IVF procedure: how does it happen? Is it dangerous to do IVF procedure? Federal free eco program to help infertile couples.

One of the modern methods of treating infertility is in vitro fertilization, IVF. In thirty percent of cases it turns out to be effective, allowing infertile couples to become happy parents. IVF was first successfully carried out in 1978, this happened in England. Since then, thousands of couples have used this method to have the opportunity to have their own children. IVF procedure – how does it happen? Is it dangerous to undergo IVF procedure for a woman?

In vitro fertilization - what is it?

The IVF procedure involves conception not in a woman’s uterus, but in artificially created conditions. In this case, the meeting place of sperm and eggs is a test tube. A few days after successful fertilization, the egg is transferred from a test tube to the uterus of a woman, who carries the baby. Quite often, this procedure results in multiple pregnancies, since several female eggs are involved in the process. In this case, at the request of the mother, excess embryos can be removed from the uterine cavity. As a rule, two embryos are left to be safe. That is why IVF - Schnitz can be recognized by the birth of twins. True, two children can be born at once even without IVF...

In what cases can IVF help an infertile couple?

In vitro fertilization may be recommended for women who have a history of ectopic pregnancy, damaged or absent fallopian tubes, or obstructed fallopian tubes. Men with low spermatogenesis can also benefit from this method of fertilization. If it is impossible to obtain sperm naturally for the procedure, doctors resort to puncture, which is performed under anesthesia.

The first stage is examination

If a married couple decides to resort to in vitro fertilization by contacting a specialized center, they must first be examined. Women are required to undergo an ultrasound of the pelvic organs and undergo various tests that determine the presence or absence of AIDS, syphilis and hepatitis viruses in the blood.

In addition, girls need to be tested for the levels of various hormones. Men need to have a spermogram done to determine the quantitative and qualitative indicators of seminal fluid. As a result of the examination, doctors will be able to decide on further actions regarding the conception of each couple.

The second stage – hormone therapy for women

Each woman undergoes hormone therapy, which lasts approximately 2 weeks. As a result of taking certain hormones, several follicles with eggs are formed in the girl’s ovaries. The fact is that for a successful IVF procedure, a supply of eggs is required. The woman gives herself daily injections of hormones that stimulate the development of follicles at home.

Upon completion of hormone therapy, the procedure proceeds as follows.

The doctor removes follicles from the woman's ovaries using a special needle that is inserted through the vagina. This process is painless and it is not at all dangerous to do this procedure for the girl’s health. When the doctor has several eggs at his disposal, all that remains is to obtain the man’s sperm to fertilize them.

As already mentioned, this can be done in two ways - naturally and with the help of a puncture. The second method is used if a man has weak spermatogenesis.

Conception and embryo diagnosis

The most exciting moment is the combination of eggs and sperm in a test tube with a special solution, where the birth of a new life occurs. Fertilized eggs spend 3-4 days in such conditions, from where the embryos, after a short study, are transferred to the woman’s uterine cavity.

Before being implanted into the uterus, embryos are subjected to examination, which will now make it possible to identify serious developmental defects and even the gender of the unborn child! If no abnormalities are found, the embryos are transferred to the woman's uterus.

The next stage of IVF goes like this...

Embryo implantation

The doctor implants several embryos (usually 2-3) into the uterine cavity, which increases the likelihood of their survival. How does this happen? This procedure is completely safe and painless. The doctor uses only a special catheter, moving the embryos into the uterine cavity through the vagina. After this, the girl feels normal and can go about her daily activities.

What is the probability of pregnancy?

Pregnancy occurs when the transferred embryos attach to the wall of the uterus. It is advisable to do a test confirming pregnancy no earlier than 12 days after the IVF procedure. Until this time, it is recommended to monitor the level of hormones in a woman’s blood every 3 days. If all the transplanted embryos take root, some can subsequently be removed from the uterus.

However, this carries the risk of losing the remaining embryo. Intervention may lead to miscarriage. According to statistics, pregnancy occurs only in 30 percent of cases after IVF. That is, many have to repeat it again and again...

Is it dangerous to do eco or not?

The IVF procedure itself is not dangerous for a woman, but taking hormonal drugs can lead to ovarian hyperfunction, as well as the formation of cysts. If these abnormalities are detected in time, the development of ovarian diseases can be prevented.

In vitro fertilization, despite the fact that it ends successfully only in every third case, is popular among wealthy infertile couples. This is a real chance for them to become happy parents. This means that IVF has a right to exist.

