How does the process of fertilization occur in humans? Fertilization is an amazing process

The fusion of a male reproductive cell (sperm) with a female (egg, ovum), leading to the formation of a zygote - a new unicellular organism. The biological meaning of fertilization is the unification of the nuclear material of male and female gametes, which leads to the unification of paternal and maternal genes, the restoration of the diploid set of chromosomes, as well as the activation of the egg, that is, its stimulation for embryonic development. The connection of the egg with the sperm usually occurs in the funnel-shaped part of the fallopian tube during the first 12 hours after ovulation.
seminal fluid, entering the woman's vagina during sexual intercourse, usually contains from 60 to 150 million spermatozoa, which, due to movements at a speed of 2-3 mm per minute, constant undulating contractions of the uterus and tubes and alkaline environment, already 1-2 minutes after intercourse they reach the uterus, and after 2-3 hours - the end sections fallopian tubes where the fusion with the egg usually occurs. There are monospermic (one sperm enters the egg) and polysperm (two or more sperm enter the egg, but only one sperm nucleus fuses with the egg nucleus) fertilization. Preservation of sperm activity during their passage in the genital tract of a woman is facilitated by a weakly alkaline environment. cervical canal uterus filled with mucous plug. During orgasm during sexual intercourse, the mucous plug from the cervical canal is partially pushed out, and then retracted into it and thereby contributes to a faster entry of spermatozoa from the vagina (where it is normal for healthy woman medium slightly acidic) in more favorable environment cervix and uterine cavity. The passage of spermatozoa through the mucous plug of the cervical canal is also facilitated by the sharp increase in mucus permeability on the days of ovulation. On the remaining days of the menstrual cycle, the mucous plug has a significantly lower permeability for spermatozoa.
Many spermatozoa located in the genital tract of a woman can retain the ability to fertilize for 48-72 hours (sometimes even up to 4-5 days). An ovulated egg remains viable for approximately 24 hours. Considering this, the most favorable time for fertilization, the period of rupture of a mature follicle with the subsequent birth of an egg, as well as the 2-3rd day after ovulation, is considered. Women using a physiological method of contraception should be aware that the timing of ovulation may fluctuate, and the viability of the egg and sperm can be significantly longer. Shortly after fertilization, zygote cleavage and embryo formation begin.
AT last years for the treatment of infertility, the method of in vitro fertilization is used - the fertilization of a human egg outside the body, culturing it to a certain stage and transferring the embryo (embryo) to the uterus. The absolute indication for this fertilization method is tubal infertility, which develops due to obstruction or absence of the fallopian tubes. In cases of male infertility, an instrumental introduction of the husband's or donor's sperm into the woman's genital tract is used in order to ensure her conception ( cm. artificial insemination).

(Source: Sexological Dictionary)

(singamia), fusion male. and wives. germ cells (gametes) in plants, animals and humans, resulting in the formation of a zygote that can develop into new organism. O. underlies sexual reproduction and ensures the transmission of hereditary traits from parents to descendants.

(Source: Dictionary of Sexual Terms)

See what "Fertilization" is in other dictionaries:

Syngamy, the fusion of a male reproductive cell (sperm, sperm) with a female (egg, egg), leading to the formation of a zygote, the edge gives rise to a new organism. Animal O. is preceded by insemination. In the process of O., eggs are activated, ... ... Biological encyclopedic dictionary

The processes associated with fertilization in cycads are so unusual that their identification, especially the discovery of spermatozoa in them at the end of the last century, made a real sensation among specialists. These processes take place in the following ... ... Biological Encyclopedia

FERTILIZATION, the key process of sexual reproduction, when, as a result of the fusion of male and female gamete(sex cells) a zygote is formed. The zygote contains the genetic information (CHROMOSOMES) of both parents (see HEREDITY). U… … Scientific and technical encyclopedic dictionary

Modern Encyclopedia

- (syngamy) the fusion of male and female germ cells (gametes) in plants, animals and humans, resulting in a zygote that can develop into a new organism. Fertilization underlies sexual reproduction and ensures the transmission of ... ... Big Encyclopedic Dictionary

FERTILIZATION, fertilization, pl. no, cf. (book). 1. Action according to Ch. fertilize fertilize. 2. In animals and plants, the formation, the emergence of the fetus due to the fusion of male and female germ cells. Reproduction by fertilization... Explanatory Dictionary of Ushakov

Chasmogamy, syngamy, gynogenesis, insemination Dictionary of Russian synonyms. fertilization noun, number of synonyms: 9 gynogenesis (1) ... Synonym dictionary

FERTILIZATION- FERTILIZATION, the connection of an egg with a spermatozoon, characterizes sexual reproduction, which is one of the most common methods of reproduction in nature. Already phenomena, conjugations (see) in protozoa and what happens at the same time ... ... Big Medical Encyclopedia

Fertilization- FERTILIZATION, the fusion of male (sperm) and female (egg, egg) germ cells in plants, animals and humans, resulting in a zygote that can develop into a new organism. Fertilization is the basis of sexual ... ... Illustrated Encyclopedic Dictionary

FERTILIZE, ryu, rish; ryonny (yon, ena); owls, whom what. Explanatory dictionary of Ozhegov. S.I. Ozhegov, N.Yu. Shvedova. 1949 1992 ... Explanatory dictionary of Ozhegov

Fertilization. See syngamy. (Source: "English Russian dictionary genetic terms. Arefiev V.A., Lisovenko L.A., Moscow: VNIRO Publishing House, 1995) ... Molecular biology and genetics. Dictionary.

Books

• , Kuzmichev, Leonid Nikolaevich, Shtyrya, Yulia Alexandrovna. Guidelines for reproductive specialists, embryologists, obstetrician-gynecologists…
• In vitro fertilization. Only facts. Information for reflection, Kuzmichev Leonid Nikolaevich, Shtyrya Yulia Alexandrovna. Guidelines for reproductive specialists, embryologists, obstetrician-gynecologists…

The birth of a new life is a real miracle. How many things must happen for a cell to turn into a person. Knowing how this truly unique process begins will be useful when planning pregnancy and expecting a child.

Conditions for fertilization

Pregnancy can occur in a girl from the moment of the onset of menstruation. In each such cycle, processes occur that prepare the woman's body for conception. It is, first of all, about the development of the necessary hormones regulating the maturation and ovulation of the egg.

Violations hormonal background can lead to negative consequences: delayed ovulation, its complete absence, abortion, infertility.

At normal process maturation of the egg, ovulation occurs in the middle of the cycle. Egg leaves the follicle and ovary, enters the fallopian tube and moves along it towards the uterus. The protection of the internal contents of the egg is carried out by a dense protein shell, in which, moreover, concentrated nutrients.

The time for fertilization and conception is limited to 24 hours. If nothing happens during this time, the egg will die.

sperm before fertilization

In the male body, under the influence of hormones, spermatozoa are formed. Their maturation occurs in the testicle, then they enter the epididymis, after which, moving along the vas deferens, they reach the seminal vesicles and prostate. It is in this gland that spermatozoa are mixed with internal secretions. This is how sperm comes out. She eventually takes part in the process fertilization.

During sexual contact about five hundred million spermatozoa enter the female genital tract along with sperm. Along the way, the weakest cells are eliminated, while only hundreds reach the goal. A large dropout occurs when moving through the mucous plug in the cervix: only the fastest and most mobile penetrate inside. The process of promotion does not end when it enters the internal genital organs of a woman. aim spermatozoa is the fallopian tube. This is where the fertilization of the egg takes place. Before that, the woman's immune system destroys another part of the spermatozoa as carriers of foreign genetic material.

The best time for fertilization

The body of a woman is best tuned for fertilization on the eve of ovulation. Therefore, for couples planning a pregnancy, it is ideal if sexual contact passes at this time.

