Where to begin effective treatment infertility by IVF, when it the only way conceive a child? This is a reasonable question, since any couple would like the attempt to be one and successful. There is only one answer - a complete examination of the state of not only reproductive, but also general condition the health of both partners.
The IVF procedure itself includes several stages: examination, stimulation of superovulation, puncture, fertilization, cultivation, transfer. Each of the stages is very responsible, but if the very first one - the examination - is incomplete, then the effectiveness of the remaining stages in the treatment of infertility will be under big question. Therefore, the process of preparing for infertility treatment by IVF is very important.
The stage includes not only examinations, but also the rules of behavior, lifestyle:
- smokers need to quit smoking, passive smoking should also be avoided;
- exclude heavy physical exertion;
- do not drink alcohol, reduce caffeine intake to 2 cups per day;
- eat right. The diet should be balanced, filled with vitamins, proteins and minerals;
- drink multivitamins intended for pregnant women, the woman's body should be as ready as possible;
- do not take hot baths, saunas, solariums, do not visit open water bodies, swimming pools;
About the survey. When you have already chosen a clinic and a doctor for the IVF program, the stage of studying two partners begins. At the first consultation, the patient should discuss the following points with a specialist:
- whether your weight is normal according to the body mass index (if your weight is not within the norm, then you must gain / lose weight before joining the program);
- report all chronic diseases, allergies, drugs that you take constantly;
- make sure that both partners are immune to rubella (lack of immunity can cause problems in the development of the fetus later in pregnancy).
These indicators can significantly change the process of infertility treatment.
Preparation for infertility treatment in Russia by IVF includes great amount surveys. Below is a list of tests for the course of infertility treatment by IVF according to the order of the Ministry of Health of the Russian Federation No. 107N.
Examination before the procedure
Partners need:
- the presence in the blood of antibodies to pale treponema;
- tests for HIV, hepatitis B and C, for the herpes simplex virus;
- microscopic examination of the genital organs for flora, Candida fungi, trichomoniasis;
- swabs for herpes simplex virus and cytomegalovirus;
- clinical blood test;
- blood biochemistry;
- coagulogram;
- general urine analysis;
- rubella antibodies;
- smear on flora;
- a smear for oncocytology (in a woman, scraping from the cervix);
- undergoes a consultation with a general practitioner, passes an ECG, fluorography and does an ultrasound of the pelvic organs;
- recommended blood donation for karyotype;
- blood clotting test.
Women separately:
- patients over 35 years old - mammography;
- hormonal blood test (FSH, LH, Estradiol, hormones thyroid gland, Prolactin);
- a picture of the tubes and uterus, hysteroscopy, laparoscopy, ultrasound observation, biopsy, tomography.
It is necessary to find out the situation with the hormonal background of the patient. If there is a problem, then hormone therapy with oral contraceptives is prescribed to even out the hormonal background of the patient.
Gather the following data:
- childhood diseases;
- information about serious diseases in the female line;
- treat your teeth;
- find out from the mother whether she had problems with conception, how the pregnancy and childbirth went.
But this common list. Depending on the particular case, additional examinations are prescribed. They also carry out manipulations, operations to prepare the uterine cavity. Operations are done only according to indications.
Next, you need to identify the woman's ovarian reserve. With age and due to the effects of ovarian surgery, anticancer chemotherapy, radiation exposure it is decreasing. Therefore, for patients of older reproductive age, this indicator is very important when considering the choice of protocol. It is set by the level of hormones AMH, FSH, inhibin B or by the number of antral follicles.
The stage of preparation for a male infertility treatment program begins with a consultation with a specialist. At the reception, an anamnesis is collected, the patient must notify about the past diseases, surgical interventions. Next, the man is sent for delivery - blood biochemistry, electrocardiograms, tests for STIs, HIV, syphilis and hepatitis. important research for men, a spermogram with a MAP test is used.
Spermogram will determine:
- sperm motility;
- the content in the seminal fluid of other cells and pathogens;
- viscosity;
- the number of spermatozoa contained in it;
- acid-base environment;
- ejaculate volume;
- color.