Just 3 decades ago, a child born outside of an official marriage was condemned and perceived as the fruit of the mother’s moral failure. Modern society treats the problem of illegitimate children more fairly: when a lonely lady decides to give birth to a child “for herself,” neither colleagues nor relatives no longer see this as a terrible sin. On the contrary, the woman is understood and supported. However, not every woman without a husband who aspires to become a mother manages to become pregnant naturally. Unfortunately, the years spent building a career take a toll on reproductive health. And then the desired motherhood is impossible without the timely intervention of doctors. In this case, eco for single women is the only opportunity to achieve motherhood. Patients in assisted reproductive technologies (ART) departments are not always successful businesswomen; often they are ordinary women with an unsettled personal life.

Having decided to become a mother using ART, any woman worries: is it possible to do IVF without a husband or is having a companion mandatory? The problem is quite delicate; I don’t want to discuss it with friends, colleagues, or parents. We will try to give a detailed answer to the question of whether a single woman can undergo IVF or use other reproductive technologies.

Legal grounds for IVF without a husband
Review of modern ART technologies
Is IVF possible under compulsory medical insurance for a single woman?
Is the impossible possible?

Contents of the article

Legal grounds for IVF without a husband

In the Russian Federation, there is Article 55 of the Federal Law on Health Protection, which stipulates the rights of single women to use reproductive technologies. The only requirement for future single mothers is mandatory consent to medical intervention. That is, the IVF procedure without a husband is possible only after signing informed voluntary consent.

On the eve of signing, the doctor explains the procedure technique to the woman in detail and talks about possible risks. Only after the patient receives detailed information about the upcoming manipulation, the employee of the ART department offers to sign the relevant documents and begins to examine the woman. Therefore, the question of whether IVF is done for single women is not posed entirely correctly: personal loneliness is not an obstacle to motherhood. But without a preliminary detailed examination, the procedure is impossible.

Review of modern ART technologies

ART departments have various technologies. Most clinics dealing with infertility problems offer their patients other ways to achieve the desired motherhood.

We list the main ones:

IVF – in vitro fertilization. The method is based on drug stimulation of the production of oocytes, which are then fertilized in vitro with donor sperm. After culturing the embryo, it is transferred to the woman's uterus.
IVF ICSI (intracytoplasmic injection) is a technique in which sperm are injected directly into the cytoplasm of the oocyte. It is used when a previous IVF attempt has failed, and is also recommended for women with immunological infertility and patients over 40 years of age.
AI (IUI) – artificial insemination or intrauterine insemination. A technique in which donor sperm are injected directly into a woman's uterus or cervical canal. AI is a more affordable procedure than various IVF options.

Is IVF possible under compulsory medical insurance for a single woman?

If your choice is happy motherhood with the help of IVF, you, of course, are interested in the cost of medical procedures. The procedures are not cheap, and the costs are not limited to paying for the medical intervention.

You should include the following items in your list of expenses:

Payment for doctor's consultations;
Payment for consultations of narrow specialists;
Payment for clinical tests, instrumental examinations;
Payment directly for the IVF, ICSI IVF or AI procedure.

The cost of eco for a single woman is no different from that for a married lady. Costs for IVF range from 120 thousand Russian rubles, IVF ICSI – from 150 thousand, AI – from 25 thousand rubles.

It is possible to carry out the IVF procedure under the compulsory health insurance quota. The right to free intervention is limited by age (22-39), the presence of contraindications to IVF, and some other aspects. A single woman who wants to succeed as a mother should get on the waiting list at any clinic specified in the federal program. If there are no contraindications to the use of ART, medical intervention will be performed free of charge.

Is the impossible possible?

When starting an IVF procedure, any woman worries – will it work? After all, the Internet is full of both positive and negative reviews on this matter. And my friends also have several instructive stories in stock! The main thing here is not to indulge yourself with illusions. On average, the IVF procedure allows you to have a child in more than 50% of cases; the AI procedure guarantees motherhood for only 20% of women.

Everything matters - the age of the expectant mother, the presence of inflammatory diseases of the female genital area, and general somatic pathologies. It is clear that the younger the woman, the greater her chances of success. Once you've made the difficult decision to become a mother, you shouldn't seek advice from friends and family. It is better to completely trust the doctor and methodically follow his recommendations. You and the doctor must become one team, striving for the goal, only then after a short period of time a child’s voice will sound in your home.

If you are confused by the low success rates after IVF, do not take them into account. After all, it is much easier to doubt the result than to systematically achieve it. Be patient, trust the doctors and remember that IVF is a real option that can give you the joy of motherhood. And we sincerely wish this for you!