On the eve of ovulation, the fallopian tubes are most mobile, the mucus in the cervix is ​​thinned, and the activity of cellular immunity decreases.

When sexual contact occurs two to four days before ovulation, the strongest, healthiest and most tenacious spermatozoa can wait for the egg to mature in one of the departments. fallopian tube.

If intercourse was before ovulation, the sperm are already waiting for the egg. In this case, given the speed of sperm movement, it is likely that fertilization will occur as early as an hour after semen eruptions.

Otherwise, the chance of conception remains for another day after ovulation. It is not possible to accurately calculate the time of ovulation by day and by hour, so fertilization is possible even on the seventh day after sexual contact. If this does not happen, a couple planning a pregnancy has to wait for the next cycle.

fertilization process

So, how does the fertilization of the egg occur in humans? Recall that it can only happen during the period of ovulation (about a couple of weeks before next menstruation).

Fertilization is the union of an egg and a sperm. Usually, several male germ cells that secrete enzymes go on the attack. The outer shell is destroyed. Most often, one of the sperm reaches the target.

After the connection of the male and female germ cells, a dense shell is formed around the egg, preventing further penetration of spermatozoa.

The fertilized egg is called a zygote. She starts moving towards the uterus. Most often, its progress through the fallopian tube is from five to seven days. During this period, active cell division is noted.

A week later, the embryo is introduced into the wall of the uterus. The production of the hormone hCG begins. germ receives oxygen and nutrients.

Whether pregnancy occurs is indicated by the presence and concentration of the hormone hCG in the woman's blood.

If pregnancy does not occur

Many couples who do not have problems conceiving children find it difficult to understand those for whom the birth of a child is different reasons seems like an impossible dream. Do not panic if pregnancy did not occur on the first (second or third) attempt. It is believed that the reason for visiting a doctor is a one-year period of regular sexual life without protection, during which conception did not occur.

With the current level of development of medicine, many couples can be helped: after treatment, they have long-awaited babies. In some cases, with male and female infertility the only way out is artificial insemination.

The essence of in vitro fertilization, or IVF, is in vitro fertilization. The egg, extracted from the body of the expectant mother, is combined with the sperm of the future father artificially, in a test tube. After that, the embryo is placed in an incubator for two to five days. Then the germ, again by artificial means, are transferred to the uterus of a woman, where its further development takes place. If it is impossible to obtain an egg or sperm from future parents, they are used donor cells.

Thus, at first glance, simple and natural process fertilization has many pitfalls. But for the sake of the happiness of the birth of a child, future parents, with the help of the latest advances in medicine, overcome all difficulties and obstacles.

Fertilization of an egg is an amazing process that has been studied by experts all over the world for long years. We know all the stages that germ cells go through before and after the cherished meeting. At the moment of fertilization, something new is formed from the parental cells, combining the genetic information from the mother and father. This microscopic unique cell is destined to become a full-fledged person in the future.

The success of fertilization depends on many factors. This process is preceded by hundreds of others, no less important. Conception will not occur if the process of maturation and movement of germ cells: sperm and eggs is disturbed.

Promotion of spermatozoa to the egg

From the moment of ejaculation to the meeting of germ cells, it takes from 3 to 6 hours. Spermatozoa are constantly moving, moving towards the site of contact with the egg. The female body is designed in such a way that the sex cells of a man meet many obstacles along the way, conceived by nature as defense mechanism. Thus, weak spermatozoa are eliminated, which are potentially dangerous and not suitable for the formation of a new life.

During one intercourse, up to 300 million spermatozoa enter the vagina, but only one will reach the goal. Millions of male germ cells die on the way to the egg and directly next to it. Most of the cells almost immediately after ejaculation follow along with the sperm. Great amount sperm cells die in the vagina and cervical mucus cervix. Some sperm cells get stuck in the folds of the cervix, but they become a reserve in case the first group of cells does not reach.

Remarkably, these stuck sperm are the cause of pregnancy before ovulation. Everyone knows that fertilization becomes possible only after ovulation, but there are chances of getting pregnant on any day of the cycle. When sexual intercourse occurs before the release of the egg, these stuck sperm cells wait for ovulation and continue on their way to the reproductive cell. Spermatozoa can stay “alive” for up to 7 days, so the risk of getting pregnant remains before and after ovulation.

Since the spermatozoa are not familiar immune system women, she takes them for foreign elements and destroys them. With excessive activity of the woman's immunity, we can talk about immunological incompatibility, which can cause infertility in a couple.

Surviving after the attack of immunity, spermatozoa move into the fallopian tubes. Contact with slightly alkaline mucus of the cervical canal provokes an increase in the activity of spermatozoa, they begin to move faster. Muscle contractions help sperm move around inside the uterus. One part goes into the fallopian tube, and the other goes into the uterine tube, where the egg is located. In the tube, spermatozoa must resist the flow of fluid, and some cells are retained by the villi of the mucosa.

At this stage in upper divisions tract, reactions are triggered that provoke capacitation (ripening) of spermatozoa. Certain biochemical substances are responsible for this. As a result of capacitation, the membrane of the sperm head changes, preparing for penetration into the egg. The spermatozoa become hyperactive.

Maturation and promotion of the egg

Regardless of the length of the cycle in a particular woman, ovulation occurs 14 days before menstruation. With a standard cycle of 27-28 days, the release of the egg from the follicle falls in the middle. It is noteworthy that the length of the cycle y different women differs and can reach 45 or more days. For this reason, experts recommend calculating the day of ovulation, focusing on the expected onset of menstruation. Two weeks must be counted from this date.

Fertilization time:

1. 14 days before menstruation, the egg leaves the follicle. Ovulation occurs. During this period, the risk of becoming pregnant is greatest.
2. Within 12-24 hours after ovulation, the sperm can fertilize the egg. This period is called the fertility window. A day after ovulation, the egg dies, but this time can be reduced depending on many factors.
3. If sexual intercourse occurred after the release of the egg from the follicle, fertilization takes only 1-2 hours. During this time, sperm cells overcome 17-20 cm from the vagina to the fallopian tubes, taking into account all the obstacles.
4. If intercourse occurred before ovulation, fertilization is possible within a week. It is noteworthy that Y-chromosome spermatozoa are faster, but live for 1-2 days, while X-chromosome cells are slow, but can withstand negative influence Wednesdays during the week. Many methods of conceiving a child of a certain gender are based on this fact.

Ovulation is a small explosion of the follicle. The egg and the fluid in which the oocyte matured enter the abdominal cavity. The "fringe" of the fallopian tubes includes the ciliated epithelium, which unidirectionally promotes the egg to exit the ovary. These cilia are activated under the influence of estrogens, hormones secreted by the ovaries after ovulation.

During this period, the egg is surrounded by cumulus cells that form the radiant crown. This crown contains follicular cells and is the secondary envelope of the egg. It becomes an obstacle for the sperm during direct fertilization.

How does the union of sex cells occur?

Fusion of gametes

Direct fertilization occurs in the fallopian tube, closer to the ovary. This stage of the journey is reached by tens of sperm cells out of hundreds of millions: the strongest, hardiest and most active spermatozoa. Only one fertilizes the egg, and the rest help it to penetrate inside the cell and die.

The most active penetrate through the radiant crown and attach to the receptors on the outer - shiny - shell of the egg. Sperm secrete proteolytic enzymes that dissolve the protein coat. This weakens the protective layer of the egg so that one sperm can get inside.

The outer shell protects the inner membrane. The spermatozoon that first reached this membrane attaches to it, and the germ cells merge in a matter of minutes. The "absorption" of the sperm by the egg starts a chain of reactions that cause changes in its shell. Other spermatozoa can no longer attach themselves, in addition, the egg cell releases substances to repel them. Having merged with the first sperm, the egg becomes impenetrable to others.

