Dynamics of hCG after IVF: what the test shows by day. How is the follicle puncture performed during IVF? What to do before IVF puncture

When carrying out artificial insemination, the collection of eggs is one of the most important tasks. It is assumed that only a successful follicle puncture during IVF will contribute to the further successful implementation of the event and the use of all chances for conceiving a baby.

Description of the procedure

Doctors note: ovarian puncture during IVF is the process of taking mature eggs. During the event, a special hollow needle is used. Mandatory control is carried out using a vaginal ultrasonic sensor.

What is impossible after the puncture of the follicles:

• after the fence, it is recommended to refuse to drive vehicles;
• from working with equipment that requires increased attention;
• excessive emotional stress;
• sexual contacts;
• visits to saunas and baths;
• an overly active lifestyle.

In order to later be able to implant the optimal number of fertilized embryos and increase the chance of conception, it is recommended to initially create the necessary support for the female body.

When does menstruation begin after follicle puncture? The procedure is carried out with mandatory monitoring of the hormonal system and the state of the uterus, since the body of each girl is unique.

Physiology indicates that menstruation should be on the third or fifth day. Only after menstruation passes, conception becomes possible.

Features of the procedure

Doctors carry out the event taking into account certain specific points. Compliance with standards determines the potential outcome.

How is an ovarian puncture done with IVF:

1. the woman arrives at the clinic at the set time;
2. pre-empty the bladder, defecate with an enema;
3. the patient changes clothes and goes to the operating room;
4. if the procedure is performed without the use of anesthesia, the girl takes an anesthetic an hour before the event or agrees to an intramuscular injection. When using anesthesia, a special catheter is used through which a certain medication is delivered;
5. the main stage lasts about 15 - 20 minutes. For control, an ultrasonic sensor and a special hollow needle are used. For safe extraction, a pump is used that allows you to carefully suck out the follicular fluid;
6. anesthesia with a catheter is terminated after the needle is withdrawn.

The correct procedure contributes to the successful collection of eggs for their further fertilization.

Follicle puncture during IVF, which involves the collection of eggs, is one of the most important stages in the treatment of infertility.

The event largely determines how effective subsequent actions will be. Compliance with the recommendation by a woman helps to increase the chance of a long-awaited motherhood in the near future.

Important questions about artificial insemination

What size should the follicles be before puncture? When conducting, cells of 18 - 22 millimeters are more often removed. In this case, the minimum allowable size is 10 mm. It is important to note that in rare cases, only 1 follicle is removed during puncture, which may already contain an egg. Size is not the only indicator that determines the further outcome of IVF.

The norm during artificial insemination still provides for the extraction of material for the development of several embryos. For artificial insemination, replanting of oocytes (immature eggs) is not recommended.

What to take with you to the puncture of the follicles? It is advisable to take with you:

• robe;
• nightgown;
• slippers.

After the procedure, a calm regimen is recommended, and the first couple of hours should be spent in the hospital under medical supervision of the patient's state of health. Doctors note that if a woman has a cold or she is afraid of intervention, the chances of success are significantly reduced.

Does ovulation occur after follicle puncture? If a crucial stage of artificial insemination is scheduled for tomorrow, care should be taken to ensure that the woman has matured several eggs. For this, ovulation is stimulated, which occurs only after the collection of material for the development of embryos. At the same time, recommendations regarding the use of special drugs to increase the effectiveness of IVF should be followed by the expectant mother. If ovulation passes before the set time, the procedure loses its meaning.

Do I need to shave before follicle puncture? The issue of bikini hair removal is decided on an individual basis. In the memos, among the recommendations, there is an item regarding a complete intimate shave. Recently, however, doctors have appointed a day when the follicle puncture will take place, but they do not advise shaving to zero.

Further actions

After the event, you need to take care of further support for the female body.

What to do after follicle puncture:

1. Rest is recommended on the first day. Any load becomes undesirable;
2. the day before the event is a crucial period when a girl is recommended to switch to light and healthy foods. At the same time, nutrition after follicle puncture remains important;
3. taking all prescribed medications is mandatory with strict adherence to time. If you need a dropper, you need to arrange a visit to the clinic with a doctor.

