What hormones are prescribed before IVF. Examinations and analyzes required for IVF

Men have one big advantage over women when diagnosing infertility: the examination is much faster and painless for them (and many women know how important this is for impatient men!)

Therefore, the first analysis that is carried out if infertility is suspected is a spermogram. Based on his findings, the physician as soon as possible can infer the status men's health. The doctor evaluates the quality of sperm - the volume and number of spermatozoa in the ejaculate, their mobility, the ability to move in " right direction". Morphological analysis allows you to assess the correctness of the structure of male germ cells.

If the spermogram shows deviations from the norm, the doctor will immediately be able to prescribe a course of treatment. In many cases, this is the course oral medications that need to be drunk within a few months. And, as the experience of reproductologists shows, very often after a course of treatment married couple in the shortest possible time can conceive a baby.

Preparing for IVF for a man

However, it also happens that conservative methods treatments are not successful. Here it can provide Negative influence and female factor infertility, and disorders in the male reproductive system (in about 40% of cases). Certain pathologies of sperm (teratozoospermia, azoospermia) do not leave a chance for the fertilization of an egg by a sperm in natural conditions.

In such a situation, the methods of assisted reproductive technologies, such as in vitro fertilization (IVF) and its variety ICSI (injection of a spermatozoon into the oocyte cytoplasm), will help an infertile couple become parents. Last Method gives excellent results in severe male factor infertility, since artificial conception in this way requires a single male gamete of proper quality.

However, proper preparation men before IVF and IVF ICSI do not differ in their main stages. The final task of the future pope is to right time donate your genetic material for "in vitro conception". This takes place on the same day and hour that future mother follicles are punctured to obtain oocytes suitable for fertilization. What measures can future parents take so that the preparation gives its result - successful fertilization on the first attempt?

Reviews and a forum where users talk about how they prepared for the in vitro fertilization procedure and what results they got, clearly show that each case is completely individual. It is impossible to transfer a technique that worked for one infertile couple exactly to another - and expect an equally effective result.

Preparation for IVF for a man, like a woman, includes two aspects - physical and psychological. On the " physical level» a man should:

Follow your doctor's instructions (if any) medicines positively affecting the quality of sperm;
if the future dad is prescribed a course of physiotherapy in preparation for IVF, you need to attend the procedures without gaps;
optimize lifestyle: give up bad habits(smoking, alcohol consumption) if present. It is better to refrain from visiting the bath and sauna - overheating has an extremely negative effect on the quality of sperm;
as far as possible, it is necessary to exclude the influence on male body toxins that adversely affect spermatozoa ( harmful production etc.);
it is necessary to prepare a man’s body for IVF by following a certain diet. It is known that certain products have a positive effect on sperm quality. The diet should be balanced, include required amount proteins. Should not be neglected vitamin supplements(but the order of their use should be consulted with a doctor).
moderate exercise, without high power loads, will be useful.

Equally important is psychological readiness spouses for in vitro fertilization. It is no secret that many men are wary and hostile about the need to consult doctors about infertility. Clinics reproductive health among other IVF preparation services, they offer couples consultations with a psychologist.

To start preparing for IVF for a man (as well as for a woman), you also need to pass an extensive list of tests. Some of them rent without fail, others are needed only for individual indications. The list of basic tests before IVF includes:

spermogram, usually given once. The analysis makes it possible to evaluate the qualitative and quantitative indicators of sperm and its suitability for conception;
general blood test (group, Rh factor) - given once;
blood test for HIV, syphilis, hepatitis B and C. The expiration date of this test is three months;
analysis blood PCR for viral antigens herpes simplex, rented once;
smear from the urethra for flora (the analysis is valid for six months);
analysis of PCR discharge from the urethra and ejaculate for cytomegalovirus and herpes simplex virus of the first and second types, shelf life - one year;
sowing on ureaplasma, mycoplasma, chlamydia, these analyzes are relevant throughout the year;
the final conclusion of an andrologist is also valid for a year.

If necessary, the doctor prescribes additional tests before IVF for men. The purpose of these surveys is to eliminate as much as possible possible risks and increase the likelihood of program success artificial insemination. Among the tests that may be needed for IVF is the MAP test - an analysis for the presence of antisperm antibodies. It is indicated if adherent germ cells were detected in the spermogram. At a positive result MAP test natural conception is impossible, ICSI is indicated.