As soon as the sperm has penetrated the egg, mechanisms are launched in the woman's body that notify other systems of fertilization. The work of the organs is restructured in such a way as to preserve the vital activity of the embryo. Since the body may begin to mistake a fertilized egg for a foreign formation, immunity weakens and cannot cause rejection of the fetus.

Formation of a new genome

The genetic information is tightly packed in the spermatozoon. It begins to open only inside the egg, around the pronucleus is formed - the precursor of the zygote nucleus. In the pronucleus, the genetic material rearranges itself to form 23 chromosomes. It is noteworthy that the genetic material from the mother ends up forming only in the process of fertilization.

Microtubules bring two pronuclei closer together. Sets of chromosomes combine to form a unique genetic code. It contains information about a hundred characteristics that a future person will have: from eye color to character traits. These characteristics largely depend on hereditary information passed down from generation to generation, but unique "blocks" are also created.

Fertilization of the egg in stages

1. Spermatozoa "attack" the egg. They hit her with their tails to make her spin.
2. The sperm enters the inside of the egg.
3. The fusion of paternal and maternal chromosomes, the formation of a new genetic program. The fertilized egg is then called a zygote.
4. 30 hours after fertilization, zygote cleavage begins. The new cells are called blastomeres.
5. On the first day after the zygote is divided in two, then divided into four blastomeres.
6. On the third day, there are eight blastomeres.
7. The fourth day is marked by the division of the zygote into sixteen cells. Since that time, the embryo is called morula.
8. Crushing continues, but liquid is formed inside the morula. The blastocyst is formed last stage development of the embryo before the transition to the uterus and implantation.
9. At this stage, the fertilization process is completed, however full pregnancy hasn't arrived yet. Then the zygote moves through the fallopian tubes into the uterus, implants and begins to develop until childbirth.

After the transfer of the fetal egg to the uterus, the process of division ends, its introduction into the endometrium begins. The place of attachment of the embryo determines the position of the child in the abdomen: when implanted along the back wall in women, the stomach is small, and when implanted along the anterior wall, it is larger.

The introduction of the embryo into the endometrium triggers many biochemical processes, so a woman may experience nausea during this period, the temperature rises and headaches occur. Specific sign implantation - bloody issues indicating damage to the walls of the uterus.

How does pregnancy begin

The first week after fertilization, the zygote is in the fallopian tubes. On the seventh day, she begins to descend into the uterus and seeks out a place to attach. In a healthy woman, the endometrium of the uterus is thickened at this stage, so the zygote is easily fixed without a significant risk of rejection. Insufficiency of the thickness of the endometrium often causes female infertility.

During the period of movement from the fallopian tubes to the uterus, the egg takes nutrients from corpus luteum, so the lifestyle of the expectant mother does not play important role on the this stage. However, after the zygote is attached to the endometrium, the situation changes: the pregnant woman must reconsider her lifestyle and nutrition, because now the development of the fetus depends entirely on her behavior. It is important to maintain a normal mental and physical condition.

The zygote burrows into the endometrium and implantation begins. This process takes about 40 hours: cells divide, they penetrate into the mucous membrane and then grow. Actively formed blood vessels, which in the future will turn into a placenta. The germinal nodule begins to form the body, and the superficial cells are the parts that are needed for the development of the fetus ( amniotic sac, placenta, umbilical cord). The completion of implantation marks the beginning of the gestation period, that is, the bearing of a child.

Amnion or amniotic sac is a sac with colorless amniotic fluid. They are needed to protect the fragile fetus from the pressure of the walls of the uterus, temperature fluctuations, noise and shock from the outside. In addition, amniotic fluid supports metabolism.

The placenta is a unique organ. It provides the fetus with everything necessary for growth, development and life. At a certain stage, the placenta performs the functions of the lungs, kidneys and digestion, and also forms hormones and other elements necessary for the full development of the child. It transports fresh maternal blood to the umbilical vein and removes metabolic products from the fetal arteries. The placenta is a kind of filter that protects the fetus from harmful microorganisms and substances. The umbilical cord connects the fetus and the placenta. Blood flows back and forth through the vessels inside it.

3 stages of pregnancy

Pregnancy is divided into three stages: the formation of the body and organs to support the life of the fetus, the adjustment of body systems, and preparation for birth. Despite the fact that pregnancy lasts 9 months, in medicine this period is counted by weeks. From birth to the appearance of a new life, about 40 weeks pass, which is equal to 10 lunar months (based on 28 days of the cycle). Therefore, the pregnancy calendar consists of 10 months. It is easier to track the changes taking place in the body of a pregnant woman using such a calendar. The pregnant woman knows exactly which week she needs to take tests and undergo an ultrasound.

How to increase your chances of successful conception

Most favorable period for conception - two days after ovulation. However, given the viability of spermatozoa for 5 days, active sex should begin 3-4 days before ovulation. Spermatozoa will already be "waiting" for the egg in the abdominal cavity and fallopian tubes.

You can accurately determine the day of ovulation by basal temperature, but you need to rely on such a calendar only after 6 months of regular measurements. AT laboratory conditions ovulation can be determined by urine and saliva.

If a woman's menstrual cycle is standard 28 days, for successful conception, you need to have sex on days 10-18 of the cycle (preferably every other day, when the first day of the cycle is the day of menstruation). You should not be too pedantic about conception, the main thing in this matter is pleasure and relaxation.

Despite the fact that frequent ejaculation reduces the volume of seminal fluid, regular sex is the key to good sperm motility. Therefore, for successful fertilization, it is enough to have sex every other day. Daily intercourse guarantees conception by 25%, while one sexual intercourse per week reduces the chances to 10%.

A woman is able to increase the likelihood of conception if, immediately after sex, she lies on her side or raises her pelvis. However, it is necessary to take into account the peculiarities of the structure of the uterus: when bending, it is better to lie on your stomach, bending slightly, and with a bicornuate form, raise the pelvis. The main thing is that the sperm does not flow out of the vagina. After intercourse, do not use hygiene products and douche, as this can change the pH of the vagina and affect sperm.

If partners have difficulty conceiving, you can go to the clinic and use diagnostic equipment to accurately track the maturation of the follicle and the time of release of the egg. Harmless and painless ultrasound diagnostics is suitable for these purposes.

It must be understood that the fertilization of the egg is not pregnancy. We can talk about successful conception only after the embryo reaches the uterus and deepens into the endometrium. From fertilization of the egg to pregnancy, a week passes. This time is needed in order to start the mechanisms that do not allow the implantation of a zygote with the wrong set of chromosomes. This is possible, but most often "broken" zygotes die before or immediately after implantation. They come out with menstrual flow, so the woman does not even know what processes took place in her body. Such phenomena, as a rule, are not called lost pregnancy.

The birth of a child is the result of a thousand incredible processes that take place inside a woman. A loving mother wants to know everything she can about her baby. For this reason, many future parents are interested in how fertilization occurs.

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Fertilization of the egg

This is how nature decreed that a woman can usually become pregnant in the middle of the cycle, when the well-known ovulation occurs. Unlike sperm, the egg is able to survive in the natural environment of a woman from 12 to 36 hours. If she does not meet with the male seed, she dies and leaves the female body through menstrual bleeding.

The answer to the question is hidden here, how long after ovulation the egg is fertilized. If ovulation has just passed, the egg has escaped from its “nest”, and the spermatozoa are already waiting or on the way, fertilization can take place in a matter of hours.

What you've been waiting for

It also happens that during one ovulation, not one egg ripens, but two or even three. How does the fertilization of the egg occur in this case? Everything happens as usual, only as a result two or three babies are born at once.