The patient is advised to record all her symptoms. Undesirable signs are severe pain in the lower abdomen or lower back, fever, profuse discharge, vomiting, nausea, urinary incontinence, diarrhea or diarrhea. Even if only one fertilized egg was taken, medical care becomes mandatory.

IVF is a serious period for every girl who dreams of motherhood. For this reason, preparation for each new stage before pregnancy is carried out under the watchful supervision of a doctor.

What can you eat after follicle puncture? First of all, it is recommended to observe the optimal drinking regimen (2 - 3 liters of water per day) to maintain the good condition of all organs.

Proper nutrition provides for the obligatory rejection of canned food, frozen meat and fish products, semi-finished products, products with food coloring, sweets, strong drinks (coffee, tea), sweet soda.

The menu is allowed to include:

• lean meat;
• fish and seafood;
• eggs;
• dairy products: cheese, cottage cheese, yogurt;
• bread (grain and wholemeal flour);
• vegetables;
• fruits and berries;
• freshly prepared juices and compotes;
• vegetable oil (sunflower, olive, corn).

Only proper nutrition, rich in vitamins and nutrients, will contribute to the maximum support of the female body.

Is it possible to eat before a puncture? The last meal before the procedure should take place at 18.00 on the eve of the scheduled event. In the morning it is not recommended to eat for a quality fence.

Each patient should understand the scheme according to which preparatory measures are carried out and how the chances of a successful outcome can be increased.

How to take an egg for IVF from a woman:

1. the patient follows advice on preparatory activities that start a few days before the appointed date;
2. sampling in the clinic;
3. the final stage includes mandatory monitoring of the woman's condition.

Each period is truly important for the expectant mother.

How many eggs are taken during a puncture? The standards stipulate that about 10 - 20 follicles are required for IVF. Successful fertilization does not occur in every case. In addition, the resulting embryos may stop in their development. Taking into account the fact that egg collection for IVF determines the effectiveness of the subsequent event, it is recommended to take hormonal drugs to stimulate ovulation in the expectant mother.

On what day do stimulations make a puncture during IVF? Specialists individually determine the most suitable day of the cycle for the procedure with the obligatory control of the menstrual cycle. Experts note that brown discharge is allowed after follicle puncture, but heavy bleeding is highly undesirable. After the procedure, it is advisable to stay in the clinic under the supervision of a doctor for at least two hours.

How to prepare for follicle puncture during IVF? Effective preparation includes following these guidelines:

• refusal of intimate relationships for 4 - 5 days;
• taking into account advice regarding the mode of eating and drinking;
• timely arrival at the clinic with all the necessary things.

Such preparatory activities increase the chances of success.

Can follicles burst before puncture? Doctors must monitor the condition of the eggs, as they should not overripe. To control growth, it is recommended to take regular tests and take special medications. If one follicle burst before the puncture, the effectiveness of the event may still be high.

Ways to increase the chances of successful fertilization

After the procedure, you should worry about increasing the chances of further conception.

Can I drink alcohol after follicle puncture? Experts allow you to drink 1 - 2 glasses of quality wine. However, if anesthesia was used during follicle puncture and there are contraindications, it is advisable to refuse alcohol.

How to behave after the puncture of the follicles? On the first day, a woman may notice moderate pain in the lower abdomen, which is normal due to the use of a special needle for egg collection. When symptoms appear, it is undesirable to take drugs on your own, since subsequently there is a risk of smoothing the picture of the complication.

If an elevated temperature after follicle puncture is accompanied by pain, it is required to consult a doctor as soon as possible to undergo a diagnosis and take the necessary actions to improve well-being. At the same time, after follicle puncture, a temperature of 37 C can be a normal indicator, since the body responds to the intervention. Calmness and observation of well-being are mandatory requirements for those who dream of motherhood.

When can I have sex after follicle puncture? The last sex before the follicle puncture can take place 4-5 days before the event. After egg retrieval, intimate rest is required.