Men over the age of 35 are required to consult a geneticist and karyotyping. The likelihood increases with age genetic disorders, and this analysis must be passed for IVF to clarify the presence or absence of pathologies that can be inherited by the child. If sexually transmitted infections are suspected, an additional PCR study of discharge from the urethra for ureaplasma and mycoplasma is indicated.

At severe pathologies male reproductive system(for example, total absence spermatozoa in the ejaculate), a testicular biopsy is performed. In this way, it is possible to identify germ cells suitable for conception in the tissues of the testis or appendages.

Infertile couples are always interested in how long it takes to prepare for IVF. It depends primarily on the state of health of both partners. Both the woman and the man must be able to provide fertile genetic material. In addition, the expectant mother must be able to endure pregnancy and give birth to a baby.

For men, as part of the preparatory period, a course of drugs that improve sperm quality may be prescribed. The duration of taking these funds can be from three months to six months. After the course of treatment, a second analysis of the spermogram is done, on the basis of which the doctor concludes that the sperm is suitable for the in vitro fertilization procedure.

Abstinence before IVF

The intensity of a man's sexual life is reflected in the quality of his ejaculate. Too frequent sexual intercourse leads to the fact that the number of sperm in the seminal fluid decreases, they simply do not have time to mature to the proper condition. Too rare sex life leads to the so-called stagnation of sperm, which does not in the best way affects its quality.

According to the recommendations of doctors, abstinence before IVF, or rather, sexual life, should correspond to a schedule of about once every three days. Immediately before donating sperm for the in vitro artificial conception procedure, you should abstain from sexual activity.

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Evgenia
I want to express my deep gratitude to Irina Gennadievna Torganova. If not for her, she would hardly have decided on this procedure. I just trusted the doctor, and she told me what to do and how to do it. Sometimes it even seemed that you were left with no choice. But it's not. Irina Gennadievna simply did not give either time or reason for doubt. IVF was done in September 2016. Despite the fact that at that time I was already 40 years old, and the man was 56, everything worked out on the first try and in a fresh protocol. The pregnancy was very easy. Already my Treasure has grown up (we are 1 year and 7 months old) and weighs 17.5 kg and 89 cm. We will grow up a little more and will definitely come to thank all the clinic staff. Thanks to all the staff of the clinic and good luck to those who are now on the way to their happiness or are still doubting whether to carry out the procedure.
Irina
We want to express our deep gratitude to the entire staff of the clinic For birth. After failed attempt IVF in another clinic, we decided to go to this clinic for CHI. Unfortunately the first attempt was unsuccessful. But we did not give up, we still had cryoshes. Thanks to Irina Gennadievna Torganova, the cryo protocol went well. In March 2018, we had a wonderful son and daughter. You are doing a miracle! And give happiness to be parents! God bless you!!!
vita
You know, I can say with confidence that first-class specialists work in the Origin, who appreciate and love their work and take care of their patients. I happened to get acquainted with this clinic in 2017. Before, I could not even think that something like this was possible. I am not a small girl, I turned 30, I heard about eco, but I didn’t go into details. But 30 years crept up unnoticed, and my husband and I have been living for 5 years. We were overtaken by a conversation about children. After talking, we realized that both are ready for procreation. Apparently, at that time, fate laughed very loudly, because in the hospital they told me something like “hey, no, honey, you won’t be able to have children anymore.” I am a positive person by nature and not an alarmist at all. Therefore, having thought over this phrase sensibly, I went directly to the Origin, it so happened that it turned out to be the closest at that time, and I just needed paid clinic. It was there that they told me everything in detail about the eco procedure, about additions and varieties. The next day I dragged my husband there. He listened and agreed. Our doctor: Mazur Sergey Ivanovich. Very cool, given to work to the maximum. I am so glad that after all the torment we found a way out and now we are waiting for the birth of our baby.
Anna
Origin in Moscow - the best clinic that came across in my path. To begin with, in the struggle for the opportunity to have children, I was far from alone. medical center and not in the same clinic. She went through all possible and impossible procedures and studies. treated and traditional medicine, in Russia and abroad, I even went to holy places and kissed the relics. The effect is zero. My first ex-husband He actively supported me in everything, and then he left me and went to a colleague who was pregnant from him. I decided not to give up and keep trying. Finally, the turn came to IVF. The first attempt in one very famous center in Moscow was a flight. The second attempt in the same place - span. The third attempt, on the advice of a friend in Ivanovo, was a success, and the fourth in Origin was a success. Finally, I sighed calmly, I will have children!
Tatiana
We contacted your clinic after long-term treatment from infertility. It was a huge shock for my husband to find out that it was in him that the reason that I could not get pregnant. But the doctors of your center performed a miracle! They returned her husband's faith in himself, and through the ixi procedure, conception nevertheless occurred. Thank you from the bottom of our hearts for our newborn son!
Faith
I tried to get pregnant for five years. In all respects, my husband and I were absolutely healthy. As a result, she was diagnosed with idiopathic infertility. The doctors of your center decided to carry out eco + ixi procedures. My husband and I were carefully prepared and everything went well. highest level. I got pregnant with twins and now we are happy parents. Low bow to you!