Let us consider how the fertilization of the egg occurs point by point.

1. After ejaculation, spermatozoa go through a long "winding" path towards the egg. If we take the average speed of the male seed, in about 3-6 hours it reaches the goal. In the process of fertilization, only one sperm will participate, and the rest are destined to die.
2. Pushing hard, the sperm breaks through the coating of the female egg. At this moment, the whole organism is informed that fertilization has occurred a moment earlier. This very signal contributes to some restructuring of the female body, designed to save any valuable pregnancy.
3. Now that we have figured out how the fertilization of the egg occurs in humans, we can see what happens next. Each of the two parental cells contains one half of the set of chromosomes. As a result, the parent cells unite and form a new, perfect cell, with all the genetic data, known as the zygote. The genetic code of the neoplasm is completely unique.
4. Within seven days, the zygote develops inside the fallopian tube, and then begins its journey to the uterus, “looking after itself a cozy place”, where it will develop over the next nine months.
5. Further, going away from the place where fertilization occurs, the egg takes the corpus luteum with it as food. For this reason, in the first week, lifestyle does not affect the development process in any way.
6. Having found a cozy place for itself, the embryo “buries itself” in the wall of the uterus. This period development, which lasts no more than 40 hours, is called implantation.
7. The outer cells begin to divide and connect with the lining of the uterus. At the place of branching, microscopic vessels are formed, which later form the placenta - the environment inside which the baby grows, feeding and developing, until birth.
8. The body of the future baby is formed from the embryonic nodule. But the aforementioned placenta, amniotic sac and umbilical cord are formed from the surface cells necessary to ensure development and safe existence. To better understand how the fertilization of the egg occurs, you can watch the video.

Basal temperature

Measurement of basal temperature is perhaps the classic method for determining the day of ovulation. Graphs of this temperature are usually made by women planning to have a baby. But how basal body temperature changes after ovulation, if the long-awaited fertilization has occurred?

If a woman is pregnant, her basal temperature rises to 37 degrees. This allows you to identify a possible position even before the delay of menstruation. Of course, it is much more effective to take tests, but since hCG is produced only after the implantation of an already fertilized egg, it must be done at least a week after intercourse. Well, when you don’t feel like waiting, measuring basal temperature will help.

After fertilization occurs, and the body has received a signal about the beginning of the process of maturation of the fetus, active production of progesterone begins. It is the beneficial effect of this hormone on the development of the embryo that increases the basal temperature to 37.0-37.1 degrees.

The long-awaited result

It should be noted that the preserved normal temperature after fertilization occurs in the female body, it indicates a lack of progesterone, and this problem, in turn, is a threat of miscarriage or spontaneous interruption. In this case, you need to consult a doctor for help.

Conceiving a child by day

First, let's figure out where the conception of a child occurs.

1. When the process of ovulation has taken place, and the egg has left the ovary, it ends up in the fallopian tube. If sexual intercourse has taken place, spermatozoa will wait for an egg ready for conception precisely inside the fallopian tube.
2. Within a few days of fertilization, the nascent embryo travels down the fallopian tube to the uterus. If the development goes wrong or the movement of the embryo is too slow, the embryo can penetrate the mucous membrane of the tubes, and this is fraught with an ectopic pregnancy.
3. After about 7 days, the embryo reaches the uterus and looks after itself a warm place where it is going to settle down and continue its development.

It is no less interesting to find out how the long-awaited fertilization of an egg takes place every day in a person.

important process

We also invite you to watch a video on how human egg fertilization occurs by day.

How fast is the process?

Many are interested in how long fertilization occurs after an unprotected love act.

There are several answers to this question. Firstly, the conception of a child can occur exclusively during ovulation or within 12-36 hours after, no more. If during this time the egg does not meet with the sperm, it dies, and then leaves the female body.

If sexual intercourse took place during ovulation or 1-2 days before it, the question of which day after intercourse fertilization occurs immediately disappears, since here we will talk more about hours. To reach the goal, the male seed needs 3-4 hours. If sexual intercourse has taken place the day before, spermatozoa are actively waiting for a meeting with an egg in the fallopian tube, and they need no more than an hour to conceive.

Thanks 1

(Insemination Artificial) is a combination of several methods, the essence of which is the introduction of a male seed or a 3-5-day-old embryo into the female genital tract during medical manipulations. Artificial insemination is performed for the purpose of pregnancy in women who cannot conceive natural ways on various reasons.

In principle, methods of artificial insemination come down to different ways and options for fertilization of the egg outside the woman's body (in vitro in laboratory conditions) with subsequent transfer of the finished embryo into the uterus for the purpose of engraftment and, accordingly, further development pregnancy.

In the course of artificial insemination, first, the germ cells are removed from men (spermatozoa) and women (eggs), followed by their artificial connection in the laboratory. After the eggs and sperm are combined in one test tube, the fertilized zygotes, that is, the embryos of the future person, are selected. Then such an embryo is planted in the woman's uterus and they hope that it will be able to gain a foothold on the wall of the uterus, as a result of which the desired pregnancy will occur.

Artificial insemination - the essence and brief description of the manipulation

For an accurate and clear understanding of the term "artificial insemination" it is necessary to know the meaning of both words of this phrase. So, fertilization is understood as the fusion of the egg and sperm to form a zygote, which, when attached to the wall of the uterus, becomes a fetal egg, from which the fetus develops. And the word "artificial" implies that the process of fusion of the egg and sperm does not occur naturally(as provided by nature), but is provided purposefully by special medical interventions.

Accordingly, we can generally say that artificial insemination is a medical way to ensure pregnancy in women who, for various reasons, cannot conceive in the usual way. When using this method, the fusion of the egg and sperm (fertilization) does not occur naturally, but artificially, in the course of a specially designed and targeted medical intervention.

Currently, the term "artificial insemination" at the everyday colloquial level means, as a rule, the procedure of in vitro fertilization (IVF). However, this is not entirely true, since specialists in the field of medicine and biology under artificial insemination mean three methods (IVF, ICSI and insemination), which are combined general principle- the fusion of the egg and sperm does not occur naturally, but with the help of special medical technologies, which ensure successful fertilization with the formation of a fetal egg and, accordingly, the onset of pregnancy. In the following text of the article, under the term "artificial insemination" we will mean three different methods of fertilization produced with the help of medical technologies. That is, its medical meaning will be invested in the term.

All three methods of artificial insemination are united by one general principle, namely, the fertilization of an egg by a spermatozoon occurs not in a completely natural way, but with the help of medical manipulations. The degree of interference in the process of fertilization during the production of artificial insemination by various methods varies from minimal to very significant. However, all methods of artificial insemination are used in order to ensure the onset of pregnancy in a woman who, for various reasons, cannot conceive in the usual, natural way.

Artificial insemination to ensure conception is used only in cases where a woman is potentially able to carry a child throughout her pregnancy, but is not able to become pregnant in the usual way. Causes of infertility, in which artificial insemination is indicated, are different and include both female and male factors. So, doctors recommend resorting to artificial insemination if a woman has no or obstructed both fallopian tubes, has endometriosis, rare ovulation, infertility of unknown origin, or other methods of treatment have not led to pregnancy within 1.5 - 2 years. In addition, artificial insemination is also recommended in cases where a man has low sperm quality, impotence or other diseases, against which he is not able to ejaculate in the woman's vagina.

For the procedure of artificial insemination, you can use your own or donor germ cells (spermatozoa or eggs). If the spermatozoa and eggs of the partners are viable and can be used for conception, then they are used for artificial insemination techniques, after being isolated from the genitals of the woman (ovaries) and the man (testicles). If sperm or eggs cannot be used for conception (for example, they are completely absent or have chromosomal abnormalities, etc.), then donor germ cells obtained from healthy men and women are taken for artificial insemination. Each country has a bank of donor cells, where those who wish to receive biological material for artificial insemination.

