that, in a test tube with eggs, add required amount active spermatozoa, based on 100-200 thousand per egg. It is also possible to use donor sperm.

Within 2-3 hours, the sperm fertilizes the egg. Next, the resulting embryo is placed in a favorable environment, where it stays for 2 to 6 days. All this time, they are introduced into the test tube essential vitamins, physiological ions, substrates and amino acids. After that, the embryos are directly transferred to the uterus, which is carried out in a matter of minutes on the gynecological chair.

If a woman cannot bear the pregnancy herself, then they resort to surrogate motherhood.

Video: In vitro fertilization. Komarovsky

In vitro fertilization pros and cons

Although IVF opens up the opportunity for infertile people to have children, this procedure can also Negative consequences, which sometimes go into the category of deplorable:

hormonal imbalance
ovarian hyperstimulation
fetal malformations
multiple pregnancy, in which it is necessary to kill the "extra" embryos for the survival of at least one or two

In addition, the IVF procedure is an expensive event that not everyone can afford, and sometimes childless couples have to give up any hopes of becoming parents, since the amount is simply unbearable for them.

On the other hand, society has prejudice to the procedure of artificial insemination - "test-tube children" are mistaken for inferior and retarded in development.

Today, the IVF procedure is being improved in many ways. New technologies are applied, the exact dosage of hormones is established, which provides necessary processes and at the same time delivers the least harm to a woman's body.

It is also important that very rarely a large number of embryos, usually only two, are placed in the uterine cavity, which prevents the need to eliminate an extra embryo. Yes, and the very joy of motherhood exceeds everything possible risks and undesirable consequences that the IVF procedure can cause.

How much does artificial insemination cost?

The price of the issue depends on the method of artificial insemination. It may vary in various clinics, but the average price list looks like this:

IGO from 28 to 40 thousand rubles
IVF from 40 to 100 thousand rubles
ICSI from 100 to 150 thousand rubles

Other methods of artificial insemination are not widespread in Russia due to their lower efficiency.

Artificial insemination of single women

Women who do not have a partner to conceive a child, but who desperately want to have a child, will be helped by the procedure artificial insemination. During this procedure, active donor spermatozoa are placed in the woman's uterus, after which the egg is fertilized.

Immediately before the procedure, the woman undergoes examinations and tests, and if necessary, hormonal stimulation is performed.

Artificial insemination at home

The procedure of artificial insemination can be carried out at home. Its essence lies in the fact that a dose of sperm obtained during ejaculation is injected into the uterus of a woman using a syringe and a catheter. Thanks to such manipulation, the chance of fertilization increases significantly, because all spermatozoa are sent to the egg, while during natural fertilization, part of the seed is poured out and neutralized by the vaginal mucus, without even entering the uterus.

For the implementation of artificial insemination at home, sterile are needed:

syringe
catheter
gynecological speculum
pipette
disinfectant
tampons
towel
gynecological gloves

It is important to carry out the procedure during ovulation, which can be determined using a special test.

The problem of artificial insemination

A detailed briefing on how artificial insemination is carried out at home can be obtained from a gynecologist, but it is important to understand that the implementation of such an important process at home can carry the risk of introducing various infections into the uterine cavity, due to the possible non-sterility of the devices used.

Artificial insemination: reviews

After analyzing the reviews of women who have decided on artificial insemination, several key aspects of the procedure can be distinguished:

pregnancy does not always occur. There are couples who have decided on IVF five or six times in a row, but never achieved the desired
many infertile women worries moral aspect, because the problem of artificial insemination still causes discussions in various circles, especially from the church, which considers such events unnatural, and condemns families without children, since they must bear their cross and not go against the will of God

artificial insemination is a colossal burden on a woman’s body, both in a moral and physical sense
despite the challenges they face married couples yet decided on artificial insemination, positive result and the joy of having a child outweighs all the risks and negative points and many are stopped only by the price of the procedure from having a child artificially again