وصف
The embryo transfer procedure is the last one of the in vitro fertilization process. It is a critically important procedure. No matter how good the IVF laboratory culture environment is, the physician can ruin everything with a carelessly performed embryo transfer. The entire IVF cycle depends on delicate placement of the embryos at the proper location near the middle of the endometrial cavity – with minimal trauma and manipulation. For IVF, the woman is stimulated with injectable medications to develop multiple eggs. Eggs develop in follicles in the ovaries. When the follicles are mature, the egg retrieval procedure removes eggs from the ovaries. Sperm is added to the eggs and the next day we check the eggs for evidence of fertilization. An appropriate number of embryos are transferred to the uterus several days later – using ultrasound guidance for best placement.
ملخص
- Embryo grading is crucial in IVF due to the less than 100% success rate. It objectively assesses embryo quality, guiding the selection of embryos for transfer. Grading helps manage controllable factors, ensuring no potential cause for cycle failure is overlooked. It also aids in explaining unexplained infertility by identifying poor oocyte or embryo quality.
- The grading process begins on the day of ovum pickup, evaluating oocyte and sperm quality. Post-fertilization, the 2PN stage (2 pro-nuclei) is checked around 17-18 hours, crucial for assessing fertilization success and nuclei status. The number of nucleoli, their arrangement, and the angle beta are important parameters at this stage.
- Embryo development progresses from 2PN to 2-cell, 4-cell, 6-cell, and 8-cell stages. By day 4, the embryo becomes a morula, followed by blastocyst formation on day 5. The blastocyst, with its inner cell mass (ICM) and trophectoderm, is a critical stage for evaluation.
- Blastocysts are graded based on the blastocyl expansion stage (1-4), ICM quality (A-C), and trophectoderm quality (A-C). The best quality is 4AA (expanded blastocyst with high-quality ICM and trophectoderm), while the poorest is 1CC. Higher quality blastocysts have improved implantation and pregnancy chances.
- Embryo transfer is a vital step that impacts IVF success. It's generally done without anesthesia, involving speculum insertion, cervical cleaning, and outer cannula insertion under ultrasound guidance. The embryologist then loads embryos into an inner cannula for gentle deposit near the fundus.
- The embryo transfer procedure should be smooth and non-traumatic, minimizing blood and mucus. Ultrasound guidance ensures accurate placement without touching the fundus. The presence of air bubbles indicates successful embryo deposition. Although rare, there's a small risk of ectopic pregnancy, especially with wide ostea and reverse peristalsis.
نموذج شهادة
حول المتحدثين
Dr. Aanchal Agarwal
MBBS,DGO,DNB,FNB(Reproductive Medicine)MNAMS Senior Consultant Infertility , IVF and Reproductive Medicine Senior Obstetrician and Gynecologist
الإفصاح المالي
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