The artificial insemination procedure is voluntary and all women and couples(consisting of both official and civil marriages) who have reached the age of 18. If a woman who is officially married wants to resort to this procedure, then the consent of the spouse will be required for fertilization. If a woman is in a civil marriage or is single, then only her consent is necessary for artificial insemination.

Women over the age of 38 may immediately request artificial insemination for the purpose of pregnancy without prior treatment or attempts to conceive naturally. And for women under 38 years of age, permission for artificial insemination is given only after documented confirmation of infertility and the absence of the effect of treatment carried out for 1.5 - 2 years. That is, if a woman is younger than 38 years old, then artificial insemination is resorted to only when pregnancy has not occurred within 2 years, subject to the use of various methods of infertility treatment.

Before artificial insemination, a woman and a man undergo an examination, the results of which determine their fertility and the ability of the fair sex to bear a fetus during 9 months of pregnancy. If everything is in order, then the procedures are carried out in the near future. If any diseases have been identified that can prevent normal development fetus and pregnancy, then they are first treated, seeking steady state women, and only after that artificial insemination is performed.

All three methods of artificial insemination are short in time and well tolerated, which allows them to be used several times without interruption to ensure pregnancy.

Methods (methods, types) of artificial insemination

Currently, in specialized medical institutions for artificial insemination, the following three methods are used:

• in vitro fertilization (IVF);
• intracytoplasmic sperm injection (ICSI or ICIS);
• Artificial insemination.

For example, if a woman has all the reproductive organs functioning normally, but the mucus in the cervix is ​​too aggressive, as a result of which the spermatozoa cannot thin it and enter the uterus, then artificial insemination is performed by insemination. In this case, sperm is injected directly into the uterus on the day of ovulation in a woman, which leads to pregnancy in most cases. In addition, insemination is indicated for low quality sperm, in which there are few motile spermatozoa. In this case this technique allows you to deliver sperm closer to the egg, which increases the likelihood of pregnancy.

If pregnancy does not occur against the background of any diseases of both the genital area (for example, obstruction of the fallopian tubes, lack of ejaculation in a man, etc.) and somatic organs (for example, hypothyroidism, etc.) in a man or woman, then for artificial insemination, the IVF method is used.

If there are indications for IVF, but additionally a man has very few high-quality and mobile spermatozoa in his sperm, then ICSI is performed.

Let's take a closer look at each method of artificial insemination separately, because, firstly, the degree of intervention in the natural process varies when using different methods, and secondly, in order to get a holistic view of the type of medical intervention.

In vitro fertilization - IVF

IVF (in vitro fertilization) is the most famous and widespread method of artificial insemination. The name of the IVF method stands for in vitro fertilization. In English-speaking countries, the method is called in vitro fertilization and is abbreviated as IVF. The essence of the method is that fertilization (the fusion of a spermatozoon and an egg with the formation of an embryo) occurs outside the woman's body (extracorporeally), in a laboratory, in test tubes with special nutrient media. That is, spermatozoa and eggs are taken from the organs of a man and a woman, placed on nutrient media, where fertilization takes place. It is because of the use of laboratory glassware for IVF that this method is called "in vitro fertilization".

Essence this method is as follows: after a preliminary special stimulation, the eggs are taken from the woman's ovaries and placed on a nutrient medium, which allows them to be maintained in a normal viable state. Then the woman's body is prepared for the onset of pregnancy, imitating the natural changes in the hormonal background. When the woman's body is ready for pregnancy, the man's spermatozoa are obtained. To do this, a man either masturbates with ejaculation of sperm into a special cup, or spermatozoa are obtained during testicular puncture with a special needle (if sperm outpouring is impossible for any reason). Further, viable spermatozoa are isolated from the sperm and placed in a test tube under the control of a microscope on a nutrient medium to the eggs obtained earlier from the woman's ovaries. They wait for 12 hours, after which fertilized eggs (zygotes) are isolated under a microscope. These zygotes are introduced into the woman's uterus, hoping that they will be able to attach to her wall and form fertilized egg. In this case, the desired pregnancy will come.

2 weeks after the transfer of embryos into the uterus, the level of human chorionic gonadotropin (hCG) in the blood is determined to determine whether pregnancy has occurred. If the level of hCG has increased, then pregnancy has occurred. In this case, the woman registers for pregnancy and begins to visit a gynecologist. If the hCG level remains within normal values, then the pregnancy did not occur, and you need to repeat the IVF cycle.

Unfortunately, even when a ready-made embryo is introduced into the uterus, pregnancy may not occur, since the fetal egg will not attach to the walls and will die. Therefore, for the onset of pregnancy, several IVF cycles may be needed (no more than 10 are recommended). The likelihood of the embryo attaching to the uterine wall and, accordingly, the success of the IVF cycle largely depends on the woman's age. So, for one cycle of IVF, the probability of pregnancy in women under 35 years old is 30-35%, in women 35-37 years old - 25%, in women 38-40 years old - 15-20% and in women over 40 years old - 6- ten%. The probability of pregnancy with each subsequent IVF cycle does not decrease, but remains the same, respectively, with each subsequent attempt, the total probability of becoming pregnant only increases.

Intracytoplasmic sperm injection - ICSI

This method is the second most used after IVF and, in fact, is a modification of IVF. The abbreviation of the name of the ICSI method is not deciphered in any way, since it is a tracing paper from the English abbreviation - ICSI, in which the sound of the letters of English language written in Russian letters that convey these sounds. And the English abbreviation stands for IntraCytoplasmic Sperm Injection, which translates into Russian as "intracytoplasmic sperm injection". Therefore, in the scientific literature, the ICSI method is also called ICIS, which is more correct, because. the second abbreviation (ICIS) is formed from the first letters of the Russian words that make up the name of the manipulation. However, along with the name ICIS, the not entirely correct abbreviation ICSI is used much more often.

The difference between ICSI and IVF is that the spermatozoon is accurately introduced into the cytoplasm of the egg with a thin needle, and not just placed with it in the same test tube. That is, with conventional IVF, the eggs and sperm are simply left on a nutrient medium, allowing the male sex gametes to approach the female gametes and fertilize them. And with ICSI, they do not expect spontaneous fertilization, but produce it by introducing a spermatozoon into the cytoplasm of the egg with a special needle. ICSI is used when there are very few spermatozoa, or they are immobile and unable to fertilize an egg on their own. The rest of the ICSI procedure is completely identical to IVF.

Intrauterine insemination

The third method of artificial insemination is insemination, during which the sperm of a man is injected directly into the uterus of a woman during the period of ovulation using a special thin catheter. Insemination is resorted to when, for some reason, sperm cannot enter the woman's uterus (for example, when a man is unable to ejaculate in the vagina, with poor sperm motility, or with excessively viscous cervical mucus).

How does artificial insemination take place?

General principles of artificial insemination by the IVF-ICSI method

Since all IVF and ICSI procedures are performed in the same way, with the exception of the laboratory method of egg fertilization, we will consider them in one section, specifying the details if necessary. distinctive features ICSI.

So, the IVF and ICSI procedure consists of the following successive stages that make up one cycle of artificial insemination:
1. Stimulation of folliculogenesis (ovaries) in order to obtain several mature eggs from a woman's ovaries.
2. Collection of mature eggs from the ovaries.
3. Sperm collection from a man.
4. Fertilization of eggs with spermatozoa and obtaining embryos in the laboratory (with IVF, spermatozoa and eggs are simply placed in one test tube, after which the strongest male gametes fertilize the female one. And with ICSI, spermatozoa are injected using a special needle into the cytoplasm of the egg).
5. Growing embryos in the laboratory for 3-5 days.
6. Transfer of embryos into a woman's uterus.
7. Pregnancy control 2 weeks after embryo transfer to the uterus.