Most often, sexual activity resumes after a month, but the complications that appear can delay the long-awaited moment of sex with a spouse. Doctors are guided by the consequences of the puncture of the follicles, the state of the woman's health, stool disorders (constipation or diarrhea), pain and discomfort to provide other advice.

Introduction.
It is important to remember that there are no two identical patients, there is no single examination and treatment scheme suitable for all, several IVF attempts can differ significantly even in the same patient. The tactics of conducting each IVF attempt, preparation for it, the choice of drugs are determined individually. That is why you may face the fact that, for example, the second IVF attempt will be different from the first, as well as from what can be offered to other patients. It is precisely because of this that it is not worth comparing the results of examinations, the methods used with what is recommended for other patients, even if, as you think, you have a lot in common. We should not forget that for many patients the need to resort to IVF is a strong psychological stress, and discussion of such problems can be very unpleasant for them.

What can improve the effectiveness of the treatment

Women:

For men:

Some explanations for the treatment of infertility by IVF:
Oddly enough, treatment may begin up to a month earlier than the scheduled treatment cycle. The preparation methods described below are not mandatory, their application is determined individually.

How to prepare medicine and inject

1. Wash your hands well.

Preparation for puncture of follicles.
The next 3-4 days before the puncture - sexual rest. On the eve of the puncture - a light lunch, in the evening - tea. In the morning on the day of the puncture, you can neither eat nor drink. It is advisable not to smoke on this day, not to chew gum.

On the day of the puncture
At the clinic, you will be taken to a room where you will change clothes, an anesthesiologist will talk to you, after which you will be taken to the operating room. Follicular puncture is performed under general intravenous anesthesia. On average, the puncture takes 15-40 minutes, depending on the response of the ovaries, the number of follicles.

• Increasing the size of the abdomen
• Severe stool disorders
• Nausea, vomiting
• Unusual back pain

• intimate relationship
• Sports
• Mastering new sports
• lift weights

Pregnancy test.

• Terminated pregnancy
• Lab error.

Introduction. We advise you to read these recommendations before starting your IVF treatment. This will save you from having to ask yourself a lot of questions, the search for answers to which can be difficult.
It is important to remember that there are no two identical patients, there is no single examination and treatment scheme suitable for all, several IVF attempts can differ significantly even in the same patient. The tactics of conducting each IVF attempt, preparation for it, the choice of drugs are determined individually. That is why you may face the fact that, for example, the second IVF attempt will be different from the first, as well as from what can be offered to other patients. It is precisely because of this that it is not worth comparing the results of examinations, the methods used with what is recommended for other patients, even if, as you think, you have a lot in common. We should not forget that for many patients the need to resort to IVF is a strong psychological stress, and discussion of such problems can be very unpleasant for them.
With a high degree of probability, we can assume that you will be assigned some preliminary examinations. To optimize your visit to the clinic for these tests, it is recommended to find out in advance what tests will be needed, whether an appointment is needed, what time you need to be at the clinic, whether these tests are performed on an empty stomach, and also whether the result of these examinations depends on the day of the menstrual cycle.
Infertility treatment with assisted reproductive technologies is carried out on the basis of your written applications, as well as informed consents, which must be filled in by you before the start of treatment.

What can improve the effectiveness of the treatment

Women:

• stop independent ("for general health") medication, bioactive food supplements. If you are prescribed any treatment, please let us know before starting the IVF cycle.
• take a multivitamin, preferably designed for the period of pregnancy (prenatal vitamins), vitamin E, folic acid (the need and mode of administration is at the discretion of your doctor).
• limit or stop smoking, drinking alcohol, as these factors can reduce the likelihood of pregnancy, increase the risk of miscarriage.
• limit the intake of drinks containing caffeine.
• Do not start a new diet or try to lose weight during an IVF treatment cycle. During this period, it is best to have a balanced, wholesome diet.
• refrain from sexual activity 3-4 days before follicle puncture, as well as in the period after embryo transfer until pregnancy is diagnosed. In the event of pregnancy, sexual rest should be maintained for a few more weeks.
• avoid significant physical exertion, as well as intense sports. Extreme sports, equestrian or cycling are best off for this period. Moderate physical activity, walking in the fresh air will be useful.
• to refuse for this period from visiting the bath, sauna, taking baths.