The in vitro fertilization (IVF) method allows childless couples to conceive and give birth to their own child genetically without endangering the mother's health. This method of conception is not effective for all couples. There are contraindications that make using the method impossible.

The decision on the possibility of extrauterine fertilization is made by the doctor after considering all the pros and cons of the procedure and taking all measures to treat diseases that prevent pregnancy.

The main indication for participation in the IVF program is the inability to cure the infertility of one of the spouses. Indications for the procedure are:

obstruction of the fallopian tubes;
ovulation disorder;
endometriosis;
anatomical features of the uterus that prevent conception.

For men, indications for IVF are sperm pathologies or disorders of seminal fluid excretion.

When can spouses be denied participation in the program?

The procedure is not prescribed if a woman is unable to carry a pregnancy to term due to health reasons. There are absolute and temporary (relative) contraindications.

Temporary obstacles to artificial insemination

Temporary contraindications are correctable, and after appropriate treatment the woman will be able to become pregnant and give birth to a baby. The artificial insemination procedure is postponed in the following cases:

pronounced adhesions in the pelvis;
accumulation of fluid in the fallopian tubes, preventing implantation of the embryo;
chronic disease of the appendages, which has worsened this year;
benign tumor in the uterus, ovaries.

After treatment, the doctor may authorize participation in the program. An obstacle to IVF is some congenital or acquired diseases of a woman, such as heart defects, brittle bones, and the absence of one kidney.

Extrauterine fertilization is not always possible due to genetic diseases of the woman. Such diseases include hemophilia and Duchenne muscular dystrophy. In this case, preimplantation genetic diagnosis is performed before the artificial insemination procedure.

Conditions that increase the chance of pregnancy

One of the conditions for the effectiveness of IVF is a woman’s body weight. It is desirable that the woman’s weight be more than 50 kg, but not exceed 100 kg.

Being underweight can lead to difficulties in inserting a fertilized egg into the uterus. Excess weight can lead to premature birth and negatively affect the health of the baby.

Smoking is considered a relative contraindication for participation in the artificial insemination program. The pregnancy rate is lower in women who smoke. There is another contraindication that affects the effectiveness of the method: age. Although the procedure is carried out after 45 years, the chance of conceiving and carrying a child decreases with age.

In what cases is IVF not performed?

In vitro fertilization is contraindicated for women whose health condition does not allow them to bear a child without risk to their own health.

Absolute contraindications:

tuberculosis, HIV, hepatitis, syphilis;
malignant tumors of any location;
blood diseases;
diabetes mellitus;
diseases of the heart, blood vessels;
hypertension that cannot be controlled with medications;
mental illness.

They do not resort to artificial insemination in case of congenital malformations of the uterus, deformations that can prevent the implantation of the embryo into the uterine wall, and childbirth. The use of in vitro fertilization is not indicated for chronic somatic diseases that cannot be treated, such as intestinal fistula or renal failure.

IVF is contraindicated for benign tumors in the genital organs. Taking hormonal drugs during the program can provoke the transition of a benign neoplasm to a malignant tumor.

The doctor makes the decision to conduct IVF for the treatment of infertility of a married couple after a comprehensive examination of the spouses. IVF is used when other methods of treating infertility are impossible.

Is it possible to do IVF to a healthy woman?

The artificial insemination procedure has clear indications. IVF is usually prescribed if pregnancy cannot be achieved by other methods.

But sometimes patients at reproductive clinics are interested in whether IVF is performed on healthy women. Yes, there are situations when patients with preserved fertility enter into the protocol. Let's talk about whether it is possible to do IVF without indications.

Male infertility

The indications for IVF include not only female but also male infertility. Often in families, men are much older than their wives.

They can no longer conceive a child, either due to age, when age-related androgen deficiency develops, or due to previous diseases (chronic prostatitis, varicocele, sexually transmitted infections).

If sperm quality is poor, natural conception is unlikely, even if the woman is young and completely healthy. Is it possible to do IVF in such cases? Yes, often this is the only way out of the current situation.

The married couple is recommended not only IVF, but also ICSI. This is a procedure in which fertilization of female germ cells is carried out “manually”, that is, the embryologist himself finds the most fertile sperm in his opinion and injects it under the shell of the egg using special instruments.

It doesn't matter:

what kind of mobility do sperm have - male gametes do not have to penetrate inside the egg on their own, they are introduced there by an embryologist;
how many sperm are contained in sperm - one sperm is enough to fertilize one egg;
what quality male reproductive cells have - even among numerous sperm with poor morphology, the embryologist can find several high-quality sperm.

