Culture and embryo blastocyst transfer are procedures for maturation and transfer of the embryo into the uterus. This procedure is one of the stages in a series of in vitro fertilization processes better known as IVF.
IVF is a procedure performed to help the process of pregnancy in couples who are difficult to have offspring due to disorders of the reproductive system (infertility). In an IVF procedure, a mature egg is taken from the ovary, then undergoes fertilization by sperm outside the body.
IVF procedures are quite complex and consist of several stages. One of the stages in IVF procedures is embryo culture and blastocyst transfer. This stage is the final stage of a series of IVF process. In the blastocyst culture stage, embryos that have formed after fertilization will undergo a maturation process until they reach the blastocyst stage, which is the embryonic development stage 5-6 days after fertilization.
Embryos that have reached the blastocyst stage have two distinct parts, namely the inner cells that will develop into a fetus, and the outer cells or trophoblasts which will later become the placenta. However, not all embryos can develop until they reach the blastocyst stage in the laboratory. This condition depends on the quality of sperm and egg cells.
After going through the blastocyst culture process, embryos that have matured (multicellular) will be put back into the uterus to be able to develop. This stage is known as the embryo blastocyst transfer stage.
Indications of culture and embryo blastocyst transfer
As part of the IVF procedure, culture and embryo blastocyst transfer can be performed on female patients who have not had children for approximately 2 years, or have undergone therapeutic treatments to increase fertility but are not producing results. This procedure is better done for women under the age of 40 years. Infertility (infertility) can be caused by several conditions as follows:- The fallopian tubes (fallopian tubes) are damaged or become blocked.
- Endometriosis.
- The function of the ovaries (ovaries) decreases.
- Ovulation disorders or egg maturation.
- Miom
- Have carried out sterilization actions.
- Impaired shape, function, and production of sperm count.
- Have or are currently undergoing radiotherapy or chemotherapy.
- No known cause
Before Culture and Embryo Blastosis Transfer
The patient will undergo a medical history examination and the doctor will explain the procedure to be undertaken, as well as the risks that can be experienced by the patient. Next, the doctor will do a vital sign examination and physical examination. After going through the physical examination stage, each patient who will undergo the IVF procedure will conduct several further examinations, including:- Hormone test. This test is done by measuring the levels of follicle-stimulating hormone (FSH), estrogen, and anti-Müllerian (AMH) in the blood to determine the quantity and quality of eggs.
- Examination of the uterine cavity. The examination can be done in 2 ways, namely sonohisterography and hysteroscopy. Sonohysterography is done by injecting special fluid into the uterus and with the help of an ultrasound machine will produce an image of the condition of the uterine cavity. Meanwhile, hysteroscopy is done by inserting an endoscope through the vagina into the uterus.
- Cement analysis. The couple or husband will undergo an analysis process with sperm samples in the laboratory to determine the quantity and quality of sperm.
- Screening for sexually transmitted infections. The doctor will examine the possibility of a partner suffering from a sexually transmitted infection, such as HIV.
- Trial transfer of artificial embryos. The doctor will transfer an artificial embryo to determine the technique and depth of the uterine cavity that will be used to place the embryo in the uterus.
- Stage of ovulation stimulation or induction. At this stage, the doctor will give several types of drugs to increase the number of eggs, such as ovarian stimulants to increase the number of eggs produced, and drugs to help the process of egg maturation. The patient will also undergo transvaginal ultrasound to monitor the development of the egg. Blood tests will also be carried out to check the effect of the drug on increasing the number of eggs.
- Stage of egg collection or follicular aspiration. This stage is done through a small surgical procedure. The doctor will insert an ultrasound device through the vagina to identify the follicle. Next, a small needle is inserted through the vagina, then directed to the ovary and into the follicle. The egg in the follicle is taken through a needle connected to a vacuum.
- Fertilization (fertilization). Fertilization can be done in two ways, namely insemination and intracytoplasmic sperm injection (ICSI). Insemination is carried out by uniting sperm from a partner and an egg that has been taken in a special cup. If the insemination technique fails to produce an embryo, the doctor will use the ICSI technique. ICSI is done by injecting healthy sperm into a mature egg directly.
