In vitro fertilization. Contraindications to IVF in women and men

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

A large number of couples who have faced the terrible diagnosis of infertility have already become happy parents today. All this became possible only thanks to scientific developments and many years of experience in test-tube conception. Children born through in vitro fertilization are no different from the rest. And some of them have already become moms and dads themselves, and naturally.

Before deciding on this procedure, it is necessary to determine the presence or absence of contraindications. They can be a reason to delay in vitro fertilization or even cancel it. This is a rather serious process that affects both partners at once. Therefore, it is extremely important to take all the recommendations and prescriptions of the doctor responsibly.

To whom the procedure is performed

In order to take advantage of the opportunity to conceive a child throughin vitro fertilization, you must obtain the approval of a qualified physician. There are certain contraindications to IVF, which somewhat limit the circle of couples who want to resort to this procedure. Indications for in vitro conception are couples who have been diagnosed with infertility (male or female), including unexplained, immunological. If a man has seminal pathologies (doctors still say “defective sperm”), natural fertilization becomes almost impossible. The best option to start in this scenario is to try the ICSI method.

Obstruction of the fallopian tubes or their complete absence becomes a direct indication for IVF. The absence of ovulation is considered a direct indication for artificial insemination. When this procedure has not brought proper results, then the doctor may refer to IVF, which usually turns out to be successful on the first attempt. Naturally, everything is very individual and depends on many factors.

If the couple is just getting ready for the in vitro fertilization procedure, it is necessary to choose a competent and qualified specialist. It is worth being prepared for the fact that success will not be momentary and you may have to go through it more than once. In any case, it is worth maintaining a positive attitude and psycho-emotional balance. Consider IVF as one of the ways to become parents, and not the only chance in life.

How to prepare

Since this method of conceiving a child is very painstaking,responsible and complex, it is important to prepare and follow all the doctor's instructions. If there are no contraindications for IVF, preparations can be started as soon as possible. The basic rule is to be he althy for both partners. Doctors believe, and practice shows, that you can’t just go through IVF and live on with everyday worries. It is very important to take a responsible approach to the moment, try to give up alcohol and smoking, the use of drugs that can adversely affect the development of the fetus.

All existing hereditary and chronic diseases should be told to the doctor. This will allow him to put together a rough idea of what difficulties may arise in the process of fetal development and the woman's carrying a pregnancy in the future. Since IVF conception involves both partners, it is important for them to prepare together and strictly follow all the doctor's instructions.

Another important factor is time. If a couple cannot conceive naturally within a year, a doctor should be consulted to determine the cause. Naturally, the statistics "says" that the younger the spouse, the higher their chances. For example, a couple at the age of 25 who are diagnosed with infertility, the chances of becoming parents through IVF is about 50%, and for those over the age of 30 it is already 25%.

It should be borne in mind that for about 10-15% of couples, the in vitro fertilization procedure will be completely unsuccessful. In this case, you will have to consider alternative methods to become parents: the use of donor cells (sperm and eggs),surrogacy or adoption.

Temporary obstacles

It happens that when IVF is stimulated, contraindications may be temporary. The list contains not only absolute obstacles, but also relative ones, which can be de alt with competently by choosing the right treatment regimen. As a rule, this concerns women's he alth. For example, adhesive process in the pelvic organs. You can get rid of it with the help of laparoscopy. Surgical removal of adhesions allows the couple to conceive naturally without resorting to in vitro conception.

If a contraindication to IVF in a woman is the presence of a liquid formation in the cavity of the fallopian tube, which is an obstacle to implantation, then it is advisable to undergo a course of treatment and then try again to get pregnant naturally. This also includes chronic gynecological diseases, in particular the uterus and appendages.

Uterine fibroids and benign neoplasms in the ovaries also serve as a temporary contraindication. In some cases, their presence does not affect the ability to become pregnant. However, if there is such a diagnosis, the doctor needs to control the size of the tumor during pregnancy and after childbirth. It can cause a threat of miscarriage, fetal growth retardation and premature onset of labor.

The right to become parents protected by law

Since 2014, the legislator has determined that all residents of the Russian Federation can apply for the right to become parents. The basis for this wasIVF order issued by the Ministry of He alth. Contraindications, as well as a complete list of indications, a detailed description of the arrangement of offices and the reasons for the procedure are contained in this document. Therefore, the list of services at the expense of the Federal Compulsory Medical Insurance Fund has been replenished, and now even those who could not previously get a procedure due to the presence of endocrine disease, endometriosis, infertility, uterine fibroids and a number of others can try to become parents of children conceived in a test tube.

It has been scientifically proven that these babies are no different from the rest. There are more than five million of them all over the world. Federal centers take on even the most complex forms of infertility, both male and female.

For future parents who understand legal documents, it is proposed to separately study the provisions of the order of the Ministry of He alth on contraindications to IVF. It is quite detailed and includes, in addition to the above diseases, also:

• diseases caused by the activity of parasites and some infections (tuberculosis of the nervous system and respiratory organs, viral hepatitis, HIV, syphilis);
• any malignant neoplasm;
• diseases of the blood, circulation and blood-forming organs;
• malnutrition, metabolism, endocrine diseases;
• nervous and mental disorders (including hereditary);
• cirrhosis of the liver, liver failure, intestinal fistula;
• diseases of the genitourinary, musculoskeletal system, including the connectivefabrics.