The entire cycle of IVF or ICSI lasts 5-6 weeks, with the longest being the stages of folliculogenesis stimulation and a two-week wait to control pregnancy after embryo transfer to the uterus. Let's consider each stage of IVF and ICSI in more detail.

The first stage of IVF and ICSI is the stimulation of folliculogenesis, for which a woman takes hormonal drugs that affect the ovaries and cause the growth and development of several dozen follicles at once, in which eggs are formed. The purpose of stimulation of folliculogenesis is the formation of several eggs in the ovaries at once, ready for fertilization, which can be selected for further manipulations.

For this stage, the doctor chooses the so-called protocol - a regimen for taking hormonal drugs. There are different protocols for IVF and ICSI, differing from each other in dosages, combinations and duration of taking hormonal drugs. In each case, the protocol is selected individually, depending on general condition body and causes of infertility. If one protocol was unsuccessful, that is, after its completion, the pregnancy did not take place, then for the second cycle of IVF or ICSI, the doctor may prescribe another protocol.

Before the stimulation of folliculogenesis begins, the doctor may recommend taking oral contraceptives for 1 to 2 weeks in order to suppress the production of the woman's own sex hormones by the woman's ovaries. It is necessary to suppress the production of your own hormones so that natural ovulation does not occur, in which only one egg matures. And for IVF and ICSI, you need to get several eggs, and not just one, for which folliculogenesis is stimulated.

Next, the actual stage of folliculogenesis stimulation begins, which is always timed to coincide with 1-2 days of the menstrual cycle. That is, you need to start taking hormonal drugs to stimulate the ovaries from 1 to 2 days of the next menstruation.

Stimulation of the ovaries is carried out according to various protocols, but always involves the use of drugs from the group of follicle-stimulating hormone, human chorionic gonadotropin and gonadotropin-releasing hormone agonists or antagonists. The order, duration and dosage of the use of drugs of all these groups are determined by the attending physician-reproductologist. There are two main types of ovulation stimulation protocols - short and long.

AT long protocols ovulation stimulation begins on the 2nd day of the next menstruation. In this case, the woman first makes subcutaneous injections of follicle-stimulating hormone preparations (Puregon, Gonal, etc.) and gonadotropin-releasing hormone agonists or antagonists (Goserelin, Triptorelin, Buserelin, Diferelin, etc.). Both drugs are administered daily as subcutaneous injections, and once every 2 to 3 days a blood test is performed to determine the concentration of estrogen in the blood (E2), as well as an ultrasound of the ovaries with a measurement of the size of the follicles. When the concentration of estrogen E2 reaches 50 mg / l, and the follicles grow to 16 - 20 mm (on average, this happens in 12 - 15 days), the injections of follicle-stimulating hormone are stopped, the administration of agonists or antagonists of gonadotropin-releasing hormone is continued and injections of chorionic gonadotropin are added ( HCG). Further, by ultrasound, the response of the ovaries is monitored and the duration of injections of chorionic gonadotropin is determined. The introduction of agonists or antagonists of gonadotropin-releasing hormone is stopped one day before the end of injections of human chorionic gonadotropin. Then, 36 hours after the last hCG injection, mature eggs are taken from the woman's ovaries using a special needle under anesthesia.

AT short protocols ovarian stimulation also begins on the 2nd day of menstruation. At the same time, a woman simultaneously injects three drugs daily at once - a follicle-stimulating hormone, an agonist or antagonist of gonadotropin-releasing hormone and chorionic gonadotropin. Every 2-3 days, an ultrasound is performed with a measurement of the size of the follicles, and when at least three follicles 18-20 mm in diameter appear, the administration of follicle-stimulating hormone preparations and gonadotropin-releasing hormone agonists or antagonists is stopped, but for another 1-2 days they are administered chorionic gonadotropin. 35-36 hours after the last injection of chorionic gonadotropin, the eggs are taken from the ovaries.

egg retrieval procedure It is performed under anesthesia, so it is completely painless for a woman. Eggs are collected with a needle, which is inserted into the ovaries through the anterior abdominal wall or through the vagina under ultrasound guidance. The cell sampling itself lasts 15-30 minutes, but after the completion of the manipulation, the woman is left in a medical facility under observation for several hours, after which she is allowed to go home, recommending to refrain from work and driving for a day.

Next, semen is obtained for fertilization. If a man is able to ejaculate, then the sperm is obtained by the method of ordinary masturbation directly in a medical facility. If a man is not capable of ejaculation, then sperm is obtained by puncture of the testicles, performed under anesthesia, similarly to the manipulation of taking eggs from a woman's ovaries. In the absence of a male partner, the donor sperm selected by the woman is retrieved from the storage.

The sperm is delivered to the laboratory, where it is prepared by isolating the spermatozoa. Then according to the IVF method eggs and spermatozoa are mixed on a special nutrient medium, and left for 12 hours for fertilization. Usually, 50% of eggs that are already embryos are fertilized. They are selected and grown in special conditions within 3 - 5 days.

According to the ICSI method, after preparing the sperm, under a microscope, the doctor selects the most viable spermatozoa and injects them directly into the egg with a special needle, after which he leaves the embryos on a nutrient medium for 3-5 days.

Ready-made 3-5 day old embryos are transferred to the woman's uterus using a special catheter. Depending on the age and condition of the woman's body, 1-4 embryos are transferred into the uterus. How younger woman- the fewer embryos are planted in the uterus, since the likelihood of their engraftment is much higher than that of older women. Therefore, the older the woman, the large quantity embryos are placed in the uterus so that at least one can attach to the wall and begin to develop. Currently, it is recommended that women under 35 years of age transfer 2 embryos into the uterus, women 35-40 years old - 3 embryos, and women over 40 years old - 4-5 embryos.
After the transfer of embryos into the uterus you need to monitor your condition and immediately consult a doctor if the following symptoms appear:

• Foul-smelling vaginal discharge;
• Pain and cramps in the abdomen;
• Bleeding from the genital tract;
• Cough, shortness of breath and chest pain;
• severe nausea or vomiting;
• Pain of any localization.

Whether pregnancy has taken place is determined by the concentration of human chorionic gonadotropin (hCG) in the blood. If the level of hCG corresponds to pregnancy, then an ultrasound is performed. And if the ultrasound shows a fetal egg, then the pregnancy has come. Next, the doctor determines the number of embryos, and if there are more than two, then the reduction of all other fetuses is recommended so that there is no multiple pregnancy. Embryo reduction is recommended because the risk of complications and adverse pregnancy outcomes is too high in multiple pregnancies. After establishing the fact of pregnancy and the reduction of embryos (if necessary), the woman goes to the obstetrician-gynecologist to manage the pregnancy.

Since pregnancy does not always occur after the first attempt of IVF or ICSI, several cycles of artificial insemination may be required for successful conception. It is recommended to carry out IVF and ICSI cycles without interruptions until pregnancy (but not more than 10 times).

During IVF and ICSI cycles, it is possible to freeze embryos that turned out to be "extra" and were not transplanted into the uterus. Such embryos can be thawed and used for the next attempt at pregnancy.

Additionally, during the IVF-ICSI cycle, it is possible to produce prenatal diagnostics embryos before they are transferred into the uterus. During prenatal diagnosis identify various genetic anomalies in the resulting embryos and produce a culling of embryos with gene disorders. According to the results of prenatal diagnosis, only healthy embryos without genetic abnormalities are selected and transferred to the uterus, which reduces the risk of spontaneous miscarriage and the birth of children with hereditary diseases. Currently, the use of prenatal diagnostics makes it possible to prevent the birth of children with hemophilia, Duchenne myopathy, Martin-Bell syndrome, Down syndrome, Patau syndrome, Edwards syndrome, Shershevsky-Turner syndrome and a number of other genetic diseases.