For men:

• An increase in temperature for several days with any disease, such as a cold, can adversely affect spermogram parameters. If you have had a fever or if at the beginning or during treatment you have had an illness, even in a mild form, inform your doctor.
• Visiting the sauna or taking a hot bath before treatment is undesirable due to the negative impact of high temperatures on spermatogenesis, as well as on sperm quality. Refrain from visiting the bath or sauna for 1 - 2 months before the start of IVF.
• Try to stop smoking and drinking alcohol 2-3 months before starting IVF fertility treatment.
• If you are a carrier of any viral infection, then in case of an exacerbation of the viral process, if external manifestations appear, notify your doctor.
• If you visit a sports club, then you should not start a new program, master new sports.
• American experts recommend limiting health jogging to a total of 35 kilometers per week during IVF treatment.
• Despite the absence of a reliably proven relationship between wearing tight underwear and poor sperm quality, experts from the WHO and the American Society for Reproductive Medicine recommend refraining from wearing such underwear during the IVF program.
• Sexual rest for at least 3, but not more than 6-7 days, before the day of transvaginal puncture of the follicles and, accordingly, the delivery of sperm.

Some explanations for the treatment of infertility by IVF:

Oddly enough, treatment may begin up to a month earlier than the scheduled treatment cycle. The preparation methods described below are not mandatory, their application is determined individually.
You may be advised to take hormonal contraceptives that belong to the class of monophasic combined oral contraceptives (eg, logest, silest, femoden). These drugs are prescribed to suppress ovulation in this cycle, prevent the appearance of ovarian cysts, better prepare the endometrium for treatment, for a more predictable period for the onset of menstruation, which allows more accurate treatment planning.
If hormonal contraceptives are not prescribed, then an ovulation test (clearplan, ovuplan, frau test) may be recommended. A few days after ovulation is confirmed, you will be asked to undergo an ultrasound examination to assess the quality of the endometrium, the condition of the ovaries.
It is also common to perform a trial "embryo transfer" in a previous cycle. Of course, no embryos will be used in this case. In order for the real embryo transfer procedure to be as effective as possible, in the middle of the second phase of the menstrual cycle, the doctor simulates the embryo transfer procedure by passing a special embryonic catheter through the cervical canal. This will allow you to clarify in advance the direction of the cervical canal, possible bends, and determine the likely difficulties during its passage. Some clinics do this for all patients without fail, some do not use this manipulation, this is largely determined by the preference of your doctor, as well as your medical history, the condition of the cervix.
All drugs used to stimulate the ovaries are made in the form of injections. Every day, preferably at the same time, you will need to do subcutaneous injections in the abdomen at the navel if drugs such as diphereline, decapeptyl, puregon, gonal-f, follistim, orgalutran, cetrotide or antagon are prescribed. You will have to master intramuscular injections if you are prescribed one of the following drugs: Pergonal, Menogon, Metrodin, Bravel, Repronex.
When you buy these medicines, the package will contain an ampoule with sterile water and a vial of powder. To avoid confusion, ask the nurse at the clinic to explain how to dilute the powder medicine and give the injection.
During this course of injections, you will need to visit the doctor every 2-3 days for an ultrasound examination to assess how the ovaries are responding, how many follicles have appeared and how they are growing. This is called ultrasonic monitoring. This is done to ensure that you receive the minimum required dose of medication, sufficient to obtain several good mature eggs.
Gradually, closer to the end of stimulation, you may begin to feel heaviness in the lower abdomen, a feeling of fullness in the abdomen may appear - these are quite likely consequences of the treatment, because often the ovaries are enlarged. If this happens, be sure to inform your doctor.