The list of necessary tests before IVF at the AltraVita clinic. To exclude contraindications to the IVF procedure and carrying a pregnancy, a married couple is examined.

Print test list Submit test results

Attention! Tests for HIV, hepatitis B and C, syphilis are taken only at the AltraVita clinic upon presentation of a passport.

For woman

once

blood type, Rh factor
determination of antibodies of the Ig M and Ig G class to the rubella virus in the blood - if Ig G is positive and Ig M is negative, then once.
In the absence of immunity to rubella, vaccination is recommended, followed by the determination of antibodies to confirm the development of immunity.

Validity 1 month

clinical analysis blood
urinalysis
smear on the flora from the urethra and cervical canal and degree of cleanliness of the vagina

Validity 3 months

Validity 6 months

Validity 12 months

cytological examination of a smear from the cervical canal and cervix
conclusion of the therapist about the state of health and the possibility of carrying a pregnancy, ECG
ultrasound thyroid gland and parathyroid glands
Ultrasound of the mammary glands (up to 35 years), if pathology is detected - mammography / after 35 years - mammography
expert ultrasound of the pelvic organs

According to indications

study of patency of the fallopian tubes
CA125 before repeat IVF
hysteroscopy, endometrial biopsy (Paipel biopsy) - performed in addition to expert ultrasound to assess the endometrium
blood test for karyotype - once

For a man

once

blood type, Rh factor

Validity 3 months

blood test syphilis (RW), HIV, hepatitis B and C
examination of a smear for flora from the urethra

Validity 6 months

Validity 12 months

molecular biological study (PCR of urethral discharge) for herpes simplex virus type 1.2, ureaplasma urealiticum, cytomegalovirus, chlamydia, mycoplasma genitalium)

According to indications

blood test for karyotype

Before surgery

Validity 1 month

general blood analysis
general urine analysis
hemostasiogram (prothrombin, thrombin time, APTT, fibrinogen concentration)
a smear for flora from the urethra and cervical canal and the degree of purity of the vagina (for women)

Validity 12 months

fluorography or radiography chest with the conclusion
medical consultation, EKG

Consultation of doctors of related specialties according to indications

geneticist
oncologist-mammologist
endocrinologist
psychiatrist
infectious disease specialist

All couples who decide to have a baby need to know what is needed for IVF. Spouses should follow healthy lifestyle life, eating rich in vitamins and trace elements, if possible, exclude alcohol and smoking. They also need to be tested before planning a pregnancy. This will allow to identify and solve existing health problems on the preparatory stage. However, in some cases, conception naturally impossible. In this case, you can contact the AltraVita Center for Reproductive Technologies.

You should be aware that some studies need to be taken, given certain rules. For example, when preparing for IVF, hormone tests should be taken on a certain day of the cycle - it is better to check with specialists about this. In addition, during some examinations it is necessary to exclude physical activity and sexual relations. Tests before artificial insemination must be taken by both partners. In addition, the list necessary research depends on the age of the patient and concomitant diseases. For example, people who have among their relatives patients with diseases that are inherited must undergo genetic testing. There are many nuances that can affect the result, so before taking the tests, you should consult with a specialist.