Culture and Embryo Blastosis Transfer Procedure
After going through the stages of stimulation, egg collection, and fertilization, the embryo will enter the blastocyst culture stage. At this stage, the egg cell that has been through the process of fertilization, will be stored in a special place in the laboratory. The doctor will monitor regularly to ensure that the egg can develop normally and form an embryo. Cells in the embryo are able to divide actively and after a few days, the embryo can be said to be mature and ready to be put back into the uterus. If the doctor has confirmed that the embryo is mature, then the patient will undergo an embryo blastocyst transfer procedure. The steps are as follows:- The patient will be laid on an examination table with the legs open and supported.
- The doctor will inject a sedative so that the patient remains relaxed during the transfer procedure.
- The doctor will insert a long, thin, and elastic tube (catheter) through the vagina, then it is directed towards the cervix and into the uterus. The patient will feel uncomfortable when a catheter is inserted.
- The catheter is connected by injection containing one or more embryos that have been given a special fluid to keep it protected.
- The doctor will inject the embryo slowly through a catheter into the uterus.
- After completing the embryo blastocyst transfer, the doctor will draw a catheter from the patient's vagina.
After Culture and Embryo Blastosis Transfer
After undergoing embryonic blastocyst transfer, patients are advised to remain lying down for several minutes in the recovery room. After the doctor makes sure the patient's condition is stable, the doctor will usually allow the patient to go home without having to undergo hospitalization. Patients can resume normal activities, but the doctor will give some instructions that patients can do at home so that embryo growth is maintained and prevent the risk of miscarriage. Among others are:- Get enough sleep and rest when you feel tired.
- Perform light movements, such as walking, to increase blood flow into the uterus.
- Consumption of nutritious foods.
- Take a pill or use injections of the hormone progesterone for 8-10 weeks after embryonic blastosis transfer. The hormone progesterone is a hormone that is actually produced naturally by the ovaries to help thicken the lining of the uterus and make it easier for the embryo to attach to the uterine wall.
- Regularly consume folic acid supplements to reduce the risk of birth defects.
- Avoid smoking and alcohol consumption.
- Avoid excessive stress because it can indirectly affect the development of the embryo.
- Check with your doctor regularly to monitor the development of the embryo.
Culture Results and Embryo Blastosis Transfer
About 12-24 days after the embryo transfer process, the doctor will test blood samples to check the development of the embryo. The results of embryo transfer are influenced by several factors, namely:- Age.
- History of reproductive organ disorders.
- Condition of the embryo.
- Causes of infertility.
- Lifestyle
- Positively pregnant. If the embryo attaches perfectly to the uterine wall and develops normally. The patient will carry out routine control to the obstetrician for further examination.
- Negative pregnancy. If the embryo is not attached to the uterine wall and fails to develop. This condition can be known when the patient returns to the menstrual cycle. The doctor will instruct the patient to stop taking the hormone progesterone and encourage the patient to retry the IVF procedure.
Risk of Embryo Blastosis Culture and Transfer
Culture and embryo blastocyst transfer are safe procedures to do. Side effects that are felt are generally mild and rarely occur. Among others are:- Stomach cramps.
- Constipation.
- Leucorrhoea
- Breast pain because of high estrogen levels
- Twin Pregnant. Occurs when more than one embryo is injected into the uterus. Twin pregnancy is at risk of causing premature birth or low birth weight.
- Ectopic pregnancy or pregnancy outside the womb. This type of pregnancy cannot be continued because it can endanger the mother.
- OHSS (ovarian hyperstimulation syndrome), which is swelling and the emergence of pain in the ovaries.
- Birth defects. As the patient's age increases, the more at risk of pregnancy. One risk is that the baby has a birth defect.
- Miscarriage. The risk of miscarriage will increase with increasing age of pregnant women.
- Fever.
- Pelvic pain.
- Severe bleeding from the vagina.
- Spots of blood in urine.
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