How to prepare medicine and inject

1. Wash your hands well.
2. Prepare everything you need for the injection: medicine, an alcohol swab for injections (sold in all pharmacies), a separate needle from a syringe, an insulin or regular syringe.
3. Open the ampoule with sterile water, put a needle on the syringe, draw water into the syringe. To collect all the water from the ampoule, lower the syringe needle to the bottom of the ampoule.
4. Remove the plastic plate from the cap of the medicine vial, pierce the rubber stopper with a needle without removing it from the syringe and inject water inside.
5. The powder dissolves almost instantly, resulting in a clear solution, without foam or clots. If the solution is cloudy or does not dissolve evenly, it is best not to use this portion.
6. Without removing the needle, turn the vial upside down, pull out the needle so that only the tip of the needle remains inside the vial and pull the drug solution into the syringe.

   If you are prescribed several ampoules of drugs at the same time, for example, 3 ampoules of puregon, then simply repeat steps 4-6 with the same water for injection. Thus, you will get a small volume of liquid containing the required amount of medicine and you will be relieved of the need to inject excess water with the medicine.

7. Disconnect the syringe from this needle and put a new sterile needle on it.
8. Turn the syringe vertically with the needle up and, gently tapping the syringe with your finger (so that air bubbles gather at the needle), gently and gently press the plunger of the syringe so that the air comes out of the syringe.
9. Choose an injection site. For subcutaneous injections, abdominal areas are used on both sides of the navel, on the right and left, alternating sides every day.
10. Wipe the selected area with an alcohol wipe several times.
11. Take the syringe with one hand and hold it at an angle to the skin of the abdomen, with the thumb and forefinger of the other hand, grab the skin fold of the treated area near the navel.
12. With a quick movement, insert the needle into the skin to the base, slowly inject the solution with the medicine.
13. Release the skin and before withdrawing the needle, press the injection site with an alcohol pad.

Remember that the last injection, the final stage of controlled stimulation of superovulation - an injection of human chorionic gonadotropin (pregnyl, profazi, horagon) necessary for the final maturation of eggs, as well as to prevent ovulation, should be done 34 - 37 hours before puncture. In this case, the effect of the drug is most optimal. This is a very important condition, which largely ensures the production of high-quality eggs. Accordingly, this injection is given in the evening the day before the puncture. For example, if the puncture is scheduled for 09.00 am on Monday, then the optimal time for the injection would be 23.00 on Saturday.

On the day of the puncture.

At the clinic, you will be taken to a room where you will change clothes, an anesthesiologist will talk to you, after which you will be taken to the operating room. Follicular puncture is performed under general intravenous anesthesia. On average, the puncture takes 15-40 minutes, depending on the response of the ovaries, the number of follicles.
During or after the puncture, your spouse donates sperm.
After the puncture, you will be taken to the ward where you will spend 1-2 hours. During this time, you will finally “wake up” after anesthesia, come to your senses, your doctor will tell you how the puncture went, how many eggs were received, what quality of sperm, you will be given further recommendations. Your spouse must wait for a message that the received sperm is suitable for further embryological work, otherwise, a second donation of sperm may be required.
Some time after the puncture, when you already feel normal, you can eat and drink tea. On this day, given the previous anesthesia, patients are not allowed to drive a car on their own.
On this evening, it is not recommended, in addition to driving a car, to drink alcoholic beverages, make important decisions, and have a sexual life.
At home after the puncture it is better to rest, lie down. This evening you may have tension, soreness in the lower abdomen, there may be slight bloody discharge from the genital tract, perhaps a slight increase in temperature.

Tell your doctor immediately about the following symptoms:

• Significant and prolonged temperature increase
• Severe vaginal bleeding
• A pronounced or increasing feeling of discomfort, a feeling of fullness in the abdomen
• Increasing the size of the abdomen
• Difficult or painful urination, burning sensation when urinating
• Severe stool disorders
• Nausea, vomiting
• Sharp or shooting pain in the lower abdomen
• Unusual back pain

From the day of the puncture, you will be prescribed new drugs aimed at maintaining the second half of the menstrual cycle, contributing to the progression of the pregnancy.