Prenatal diagnosis before embryo transfer to the uterus is recommended in the following cases:

• The birth of children with hereditary and congenital diseases in the past;
• The presence of genetic abnormalities in parents;
• Two or more unsuccessful attempts IVF in the past;
• Vesical mole during past pregnancies;
• A large number of spermatozoa with chromosomal abnormalities;
• The woman is over 35 years of age.

General principles of artificial insemination by insemination

This method allows you to conceive in conditions as close to natural as possible. In view of high efficiency, low invasiveness and relative ease of implementation, artificial insemination is a very popular method of infertility therapy.

The essence of the technique artificial insemination consists in the introduction of a specially prepared male sperm into the female genital tract during ovulation. This means that for insemination, according to the results of ultrasound and disposable test strips, the day of ovulation in a woman is calculated, and on the basis of this, the period for introducing sperm into the genital tract is set. As a rule, to increase the likelihood of pregnancy, sperm is injected into the woman's genital tract three times - one day before ovulation, on the day of ovulation and one day after ovulation.

Sperm is taken from a man directly on the day of insemination. If a woman is single and does not have a partner, then donor sperm is taken from a special bank. Before being introduced into the genital tract, the sperm is concentrated, pathological, immobile and non-viable spermatozoa, as well as epithelial cells and microbes are removed. Only after processing the sperm containing the concentrate active sperm without impurities of microbial flora and cells, injected into the female genital tract.

The insemination procedure itself is quite simple, therefore it is carried out in a clinic on a conventional gynecological chair. For insemination, a woman is located on a chair, a thin elastic flexible catheter is inserted into her genital tract, through which concentrated, specially prepared sperm is injected using a conventional syringe. After the introduction of sperm, a cap with sperm is put on the cervix and the woman is left to lie down in the same position for 15-20 minutes. After that, without removing the cap with sperm, the woman is allowed to get up from the gynecological chair and do the usual usual things. The cap with sperm is removed by the woman herself after a few hours.

Prepared sperm, depending on the cause of infertility, the doctor can enter into the vagina, into the cervix, into the uterine cavity and into the fallopian tubes. However, most often sperm is injected into the uterine cavity, since this option of insemination has optimal ratio efficiency and ease of implementation.

The artificial insemination procedure is most effective in women under 35 years of age, in whom pregnancy occurs in about 85 - 90% of cases after 1 - 4 attempts to introduce sperm into the genital tract. It must be remembered that women of any age are recommended to make no more than 3-6 attempts of artificial insemination, because if they all fail, then the method should be recognized as ineffective in this particular case and move on to other methods of artificial insemination (IVF, ICSI).

Lists of drugs used for various methods of artificial insemination

Currently, the following drugs are used at various stages of IVF and ICSI:

1. Gonadotropin-releasing hormone agonists:

• goserelin (Zoladex);
• Triptorelin (Diferelin, Decapeptyl, Decapeptyl-Depot);
• Buserelin (Buserelin, Buserelin-Depot, Buserelin Long FS).

• Ganirelix (Orgalutran);
• Cetrorelix (Cetrotide).

• Follitropin alfa (Gonal-F, Follitrope);
• Follitropin beta (Puregon);
• Corifollitropin alfa (Elonva);
• Follitropin alfa + lutropin alfa (Pergoveris);
• Urofollitropin (Alterpur, Bravelle);
• Menotropins (Menogon, Menopur, Menopur Multidose, Merional, HuMoG).

• Chorionic gonadotropin(Chorionic gonadotropin, Pregnyl, Ecostimulin, Horagon);
• Choriogonadotropin alfa (Ovitrelle).

• Progesterone (Iprozhin, Crinon, Prajisan, Utrozhestan).

• Dydrogesterone (Dufaston);
• Megestrol (Megeis).

For artificial insemination, all the same drugs can be used as for IVF and ICSI cycles, if it is planned to introduce sperm into the genital tract against the background of induced rather than natural ovulation. However, if insemination is planned for natural ovulation, then, if necessary, only preparations of pregnene and pregnadiene derivatives are used after sperm is introduced into the genital tract.

Artificial insemination: methods and their description (artificial insemination, IVF, ICSI), in which cases they are used - video

Artificial insemination: how it happens, description of methods (IVF, ICSI), comments of embryologists - video

Artificial insemination step by step: egg retrieval, fertilization by ICSI and IVF methods, embryo transplantation. The process of freezing and storing embryos - video

List of tests for artificial insemination

Before starting IVF, ICSI or insemination for the purpose of choosing best method artificial insemination, the following studies are carried out:

• Determination of the concentrations of prolactin, follicle-stimulating and luteinizing hormones and steroids (estrogens, progesterone, testosterone) in the blood;
• Ultrasound of the uterus, ovaries and fallopian tubes by transvaginal access;
• The patency of the fallopian tubes is assessed during laparoscopy, hysterosalpingography or contrast echohysterosalpingoscopy;
• The condition of the endometrium is assessed during ultrasound, hysteroscopy and endometrial biopsy;
• Spermogram for a partner (in addition to the spermogram, a mixed antiglobulin reaction of spermatozoa is performed if necessary);
• Tests for the presence of genital infections (syphilis, gonorrhea, chlamydia, ureaplasmosis, etc.).

• Blood test for syphilis (MRP, ELISA) for a woman and a man (sperm donor);
• Blood test for HIV / AIDS, hepatitis B and C, as well as for the herpes simplex virus for both a woman and a man;
• Microscopic examination of smears from the vagina of women and the urethra of men for microflora;
• Bacterial sowing of smears from the genital organs of a man and a woman for Trichomonas and gonococci;
• Microbiological examination of the separated genital organs of a man and a woman for chlamydia, mycoplasma and ureaplasma;
• Virus detection herpes simplex 1 and 2 types, cytomegalovirus in the blood of women and men by PCR;
• General analysis blood, biochemical analysis blood, coagulogram for a woman;
• General urinalysis for a woman;
• Determination of the presence in the blood of antibodies of types G and M to the rubella virus in a woman (in the absence of antibodies in the blood, rubella is vaccinated);
• Analysis of a smear from the genital organs of a woman for microflora;
• Pap smear from the cervix;
• Ultrasound of the pelvic organs;
• Fluorography for women who have not done this study for more than 12 months;
• Electrocardiogram for a woman;
• Mammography for women over 35 and breast ultrasound for women under 35;
• Consultation of a geneticist for women whose blood relatives have had cases of the birth of children with genetic diseases or birth defects development;
• Spermogram for men.

Indications for artificial insemination

Indications for IVF are the following conditions or diseases in both or one of the partners:

1. Infertility of any origin that is not amenable to therapy hormonal drugs and laparoscopic surgical interventions produced for 9 - 12 months.

2. The presence of diseases in which the onset of pregnancy without IVF is impossible:

• Absence, obstruction or anomalies in the structure of the fallopian tubes;
• Endometriosis, not amenable to therapy;
• Lack of ovulation;
• Depletion of the ovaries.

4. Low sperm motility.

Indications for ICSI are the same conditions as for IVF, but with the presence of at least one of the following factors on the part of the partner:

• Low sperm count;
• Low sperm motility;
• A large number of pathological spermatozoa;
• The presence of antisperm antibodies in semen;
• A small number of eggs received (no more than 4 pieces);
• The inability of a man to ejaculate;
• Low percentage of egg fertilization (less than 20%) in past IVF cycles.