If, for some indicator, the spermogram deviates from the norm, then the specialist prescribes a study on hormones. If infections are detected, a man should undergo a course of treatment and only after that he should be tested for a spermogram again.
Sometimes genetic counseling is needed. Provided that the man has defects in the Y-chromosome, congenital absence of the vas deferens.
Types of IVF protocols for effective infertility treatment
I would like to note that with more complex forms infertility, additional manipulations and treatment are prescribed.
Having all the results of the examinations of the couple, the specialist selects the protocol.
- Super long protocol (2-3 months).
- IVF protocol with minimal stimulation
- Ultrashort protocol (duration 10 days).
- IVF puncture natural cycle
- But more often they choose a long and a short protocol.
- Long protocol (3-4 weeks)
- Short cut (1-12 days)
Each of them has its own characteristics. The success of infertility treatment by IVF depends on the choice of the program. Therefore, consult, ask questions to your specialist in order to understand for what reasons you are assigned certain kind programs.
The next stage in the treatment of infertility is stimulation. It is carried out in order to increase the number of egg maturation by an average of 15 to 20. This procedure carried out by preparations of FSH, chorionic gonadotropin, analogues of gonadoliberin. Since blood clotting occurs during stimulation during infertility treatment, a woman needs to drink from 2.5 liters mineral water, fruit drinks, use more broths, soups. Failure to follow these recommendations can lead to ovarian hyperstimulation.
Puncture. This is the next procedure. Her task is to collect mature eggs after stimulation.
This stage is quite complicated from a medical point of view, it is carried out under general anesthesia. The puncture takes 30-40 minutes. How can the patient improve efficiency:
- follow the dosage regimen. This is one of the most important points, since the procedure can be disrupted;
- tell the anesthesiologist about any drug allergies;
- 2-3 days before the puncture, refrain from sexual intercourse;
- 2-3 days before and after the puncture, eat more protein;
- do not eat on the day of the puncture.
Next comes fertilization. This manipulation is carried out by embryologists in the laboratory. Fertilization requires eggs and seminal fluid. The eggs were collected during the puncture. Now it is worth paying attention to obtaining sperm.
Semen is best taken on the day of the puncture. There are rules for collecting seminal fluid.
For all best conditions Of course, ideal is getting ejaculate through masturbation. WHO recommends this particular method of seminal fluid for egg fertilization in the treatment of infertility. It is also recommended to take the ejaculate in the clinic - there are all conditions for the correct delivery. But if desired, a man can do this at home. However, the ejaculate must be collected in a sterile special container, within an hour after receiving the sperm, it must be delivered to the clinic in compliance with temperature regime.
Spermogram rules:
- refrain from sexual intercourse for 2-3 days before surrender;
- exclude the use of alcohol, drugs;
- exclude hot baths, saunas, solariums.
At home, follow all of the above rules, plus: do not let direct sun rays, wash your hands and penis thoroughly, do not allow the sperm to overheat above 25 degrees.
If the collection of seminal fluid by masturbation is not possible, then the procedure for surgical collection of sperm is given.
There are several ways:
- TESA: aspiration from the testis. The seminal fluid is aspirated through the skin of the scrotum with a needle.
- PESA: collection with a needle through the epididymis.
- MESA: incision of the skin of the testicle, collection from the tubules of the epididymis.
How does a man prepare?
- abstaining from sex for 4 days;
- exclude alcohol, smoking;
- do not visit saunas, solariums, do not take hot baths;
- inform about the drugs you are taking;
- if there is a problem, the doctor may prescribe stimulation of sperm production.
Before the biopsy:
- from 20:00 pm do not eat;
- drink only tea, mineral water;
- do not eat breakfast on the day of the biopsy.
Again, there are cases of previous failed attempts treatment of infertility, immunological infertility, oligozoospermia, asthenozoospermia, azoospermia or difficult situations infertility in a couple, the ICSI procedure is used. With this method, the best spermatozoa are selected and injected directly into the egg.