Embryo transfer is usually carried out 2-3 or 5-6 days after the puncture. Transfer time is not as important as puncture time. This painless procedure is performed with a special soft, thin catheter. Before manipulation, in case of excitement, you can take a sedative, often, in addition to this, no-shpu is prescribed.
After you sit on the chair, a mirror will be inserted into the vagina, the vagina and cervix will be treated with sterile water or saline, then a catheter will be inserted into the uterine cavity under ultrasound control, through which your embryos will be delivered to the uterine cavity. The number of transferred embryos in each case is discussed individually and must be agreed with you. After the transfer, the embryologist necessarily examines the catheter under a microscope in order to check that there are no embryos left in the catheter.
Once the embryo transfer has been completed, you may be allowed to go home immediately, as this has not been shown to reduce the chance of pregnancy. although most clinics still prefer to let you lie down for 1-2 hours after the procedure. On the way home or already at home, you may have slight bleeding - you should not be afraid of this, of course, this is not a “falling out” of embryos from the uterine cavity.

• Take a hot bath or go to the swimming pool for the first 2 days after the transfer
• Use hygienic tampons
• intimate relationship
• Sports
• Mastering new sports
• Take any non-prescribed medication
• lift weights

Try to keep yourself busy during the two weeks between embryo transfer and pregnancy test.

Pregnancy test.
Available for 13-14 days after embryo transfer. To do this, you need to come to the clinic on an empty stomach and donate blood from a vein. Basically get clearly positive or negative results.
If you get a negative (negative) answer, this means that, unfortunately, pregnancy did not occur in this attempt. The first thing to do in this case is not to despair and remain confident that you will still get pregnant, for example, in the next attempt. And this time you stop taking all prescribed drugs, wait for your period and after a while apply for a second consultation for further recommendations. Menstruation that came on the background of the withdrawal of these drugs may differ from normal menstruation - be longer, more painful, more plentiful, and may pass as usual.
If a positive answer came, accept congratulations on the pregnancy. You should definitely continue taking all your medications. After a week or 10 days - depending on the policy of the clinic - you come for an ultrasound examination. This is extremely important, since in this case a fetal egg will be detected, its localization (uterine or ectopic pregnancy) will be determined, and also, if several embryos were transferred, how many embryos have “taken root” and are developing.
But sometimes there are "weakly positive" answers. This may be due to the following:

• Late but normal embryo implantation
• Terminated pregnancy
• Ectopic (ectopic) pregnancy
• Lab error.

In all of the above cases, further ultrasound and hormonal monitoring is extremely important to clarify this situation.

Pregnyl is a hormonal drug that contains human chorionic gonadotropin (hCG). The drug is available in two dosages: 1500 and 5000 OM. The drug is used to correct hormonal disorders in the reproductive sphere in both women and men.

The process of growth and maturation of the follicle occurs under the action of pituitary hormones: follicle-stimulating (FSH) and luteinizing (LH) hormone. The LH peak plays a decisive role in the process of ovulation. And hCG acts similarly to luteinizing hormone.

Indications for the use of Pregnyl are hormone replacement therapy in the luteal phase as an ovulation stimulator in women, and in men as a testosterone stimulator.

Contraindications for the appointment of Pregnil are:

• diagnosed malignant neoplasms of any localization;
• intolerance to any of the components of the drug.

Pregnil with IVF: why is it prescribed?

Why are Pregnyl injections needed in IVF? This drug is an indispensable assistant in the procedures of assisted reproductive technologies, namely, in carrying out in vitro fertilization.

In order to achieve the goal - the collection of eggs during the puncture, you must first grow follicles in which the eggs mature. The maturation of the follicles occurs due to the influence of the hormones FSH and LH. The periovulatory peak of luteinizing hormone, which promotes the maturation of ovarian follicles in a woman's body, may not occur. This, in turn, will disrupt the operation of the IVF protocol. In order for the stimulation of ovulation to end successfully and the fertility doctors receive high-quality eggs, Pregnil is used.

Chorionic gonadotropin, which is part of Pregnil, acts similarly to the LH hormone. With its introduction, the maturation of dominant follicles occurs, after which it becomes possible to collect eggs.

In in vitro fertilization, Pregnyl can also be used to support the luteal phase, the second phase of the stimulated cycle.

