Can infertility causes have a psychosomatic origin?

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Važnost termina embrio transfera

Jedna od najznačajnijih odluka tokom IVF postupka je odlučiti kada će se embrion preneti u matericu. Da bi se razvilo više jajašaca tokom in vitro oplodnje jajnici se moraju stimulisati lekovima. Ultrazvuk se može koristiti za vizualizaciju jajnih ćelija kao „folikula“.

U trenutku kada folikuli narastu do određene veličine i smatraju se dovoljno zrelim, tada se pacijentkinji daje dodatni lek u vidu takozvane „stop“ injekcije koji se zove „okidač“. Ovaj lek se primenjuje tako da izazove oslobađanje jajnih ćelija u folikularnu tečnost. U narednih 36 sati jajne ćelije se aspiriraju odnosno vade. Nakon vadjenja, jajne ćelije se oplođuju spermom partnera ili spermom donora. Stvoreni embrioni se potom uzgajaju u laboratoriji do dana transfera embriona.

Embrion se razvija u laboratoriji i u početku se sastoji samo od nekoliko ćelija koje se vremenom dele i množe. Oblik embriona se takođe menja pri nakupljanju ćelija i prelazi u fazu "cepanja" i kasnije u razvijeniji oblik blastociste.

Razvoj blastociste čini embrion različitijim sa različitim odeljcima. Jedan odeljak, na primer, nalazi se u osnovi sledeće posteljice, dok će se drugi razviti u plod.

Faze embrio transfera

Postoji nekoliko različitih faza razvoja embriona u kojima se oni mogu preneti u matericu. U nekim slučajevima transfer embriona vrši se u ranoj fazi drugog, pa čak i prvog dana.

Međutim, obično se embrioni prenose u dve specifične faze:

  • Faza cepanja: koja je treći dan života embriona - obično se naziva "transfer 3 dana";
  • Faza blastociste: ovo je peti dan života embriona i obično se naziva "transfer 5 dana".

U naučnom i medicinskom svetu još se raspravlja koje vreme je najbolje za prebacivanje embriona. Različite klinike imaju različita pravila za dan prenosa, neke to rade u fazi cepanja, neke u fazi blastociste.

Ponekad su odluke o fazi u kojoj će se embrion preneti različite za svakog pacijenta na osnovu dijagnoze koja se radi specijalno za ovog pacijenta i posebno se biraju prema njegovim individualnim potrebama.

Prednosti prenosa embriona na 5 dan

Najznačajnija korist od transfera u stadijumu blastociste je činjenica da možete izabrati najjače embrione koji više vole da se implantiraju i kao rezultat toga zatrudnite.

Čekanje da se embrion razvije do faze blastociste vrsta je same selekcije. U stvari, neki embrioni lošeg kvaliteta ili sa genetskim nepravilnostima ili poremećajima imaju manju šansu da prežive 5 dana i postanu blastocista. Što znači da se na neki način embrioni niskog kvaliteta eliminišu i ostavljaju vas da izaberete među najjačim.

Studije pokazuju da žene koje proizvode mnogo embriona mogu imati koristi od transfera na 5 dan. Pacijentkinje koje su dobro reagovale na lekove za stimulaciju i iz čijih jajnih ćelija je kreirano više embriona, imale su višu stopu trudnoće. Međutim, kod starijih žena i žena koje su proizvele manje količine jajnih ćelija ili embriona ove koristi nisu bile vidljive. U slučajevima ovih žena, nema očiglednih prednosti da se izvrši transfer na 5 dan u odnosu na transfer 3 dan.

Nedostaci faze blastociste u poređenju sa transferom na dan 3

  • Kao što je ranije rečeno ponekad su embrioni preslabi da bi preživeli 5 dana i prerasli u blastocistu. To, međutim, istovremeno predstavlja i rizik jer može rezultirati otkazivanjem ciklusa zbog nedostatka embriona koji se prenose. Ako starija žena želi da izvrši transfer na 5 dan i ima samo nekoliko embriona, onda je šansa da nijedan od embriona neće preživeti do petog dana, veća i nažalost pacijent ostaje bez embrio transfera.
  • Takođe postoji rizik da će ostati manje embriona ili čak da neće biti uopšte embriona za zamrzavanje koje se može koristiti za buduće embrio transfere u sledećim pokušajima.
  • Postoji malo veći rizik od višeplodne trudnoće.
  • Postoji malo veća šansa da pol deteta bude muški.

Ukratko, prenošenje embriona u fazi blastociste ima jasne prednosti za mlađe žene koje su u stanju da proizvedu više embriona povećavajući stopu trudnoće i pružajući im mogućnost izbora najkvalitetnijih embriona. Međutim, žene starije životne dobi i sa smanjenim mogućnostima proizvodnje embriona i embriona visokog kvaliteta nemaju jasne prednosti za korišćenje embrio transfera na 5 dan.

Da li preneti 1 ili više embriona je odluka koje vas takođe čeka u ovoj fazi IVF postupka. Pročitajte više o ovoj temi u našem ranijem blog postu.

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