Artificial insemination is a rather complicated procedure, so a married couple who decides to use the help of the clinic's specialists must thoroughly prepare for conception. To do this, first of all, you should pass tests for IVF.

What tests are needed for IVF?

Pre-pregnancy screening should include the usual set dispensary events, such as consultation with a general practitioner, general clinical examinations and specialized examinations for women and men, such as swabs for genital infections

If a couple suffers from infertility and plans to use ART, then the examination before IVF includes a more extended list. Women are often asked to donate blood for FSH, AMH and other female sex hormones. Men with infertility are advised to be tested for ICSI. Full list analysis for IVF and preparation for ICSI is presented below and is available for printing.

Having received the results complete examination couples, the doctor will determine the time when IVF can be done. To exclude contraindications to the procedure and pregnancy, a married couple is examined.

First of all, patients are invited to undergo an initial consultation with a reproductive specialist, during which a plan is drawn up for examining and correcting the identified violations as part of pregnancy planning. The doctor will also determine which tests to artificial insemination need to be handed over. There is a mandatory examination (in accordance with the order of the Ministry of Health of the Russian Federation of August 30, 2012 No. 107n “On the procedure for using assisted reproductive technologies, contraindications to their use”) and examination according to indications.

If a couple is recommended in vitro fertilization, then both partners will have to undergo examinations and take tests. A man can avoid them only if fertilization with donor sperm is planned.

If conception is planned to be carried out using biological material the man himself, then there is no escape from the analyzes. In this article, we will tell you what tests future dads need to take before IVF with their wife, as well as where and how best to do them.

Participation of a man in IVF

In vitro fertilization means conception, which will not take place in maternal organism, but in a test tube. For conception, as in the case of natural conception, two sex cells are required - male and female. The eggs of the woman are collected by puncture after preliminary hormone therapy. The man donates sperm himself, having received it by masturbation.

If the amount of sperm is pathologically low or ejaculation does not occur at all, spermatozoa can get surgically directly from their seminal ducts.

A man can become a sperm donor for his own wife in most cases, with the exception of total cases of infertility - in the absence of testicles from birth or as a result of trauma, in the complete absence of live spermatozoa and their affected DNA.

In all other cases, a man can become a dad, and modern reproductive technologies will help him in this. Even with the prevailing number of dead sperm, doctors can get only 1-2 absolutely healthy and mobile sperm in order to apply the ICSI method (insertion of sperm with a thin hollow needle under a microscope directly under the shell of the egg). If the sperm cells are dead, but the DNA is preserved in them, the chances of high-tech medical care are preserved.

In order to plan the method of fertilization and the IVF protocol, the reproductologist must clearly understand what are fertile functions a man and his state of health in general, because the viability of the resulting embryos directly depends on how high-quality DNA material from the father’s side the future mother’s egg fertilized by sperm will receive. That is why a man needs to be tested.

List of required tests

Before IVF with his wife, the husband needs to visit any clinic where it is possible to make a spermogram. It is best to do it in the clinic where it is planned to carry out the in vitro fertilization procedure itself.

Spermogram - key analysis, which gives the doctor a complete picture of the composition and quality of the ejaculate. Male germ cells will be evaluated in many ways - viability, mobility, morphological properties, activity. You will have to do a spermogram more than once, because sperm changes its composition over time.

Usually, the first analysis is taken before IVF planning, and the second - at the time of the start of the IVF protocol. The analysis is paid, it costs about 1-1.5 thousand rubles.

Since men are usually very busy and do not have enough free time in order to run around the doctors with jars, you should optimize your time costs as much as possible.

It is best to do the entire range of necessary tests in one clinic. It will not take much time, you will not have to sit in queues and be late for work. It will be enough to come at the appointed time, pay for laboratory tests and a doctor's appointment, and do all the necessary research.

If the family cannot afford to pay for each test, almost all tests from the list presented can be done at the polyclinic at the place of residence, but in this case there will be no optimization - the examination will take a lot of time. All research is done on compulsory medical insurance policy in the clinic, except for the spermogram. You will have to pay for it anyway.