Types of IVF

Depending on the indication for the use of in vitro fertilization, it is customary to distinguish between several ways to carry it out:

• In Vitro Maturation (IVM) - means maturation or maturation in vitro. This term means that an immature egg is taken for the fertilization procedure. In special sterile laboratory conditions, it is placed in a nutrient medium for final maturation. As soon as the eggs reach the peak of maturity, they are artificially fertilized and cultured. At this stage, specialists control the process of embryo development. The advantage for a woman is that she does not have to use a large amount of hormonal drugs. Which in some cases serves as a contraindication to IVF, as such.
• Intracytoplasmic injection (ICSI) - in which specially selected he althy sperm is injected into the egg. The procedure is indicated for couples whose main reason for the impossibility of natural conception is male infertility. The essence of the method is that a thin glass needle with one active spermatozoon is inserted into the inside of the egg. Biomaterial is selected visually.
• A variation of ICSI is the PICSI method. The difference from it lies in a more careful selection of spermatozoa. For this, special tests are used. Only a mature and he althy spermatozoon is taken as a male biomaterial.
• Assisted hatching helps the fertilized eggimplanted in the body of the uterus. Hatching breaks down the thin shell that surrounds the embryo and prevents it from attaching.

Paid or quota?

This question worries many. However, for those couples who want to become parents, the cost of IVF is negligible compared to years of agonizing waiting.

There are two options to undergo the in vitro fertilization procedure: for a fee or under a quota from the CHI fund. The first option is available at any specialized medical center. In large cities, there are a large number of them, and prices differ depending on the level of service. On average, the cost of one procedure is from 110 thousand rubles. For those who do not have the opportunity to pay for the procedure, the state offers to use the service for free in the order of the existing queue.

If there are no contraindications for IVF under compulsory medical insurance, then the couple can apply to the medical institution that got the quota. However, there is a possibility that when contacting a doctor, patients will find out that there are no vacancies for the current year. All that remains for them is to either wait their turn or go to the institution where the quotas are still left. The level of service does not always meet expectations. Therefore, future parents have to either pay for IVF, or wait for the moment when the turn comes to them.

General contraindications

There are contraindications for any medical intervention in the natural processes of the body. And this also applies to IVF. Each case must be consideredsupervising physician, and only he, having a clear idea of the patient's state of he alth, after the studies and analyzes carried out, can give approval for this procedure. In vitro fertilization should be carried out only in a specialized medical institution, after a series of studies of women's and men's he alth.

The first reason that can serve as a contraindication to IVF is the short period of unsuccessful attempts to conceive naturally. In medical practice, it is accepted that the reason for contacting a specialist is the absence of pregnancy during the year. This is the basis for assuming the likelihood of a couple developing infertility.

The cause can be determined after a number of studies that reveal even hidden factors, such as a low-level inflammatory process or the presence of chronic diseases.

How things go

An integral part of the preparation is hormonal stimulation, and therefore it is important that a woman does not have oncological diseases and does not have a tendency to develop them. The duration of the first stage is 2 weeks. A woman is prescribed hormones that contribute to the maturation of the egg. The degree of readiness is determined by ultrasound, then the eggs are removed from the ovary with the help of a puncture, and in the laboratory they are combined with spermatozoa.

The fertilized cell is placed in an incubator for 5-6 days. In case of a successful process, the specialist checks the cell for the presence or absence ofpathologies, genetic abnormalities. If the embryo meets all the criteria, it is transplanted into the woman's uterus using a special catheter. According to the current instructions, for a month after the removal of the egg, the woman continues to take hormonal drugs that minimize the risk of miscarriage.

Effect of in vitro conception

Men have fewer contraindications to IVF. Do not assume that all responsibility lies solely with the woman. The success of the whole procedure depends on the quality of the seed used. Since the cells of both partners are involved in the process of fertilization, it is important to monitor he alth together and follow all the doctor's recommendations.

It happens that during the preparation, temporary contraindications to IVF in a woman were revealed (by quota or for a fee - it does not matter). In this case, it is necessary to immediately begin to treat or eliminate the cause. The more time passes, the less chance of getting pregnant even with IVF.

What is not allowed in preparation for IVF and during it

It is important to pay attention to what contraindications to IVF are in general. Among other things, there are rules of conduct that are binding. First you need to normalize your he alth, give up bad habits, stabilize sleep and avoid stress.

It is worth noting separately that the use of drugs during the preparation and the IVF procedure itself without the consent of the doctor is prohibited. Even if they previouslybrought the desired result. This also applies to the massage mat "Pranamat Eco", a contraindication to the use of which is pregnancy. In extreme cases, it is advisable to clarify with the attending physician the appropriateness of its further use. It is possible that with a successful attempt to get pregnant, it will be allowed to be used only under certain conditions.

It is also worth paying attention to various kinds of dietary supplements, which are now widely distributed on the market. For example, Eco Slim. In the instructions for use in contraindications, the manufacturer indicates that the drug is not recommended for use during pregnancy. Therefore, during the period of planning and preparation before IVF, drugs that affect weight loss should be abandoned.