Pregnyl in IVF protocols

Pregnyl is an integral part of the in vitro fertilization protocol. The goal of inducing superovulation in in vitro fertilization is to obtain full-fledged, high-quality eggs that can be fertilized to produce blastocysts. In order for this process to be controlled, an injection of Pregnil is introduced during IVF.

Pregnyl with IVF in the natural cycle

Pregnyl in the natural cycle is widely used. In order to indicate the approximate date of ovulation, ultrasonic folliculometry is performed - the measurement of the growing ovarian follicle. When the follicle reaches sufficient size, Pregnyl is injected at a dosage of 5000-10000 units, and ovulation occurs after 35 hours. It is during this period that it is recommended to live sexually for the onset of pregnancy.

Pregnyl during IVF before follicle puncture

Pregnyl in IVF before in the ovary is prescribed to maintain the maturation of follicles in a stimulated cycle. An injection of Pregnyl 10000 during IVF is carried out intramuscularly 35 hours before the intended puncture. The dose of the drug, as well as the time of admission, are prescribed strictly by the hour. If the method of administration of the drug is violated, premature ovulation may occur and there will be no need, the expediency of a puncture.

If there was stimulation with Pregnil in IVF, then the next day you do not need to inject anything. After the injection of the drug and before the puncture of the follicles, Pregnil will no longer be prescribed.

Pregnyl with IVF after embryo replanting

Why is Pregnyl needed after IVF? Prerot after embryo transfer can be used to maintain the corpus luteum phase. After all, it is it that produces the most important pregnancy hormone - progesterone. Progesterone deficiency can cause threatened miscarriage, miscarriages, and spontaneous abortions. The drug is prescribed in an amount of two to three injections. It may also be the appointment of drugs of the gestagen series. The dosage of the drug is prescribed exclusively on an individual basis.

How and where to inject Pregnyl with IVF?

Pregnyl is produced in the form of a dry substance, to which a solvent is attached. Before performing the injection, wash your hands well, draw up the solvent into the syringe and add it to the lyophilisate. A prerequisite is the complete dissolution of the powder. Depending on the prescribed dosage, the required amount of the drug is collected, the injection site is wiped with an alcohol wipe, then the solution is injected intramuscularly slowly.

When is Pregnyl injected with IVF? 35 hours before the time of the proposed follicle puncture.

How much to inject Pregnyl as a trigger for IVF? The dosage is selected individually depending on the state of the hormonal background of the woman. Basically, this figure is 10,000 units.

Feelings after an injection of Pregnyl during IVF

Each person is individual, so the sensations after the injection of Pregnyl can be radically different. Some women note pulling pains in the lower abdomen, pains of a stabbing nature; others - nausea and even vomiting. There are women who have not noted anything new in their feelings.

Side effects of Pregnyl

Like any drug, especially hormonal, Pregnil can have various side effects, but their occurrence is rare.

There may be violations of the general condition in the form of general weakness, fatigue.

Local side effects in the form of edema, pain, hyperemia in the injection area. In some cases, urticaria may occur.

In very rare cases, a generalized rash with fever may occur. In rare cases, thrombosis of various localization may occur. Pain in the mammary glands can also accompany such therapy.

Pregnil with IVF: reviews

Pregnyl in vitro fertilization has helped thousands of women achieve the coveted growth of follicles, ovulation in the natural cycle, as well as the maturation of several follicles in the in vitro fertilization protocol. Almost 90% of all women who have passed with the use of Pregnil, either received a fixed ovulation, or noted the onset of a desired pregnancy. The drug has the best effect on the growth of follicles, maintaining the luteal phase in a stimulated or natural menstrual cycle.

Irina Drozdova, obstetrician-gynecologist, specially for the site

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At each of its stages. You will be able to find out which regimen should be observed, what can and cannot be done at the stage of superovulation stimulation, after puncture and after embryo transfer.

The IVF procedure can be divided into four important steps:

1. Follicle Growth Induction
2. Puncture of stimulated follicles
3. Embryo transfer
4. Post-transfer period

This stage takes an average of 8-12 days and includes injections of drugs to stimulate the growth of follicles. Gonadotropin preparations are used (Menopur, Puregon, Gonal-f, Elonva, etc.), as well as drugs to suppress the work of the pituitary gland - gonadotropin-releasing hormone agonists and antagonists (diphereline, decapeptyl, cetrotide, orgalutran).