Additional tests

They can be prescribed by a doctor on an individual basis. This could be a blood test for hormones or an ultrasound. prostate- it all depends on which of the spouses turned out to be infertile and what are the forecasts for the success of IVF in a particular case.

Men who are over 35 years old, together with their spouse, are required to visit a geneticist to do karyotyping tests - the risks of fetal chromosomal abnormalities increase not only with the age of the woman, but also with the age of the man.

If there were several IVF attempts and all of them were unsuccessful, a man and a woman at any age need to do it together genetic analysis, which allows you to set partner compatibility. In order not to waste time and money on ineffective protocols, it is better to do such an analysis at any medical genetic center or family planning center even before the first IVF. Because of genetic incompatibility pregnancy does not occur in 5% of cases.

The minimum list of tests for men before IVF is contained in the attached video.

Preparation for the in vitro fertilization procedure involves numerous examinations aimed both at finding out the cause of infertility and at eliminating factors that can become a contraindication to IVF. Scroll mandatory tests is fixed in one of the main documents regulating ART in Russia – the Order of the Ministry of Health “On the procedure for using ART”.

The order was adopted in 2013, since then no changes have been made to the list of analyzes, therefore the list of 2015 is also relevant in 2016 - for receiving or joining the program. All studies are divided into two groups: to identify indications for the use of ART and to determine contraindications. We list them, indicating the average cost in Moscow clinics and laboratories.

Studies to determine the causes of infertility and indications for ART

The need for a detailed examination before IVF is defined by law

1. Blood test for group and Rh factor (from 550 rubles).

2. Assessment of the endocrine status; first of all, study hormonal background. Blood for hormones is donated on day 3-5 of the cycle, with the exception of progesterone and estradiol, which are taken on day 20-22 ( best option- one week after ovulation). The day before the test, it is important to exclude smoking, alcohol and emotional stress, give up physical activity and from taking certain drugs (their list is discussed with the doctor). Blood is taken on an empty stomach, in the morning.

follicle stimulating hormone;
luteinizing hormone;
estradiol;
growth hormone;
prolactin;
thyroid hormones (T1-T4 and TSH);
progesterone.

Addition to laboratory research are instrumental - transvaginal ultrasound to examine the uterus and ovaries.

average cost analysis to determine the level of one hormone - 550 rubles. Many clinics offer comprehensive programs Women's hormonal profile(from 5000 rubles)

3. Evaluation of the patency of the pipes. It is done primarily by instrumental research- laparoscopy and hysterosalpingography.

4. Study of the state of the endometrium. The main method - involving research inner surface uterus and biopsy diagnostic curettage) with histological examination.

Identification of contraindications

Contraindications to in vitro fertilization - both absolute and relative - are common diseases, therefore, everyone who plans to enter the ART program needs to do an ECG, fluorography, ultrasound abdominal cavity, thyroid gland and small pelvis, get the opinion of the therapist and narrow specialists, if any chronic diseases. Women over 35 should have mammography results on hand, and women under 35 should have an ultrasound of the mammary glands. In addition, you need to pass a number of tests.

1. Analysis for the presence of antibodies. A number of diseases, while not dangerous in a normal situation, during pregnancy can have a serious negative effect on the fetus. To assess the degree of risk, blood tests for the presence of antibodies to the following diseases(from 550 rubles):

herpes virus;
toxoplasmosis;
rubella.

2. Blood for HIV, syphilis, hepatitis. The cost of one analysis is from 500 rubles. Some laboratories offer comprehensive programs that include the determination of HIV, hepatitis, and syphilis in the blood. Price - from 1700 rubles.

3. Clinical and biochemical analyzes blood, which allow to identify common diseases, disorders in work individual bodies. The price is from 700 rubles. for clinical analysis up to 5500 for advanced biochemistry.

4. to assess blood clotting (1200-3500 rubles, depending on the set of indicators).

5. A smear on the flora to assess the cleanliness of the vagina and the absence (or content in normal amount) microorganisms such as:

yeast;
trichomonas;
streptococci, staphylococci;
gonococci;
coli.