The essence of the study:

After obtaining a woman's eggs in an IVF cycle and fertilizing them with her husband's sperm, doctors obtain several embryos.
Cell samples are taken from these embryos at a certain stage of development and examined for mutations or genetic diseases.
Embryos with genetic abnormalities are not used.
Healthy embryos remain - they can be transferred to the uterus, expecting that the child will develop well and be born healthy.

There are cases when most embryos exhibit some kind of damage to the genetic material. In such married couples, without the IVF and PGD procedure, the pregnancy would most likely have died early or the child would have developed malformations. But PGD allows you to prevent all these consequences.

To assess the risk of mutations or transmission of genetic diseases, you should consult a geneticist. He will determine whether IVF can be done on a healthy woman using PGD to prevent chromosomal abnormalities in the child.

Freezing eggs and embryos for the future

A woman's reproductive health declines with age. After 35 years, the chances of pregnancy decrease sharply. There are fewer eggs and their quality decreases. Therefore, many women want to freeze their reproductive cells in case they want to experience the joy of motherhood again in later reproductive years.

When planning to freeze eggs, a woman undergoes superovulation stimulation so that they mature in as large a quantity as possible. Then the follicles are punctured. Under anesthesia, mature eggs are removed from the woman's ovaries. They can even be fertilized if the couple wants to freeze the embryos that are ready for transfer to the uterus.

Thus, after fertilization of the eggs and cultivation of the embryos, there is only one step left before pregnancy. A woman can leave all embryos in cryogenic storage in order to use this biological material in the future. But one of them can be transferred to the uterus now. In this case, this will be a completed IVF cycle, which is performed without medical indications.

Now you know whether IVF can be performed on healthy women. But it should be remembered that if a patient wants to undergo the in vitro fertilization procedure just like that, without having any medical grounds for this, she will most likely be refused at the reproductive center. It is better to get pregnant naturally, if possible, and if such a pregnancy does not carry any risks for the mother and child.

Question:
I would like to know whether it is permissible to use IVF (in vitro fertilization) in accordance with the Koran and Sunnah for infertility in order to have children?

Answer:
Praise be to Allah

First: Without a doubt, children are a blessing and an adornment to this world, and procreation is one of the greatest purposes of marriage. A righteous child is the wealth of his parents both in this life and in the Hereafter, and his good deeds will be recorded for his parents as well. Spouses may face problems such as the absence of children or a delay in their appearance. In this case, they should be patient and hope for a reward, diligent in dua and prayers for forgiveness. They must understand that there is wisdom in Allah's predestination. If a person knows the ways of having children permitted by Islam, then there is no mistake in using them. But a Muslim must beware of false methods associated with witchcraft and superstition, and he must be wary of doctors who have no fear of Allah and only seek to profit from those who want to have children, so some of them replace eggs or sperm. For this reason, some scientists have banned such methods of conception or set strict conditions for them.

Secondly: one of the ways that helps spouses conceive a child is IVF (in vitro or artificial fertilization). This method involves stimulating ovulation so that a woman's ovaries produce several eggs rather than just one, as is usually the case. This is done by injecting decapeptyl to prepare the ovaries for the next stage, which is the injection of hormones to stimulate “superovulation”. After making sure that the eggs are mature, the woman is given an injection of gonadotropin to complete the maturation of the eggs and retrieve them. Typically, this injection is given 36 hours before egg retrieval.

On the day of egg retrieval, the husband's sperm is collected, the sperm are separated from the seminal fluid and 100,000 sperm are added to each egg in special incubators to allow fertilization to occur. After 2-3 days, the fertilized eggs form embryos, then the embryos are divided into categories depending on their quality. The best embryos are transferred into the uterus, and after some time a pregnancy test is performed. According to doctors, the effectiveness of IVF is 30-40%.

Brief summary by Dr. Osama Salih, a specialist in gynecology, obstetrics, infertility and laparoscopic medicine from Britain and head of the IVF department at Dar al-Shifa Hospital. See Al-Watan Clinic magazine.

Thirdly: regarding the Shariah provision of IVF, according to Sheikh Abdullah ibn Jibrin (may Allah protect him) and the scholars of the Standing Committee, it should be prohibited for reasons of caution. According to another opinion, it may be permitted subject to certain conditions being met, namely:

1. Urgent need. Lack of pregnancy for one or two years is not a reason to use IVF and other similar methods. Spouses must be patient, because perhaps Allah will soon grant them relief and they will not have to resort to forbidden things.