At this stage, the growth of follicles is monitored, and if necessary, the dose of prescribed drugs is adjusted. Further, when the follicles reach a diameter of 18-20 mm, an ovulation trigger (hCG drug or a gonadotropin agonist) and the date of the puncture are assigned.

During the stimulation of follicle growth, it is recommended to lead a measured healthy lifestyle, spend more time in the fresh air, and exclude physical activity. It is also advisable not to live sexually. It is important to understand that when prescribing stimulation, we achieve the growth of all available antral follicles, so sometimes more than 10 of them can grow. The ovaries increase in volume, which can lead to a feeling of heaviness and discomfort in the lower abdomen.

You can not take laxatives and do a cleansing enema before a puncture without the permission of a doctor.

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The puncture of the follicles is performed under anesthesia and takes no more than 20 minutes. After egg collection, the woman lies under observation in the ward for 2 hours, then, with the doctor's recommendations, she is discharged home.

Driving after the procedure is prohibited.

On this day, luteal phase support is scheduled, preparation for embryo transfer.

For this purpose, progesterone preparations (progesterone, utrozhestan, krynon, iprozhin), duphaston, in some cases estrogens (divigel, proginova, estogel), hCG preparations are prescribed.

On the first day after the puncture, a woman may experience moderate pain in the lower abdomen. This is normal, since during the puncture, the ovarian tissue is injured with a needle, which can cause pain in the future. But when pain occurs, painkillers should not be taken, since their therapeutic effect can smooth out the picture of a possible complication, and help can be provided late. If you experience intense abdominal pain, as well as weakness, dizziness, bleeding, you should contact your doctor.

After the puncture, sexual rest is necessary for two weeks. At this time, you can also not take a hot bath, visit the sauna, solarium, swimming pool, gym.

The next day after the puncture, up to the moment of determining the blood for hCG, it is recommended to drink a large amount of non-carbonated water or fruit drink without sugar (up to 3 liters). Food should contain a lot of protein and a minimum of coarse fiber (raw vegetables, fruits, legumes, black bread should be excluded). It is also necessary to limit coffee, strong tea, cola, the intake of alcoholic beverages is unacceptable.

After puncture of a large number of follicles, sometimes from 2-3 days there may be complaints characteristic of ovarian hyperstimulation syndrome: a feeling of fullness and bloating, nausea, vomiting, diarrhea, shortness of breath, rapid heartbeat (tachycardia), dry cough. If such signs appear, you should immediately contact your doctor.

The embryo transfer procedure is usually performed in the afternoon and in a standard situation does not require special preparation.

After the embryo transfer, you can rest in the ward for an hour.

This period lasts 14 days, after which a blood test for hCG is taken to diagnose pregnancy. These days, we recommend issuing a certificate of incapacity for work so that a woman can follow all the necessary recommendations. During this period it is necessary:

• Continue to observe the drinking regime and diet;
• Exclude physical activity, do not engage in fitness, but do not lie down all day, short walks in the fresh air with a total duration of at least an hour will do;
• Do not stay in a forced position for a long time (for example, sitting) - this contributes to stagnation of blood in the small pelvis;
• Try to feel only positive emotions and confidence in success.

In some cases, after embryo transfer, spotting may appear, which does not exclude the onset of pregnancy. In this case, you should not cancel drug support and try to contact your doctor as soon as possible.

With a positive blood test for hCG, it is necessary to approach your doctor for further recommendations on treatment and the timing of the withdrawal of some medications. In addition, the doctor introduces the woman to the plan for monitoring pregnant women after the IVF program.

In the case of a negative test for hCG (that is, in the absence of pregnancy), support drugs are usually canceled, an appointment with the attending physician is recommended after the next menstruation . After an IVF cycle with stimulation, the ovaries can return to normal within 1-2 months. In some cases, combined estrogen-gestagen preparations are prescribed by a doctor for therapeutic purposes.

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