The cost of the study itself starts from 500 rubles, you will have to pay separately for the collection of material (from 400 rubles)

6. Examination for the presence of urogenital infections and chronic infectious diseases involving a smear. The doctor collects biomaterial from the mucosa, after which it will be studied PCR methods or RIF. Before taking a smear, it is important to refrain from sexual intercourse, not to use vaginal tablets, candles, douching. This method reveals:

It makes sense to pass comprehensive study, since it involves taking one smear for all indicators. average price complex - from 3200.

7. Complete urinalysis to assess kidney function and the absence of infection in bladder(from 200 rubles)

8. Colposcopy with (from 1200 rubles)

If deviations are found in the analyzes, do not panic. Most of the contraindications are relative, that is, you can join the program after eliminating the factors that can negative impact. For example, in the absence of antibodies to rubella, a vaccination is recommended, three months after which you can start the IVF procedure.

List of studies for men

The list of tests that are needed for IVF has also been compiled for men. Most of them coincide with the "female" version, but there are some features. Like women, they need to get the results of fluorography and the opinion of the therapist. In the list of laboratory tests:

blood test for Rh factor and group;
antibodies to HIV and hepatitis;
analysis for syphilis;
urogenital infections - necessary tests the same as for women;
a smear on the flora from the urethra;
determination in the blood of antibodies to the diseases listed above;
. If it is found, another study is prescribed - an antiglobulin reaction. The basic cost is from 1500 rubles.

Tests after IVF

After unsuccessful IVF appointed additional examinations to identify the causes

The first analysis that a woman needs to pass after the in vitro fertilization procedure is, which is given about two weeks (sometimes on day 12) after the transfer has been made. Its results allow us to conclude whether the pregnancy has occurred or the attempt was unsuccessful.

After a failure, it is first of all important to find out its causes, so that when you try again to minimize the action. negative factors and increase the chances of a favorable outcome. Therefore, it is possible that a doctor will be appointed additional research. Their list might look like this:

An analysis for the presence of antiphospholipid antibodies, which is prescribed to diagnose diseases of the immune system.
Detection of antibodies to hCG. The reason for their formation in the body is not fully understood, but the mechanism of action is known: antibodies disrupt receptor binding corpus luteum and chorionic gonadotropin, which leads to a change in hormonal levels and termination of pregnancy.
to determine tissue compatibility antigens in both spouses.
Immunogram for the study of cytotoxic cells.
Extended hemostasiogram with determination of lupus coagulant, D-dimer and other criteria.
Revealing chromosomal disorders by studying.

Unlike those listed above, these tests are not mandatory and are prescribed at the discretion of the doctor only after an IVF attempt (or several attempts) has failed.

Validity periods

Each assay has an "expiration date". It refers to the period during which these studies are considered valid and relevant. If more time has passed since the date of delivery, you will have to take the tests again to receive a quota or enter the CHI program. Let's list the deadlines.

One month:

smears for flora;
blood tests for biochemistry and clinical;
Analysis of urine;
hemostasiogram.

Three months:

blood for syphilis and hepatitis;
blood for HIV.

Six months:

ELISA (antibodies to rubella, toxoplasmosis, genital herpes);
PCR (urogenital infections);
spermogram.

One year:

smear for oncocytology;
hormonal studies;
fluorogram;
electrocardiogram;
data from pipe patency studies;
Ultrasound and mammography.

They do not have an expiration date and are performed once for the group and Rh factor, as well as karyotyping.

Mandatory examinations before IVF

Where to get tested

Tests that are mandatory for participation in compulsory medical insurance programs and for obtaining a quota can be taken free of charge, with a referral from a local therapist or from a gynecologist from antenatal clinic. This option is inconvenient in that it takes a lot of time, since most studies are done by appointment. You will have to very carefully and accurately calculate the timing of the tests, so that all of them are valid by the time the documents for IVF are submitted.

The second option is convenient, but expensive: paid testing in the clinic where the procedure will be performed, or in independent laboratories. Many clinics today offer comprehensive programs, the cost of which may include specialist consultations. The average cost of the complex - from 30 000 rubles per spouse, it does not include instrumental manipulations and some actions for taking material (for example, a smear for oncocytology).

Finally, the third option is a combination of free and paid analyzes. Some studies make sense to go to the laboratory in the direction of the antenatal clinic (for example, general analyzes blood and urine, biochemistry). Others, especially complex and demanding special equipment, - in a paid clinic.