2. A woman should not reveal her awrah to male doctors if there are female doctors.

3. The husband is prohibited from masturbating to obtain sperm. He can have intimacy with his wife without penetration.

4. A woman's eggs and a man's sperm cannot be frozen for future use, they must be immediately transplanted into the uterus. This must be done without delay to prevent their mixing with others and their use by strangers.

5. The sperm must belong to the husband, the egg must belong to the wife, and the embryo must be transferred only to the wife's uterus. Everything else is strictly prohibited.

6. Spouses must completely trust the doctors performing the procedure.

Sheikh Muhammad ibn Uthaymeen (may Allah grant him His mercy) was asked about the ruling of placing an egg in a test tube, fertilizing it and transferring it to the uterus for further development. He replied:

"1. If there is no need for this procedure, then we do not think that it is allowed, since it involves the extraction of the egg, and this entails unnecessary opening of the awrah. It also involves surgery, which can have negative consequences in the future, such as damage to the fallopian tubes or infection.

If we leave everything as intended by the Most Merciful of those who show mercy and the Wisest Judge, then this will be closer to the proper attitude towards Allah, better and more useful than using methods invented by people, which at first may seem good, but in the end ultimately lead to failure.

2. If there really is a need for this procedure, then we do not think that there is an error in its implementation provided that three conditions are met:

— Fertilization must be done with the husband's sperm. It is not permissible to use the sperm of any other person except the husband, because Allah says:

وَاللَّهُ جَعَلَ لَكُمْ مِنْ أَنْفُسِكُمْ أَزْوَاجًا وَجَعَلَ لَكُمْ مِنْ أَزْوَاجِكُمْ بَنِينَ وَحَفَدَةً وَرَزَقَكُمْ مِنَ الطَّيِّبَاتِ أَفَبِالْبَاطِلِ يُؤْمِنُونَ وَبِنِعْمَةِ اللَّهِ هُمْ يَكْفُرُونَ

“Allah made for you a spouse from among yourself, gave you children and grandchildren from them and endowed you with benefits. Do they really believe in lies and do not believe in the mercy of Allah?
See Surah Bees 16:72

- The sperm must be obtained in a permitted way, for example, through intimacy with the spouse and ejaculation between her thighs or into her hand in order to fertilize the egg with this sperm.

— The fertilized egg must be transplanted into the wife’s uterus. Under no circumstances is it permissible to use another woman's womb, because this is considered to be the entry of a man's sperm into a woman's womb, which is not permitted to him. Allah says:

نِسَاؤُكُمْ حَرْثٌ لَكُمْ فَأْتُوا حَرْثَكُمْ أَنَّى شِئْتُمْ وَقَدِّمُوا لِأَنْفُسِكُمْ وَاتَّقُوا اللَّهَ وَاعْلَمُوا أَنَّكُمْ مُلَاقُوهُ وَبَشِّرِ الْمُؤْمِنِينَ

“Your wives are arable land for you. Come to your arable land whenever and however you wish. Prepare good deeds for yourself, fear Allah and know that you will meet Him. Give joy to the believers!”
See Surah "Cow" 2:223

The word 'arable land' refers exclusively to the wife and this means that it is not applicable to any other woman except the wife.”
See Majma Fatawa by ash-Shaykh al-Uthaymeen, 17/27,28.

He (may Allah grant him His mercy) also said:
“Artificial insemination involves removing the husband’s sperm and placing it into the wife’s womb using a syringe. This is a very serious matter. Who can guarantee that a man’s sperm will not be placed in the womb of another man’s wife?! Therefore, we think that all precautions should be taken and we should not issue fatwas on this issue, except in certain cases where we know the husband, wife and doctor. There are fears that permissiveness in this matter could lead to bad consequences.

This matter cannot be taken lightly, because if a substitution occurs, it will lead to mixing of genealogies and complete confusion, which is prohibited by Sharia. Therefore, the Prophet (peace and blessings of Allaah be upon him) said:
“You cannot have sex with a pregnant woman until she gives birth.” I will not issue fatwas on this issue, except in individual cases where I know the husband, wife and doctor.”
See Majma Fatawa by ash-Shaykh Ibn Uthaymeen, 17/No.9.

The Fiqh Council of the Organization of the Islamic Conference issued the following decision on this issue:
“There is no harm in resorting to this procedure if necessary, but be sure to take all precautions.”
See Majalat al-Majma, 3/1/423.

We ask Allah to bless the couple with righteous offspring without the need to use such methods and to give them patience in overcoming this test.

And Allah knows best