1. From the side of the man:

• Sperm with low fertility (small number, low motility, high percentage of defective spermatozoa, etc.);
• small volume and high viscosity sperm;
• The presence of antisperm antibodies;
• Violation of the ability to ejaculate;
• Retrograde ejaculation (ejection of semen into the bladder);
• Anomalies in the structure of the penis and urethra in a man;
• Condition after vasectomy (ligation of the vas deferens).

• Infertility of cervical origin (for example, too viscous cervical mucus, which prevents sperm from entering the uterus, etc.);
• Chronic endocervicitis;
• Surgical interventions on the cervix (conization, amputation, cryodestruction, diathermocoagulation), which led to its deformation;
• unexplained infertility;
• Antisperm antibodies;
• Rare ovulation;
• Allergy to semen.

Contraindications for artificial insemination

Currently, there are absolute contraindications and restrictions to the use of artificial insemination methods. In the presence of absolute contraindications the fertilization procedure should not be carried out under any circumstances until the contraindication factor has been removed. If there are restrictions on artificial insemination, the procedure is undesirable, but it is possible with caution. However, if there are restrictions to artificial insemination, it is recommended to first eliminate these limiting factors, and only then produce medical manipulations because it will increase their efficiency.

So, according to the order of the Ministry of Health of the Russian Federation, contraindications for IVF, ICSI and artificial insemination are the following conditions or diseases in one or both partners:

• Tuberculosis in active form;
• Acute hepatitis A, B, C, D, G or exacerbation of chronic hepatitis B and C;
• Syphilis (fertilization is postponed until the infection is cured);
• HIV / AIDS (at stages 1, 2A, 2B and 2C, artificial insemination is postponed until the disease passes into a subclinical form, and at stages 4A, 4B and 4C, IVF and ICSI are postponed until the infection enters the remission stage);
• Malignant tumors of any organs and tissues;
• Benign tumors of the female genital organs (uterus, cervical canal, ovaries, fallopian tubes);
• Acute leukemias;
• myelodysplastic syndromes;
• Chronic myelogenous leukemia in terminal stage or requiring therapy with tyrosine kinase inhibitors;
• Blast crises in chronic myeloid leukemia;
• Aplastic anemia of severe form;
• Hemolytic anemia during periods of acute hemolytic crises;
• Idiopathic thrombocytopenic purpura, not amenable to therapy;
• An acute attack of porphyria, provided that the remission lasted less than 2 years;
• Hemorrhagic vasculitis (purpura of Shenlein-Genoch);
• Antiphospholipid syndrome (severe);
• diabetes mellitus with kidney failure terminal stage when kidney transplantation is not possible;
• Diabetes mellitus with progressive proliferative retinopathy;
• Polyarteritis with damage to the lungs (Churg-Strauss);
• Nodular polyarteritis;
• Takayasu syndrome;
• Systemic lupus erythematosus with frequent exacerbations;
• Dermatopolymyositis requiring treatment with high doses of glucocorticoids;
• Systemic scleroderma with high process activity;
• Sjögren's syndrome in severe course;
• Congenital malformations of the uterus, in which it is impossible to carry a pregnancy;
• Congenital malformations of the heart, aorta and pulmonary artery(atrial septal defect, defect interventricular septum, patent ductus arteriosus, aortic stenosis, aortic coarctation, pulmonary artery stenosis, transposition of great vessels, full form of atrioventricular communication, common truncus arteriosus, single ventricle of the heart

• Low ovarian reserve according to ultrasound or the concentration of anti-Mullerian hormone in the blood (only for IVF and ICSI);
• Conditions in which the use of donor eggs, spermatozoa or embryos is indicated;
• Complete inability to bear pregnancy;
• Hereditary diseases linked to the female sex X chromosome (hemophilia, Duchenne myodystrophy, ichthyosis, Charcot-Marie amyotrophy, etc.). In this case, it is recommended to perform IVF only with mandatory pre-implantation diagnostics.

Complications of artificial insemination

Both the artificial insemination procedure itself and those used in various methods medicines can be very rare cases lead to complications such as:

For carrying out any method of artificial insemination, sperm can be used as a partner of a woman (official or common-law husband, cohabitant, lover, etc.) and a donor.

If a woman decides to use her partner's sperm, then he will have to undergo an examination and pass the biological material in the laboratory of a specialized medical institution, indicating the necessary information about yourself (full name, year of birth) in the reporting documentation and signing an informed consent to the desired method of artificial insemination. Before donating sperm, a man is recommended not to have sex for 2 to 3 days and not to masturbate with ejaculation, and also to refrain from drinking alcohol, smoking and overeating. Sperm donation is usually done on the same day that the woman's eggs are collected or the insemination procedure is scheduled.

If a woman is single or her partner is unable to provide sperm, then you can use donor sperm from a special bank. The sperm bank stores frozen sperm samples of healthy men aged 18-35 years, among which you can choose the most preferable option. To facilitate the selection of donor sperm, the data bank contains template cards that indicate physical parameters male donor, such as height, weight, eye and hair color, shape of nose, ears, etc.

Having chosen the desired donor sperm, the woman begins to produce necessary training to artificial insemination procedures. Then, on the appointed day, the laboratory staff defrost and prepare the donor sperm and use it for its intended purpose.

Currently, only donor sperm is used from men with negative HIV tests for the herpes simplex virus in their blood;

For each sperm donor, according to order 107n of the Ministry of Health of the Russian Federation, the following individual card, which reflects all the basic and necessary parameters of the physical data and health status of a man:

Individual sperm donor card

FULL NAME.___________________________________________________________________
Date of birth ________________________ Nationality ______________________
Race ___________________________________________________
Place of permanent registration ____________________________________________
Contact number_____________________________
Education_________________________Profession____________________________
Harmful and/or dangerous factors of production(yes/no) What:_________
Marital status (single/married/divorced)
Presence of children (yes/no)
Hereditary diseases in the family (yes/no)
Bad habits:
Smoking (yes/no)
Drinking alcohol (with frequency ___________________) / do not drink)
Use of narcotic drugs and/or psychotropic substances:
Without a doctor's prescription
(never used/with a frequency of _________)/regularly)
Syphilis, gonorrhea, hepatitis (not sick / sick)
Have you ever had a positive or indeterminate response to an HIV, hepatitis B or C virus test? (Not really)
Is/is not under dispensary observation in the dermatovenerological dispensary / neuropsychiatric dispensary _______
If so, which specialist doctor _______________________________________________
Phenotypic traits
Height Weight__________________
Hair (Straight/Curly/Curly) Hair Color _____________________________
Eye shape (European/Asian)
Eye color (blue/green/gray/brown/black)
Nose (straight/hooked/snub/broad)
Face (round/oval/narrow)
Presence of stigmas____________________________________________________________
Forehead (high/low/normal)
Additional information about yourself (optional)
_________________________________________________________________________
What have you been sick for the last 2 months?
Blood type and Rh factor ________________ (_______) Rh (_______).

Artificial insemination of single women

According to the law, all single women over the age of 18 are allowed to use the artificial insemination procedure in order to have a child. For the production of artificial insemination in such cases, as a rule, resort to the use of donor sperm.

Price of procedures

The cost of artificial insemination procedures varies in different countries and for different methods. So, on average, IVF in Russia costs about 3-6 thousand dollars (together with medicines), in Ukraine - 2.5-4 thousand dollars (also together with medicines), in Israel - 14-17 thousand dollars (together with medicines). ). The cost of ICSI is about $700-1000 more than IVF in Russia and Ukraine, and $3000-5000 more in Israel. The price of artificial insemination ranges from $300 - $500 in Russia and Ukraine, and about $2,000 - $3,500 in Israel. We have given prices for artificial insemination procedures in dollar terms, so that it is convenient to compare, and also easy to convert into the required local currency (rubles, hryvnias, shekels).