As a result of obtaining biomaterial from both partners, embryologists in the laboratory carry out fertilization.
The next step in the infertility treatment program is the transfer of the embryo into the uterine cavity. This is one of the most crucial moments of the program.
The process is painless, short, as the expansion of the cervix this way does not require. Embryos are introduced using a special catheter under ultrasound supervision. Usually the transfer occurs for 2-3 days. The doctor himself decides on the number of embryos transferred into the uterine cavity. The task of the patient is to remain calm and have a good rest after the procedure, to follow all the recommendations of the doctor.
Effective infertility treatment depends not only on the chosen doctor, clinic, equipment used in the clinic, but also very much depends on the couple themselves - whether they followed all the prescriptions, they reported all necessary information health professional. Therefore, patients should always be on the alert, ready to answer all questions, always inform the doctor about the condition at every stage. AT this case additional research and analysis will not be superfluous. Infertility treatment is a cumulative work of a doctor and patients, carefully carried out, leads to a successful conception.
Treatment Specialists:
Procedures and prices in St. Petersburg
Procedure
Obstetrician-gynecologist-reproductologist primary reception (examination, consultation)
4500p
12 IVF programs
Ready-made programs, expand to view
Procedure
in vitro fertilization
$118,000
Repeated in vitro fertilization
$98,000
IVF with ICSI in the natural cycle
49600P
IVF in natural cycle using 8 donor oocytes
Cammi Pham
Marketer, founder of ThinkRenegade agency, blogger.
By working less, you can achieve best results. As an example, let's look at a small business owner who works non-stop. It can operate 24 hours a day, but it doesn't have the same capabilities as corporate competitors. A big company can assemble a cool team, invest a lot of money in the same project as a startup.
But sometimes small companies manage to do what was not under the power to do large competitors. Facebook bought Instagram - a 13-person company - for a billion dollars. Snapchat, a young startup of 30 employees, turned down offers from tech giants like Facebook and Google. Part of their success depended on luck. In everything else - from efficiency.
There is a huge difference between being busy and being productive. If you have a lot to do, it does not mean that you are productive. Being productive means managing your time effectively and distributing your energy.
If you want to work not for 80, but for 40 hours a week, having time to complete several times more work Please try to follow these guidelines.
1. Don't work overtime
Have you ever wondered why in working week 40 hours? In 1926, Henry Ford, an American industrialist and founder of the Ford Motor Company, conducted an experiment: he reduced the number of working hours per day from ten to eight and reduced the number of working days from six to five. The result was interesting: productivity increased dramatically.
The more time you devote to work, the less efficient and productive you will be at work.
When the project is scheduled for 60 and more hours per week, it will take more than two months to complete. Productivity drops, project deadline is pushed back. The same number of workers can complete the same task in the same time frame, working 40 hours a week.
2. Get good sleep
The US military conducted an unusual study: they reduced the duration of a night's sleep of soldiers by an hour. At the same time, young people showed a decrease in cognitive abilities, both in the state alcohol intoxication(according to the American classification - 10th degree) Why We Have to Go Back to a 40-Hour Work Week to Keep Our Sanity. How ironic, you can get fired if you work drunk and working all night long counts normal. Both in the first and in the second case, the state of the worker is identical.
When you notice that you are working unproductively, ask yourself if you are one of the 70% of people who constantly do not get enough sleep.
Perhaps you can work normally after a sleepless night. But it's very unlikely that you're looking at the world with joy and optimism. Negative attitude, poor health, lack of empathy and desire to act - the consequences of overwork.
Most people who have achieved incredible heights in their field understood how much. Here are some examples from history:
- Leonardo da Vinci took several naps a day if he wanted to sleep less at night.
- The French emperor Napoleon Bonaparte never hesitated to take a nap during the day. He did this daily.
- Thomas Edison was embarrassed by his habit of sleeping during the day, but he practiced it every day.
- Wife american president Eleanor Roosevelt went to bed every time important speech to replenish strength.
- Singer Gene Autry regularly slept in his dressing room during breaks between performances.
- US President John F. Kennedy ate lunch in bed every day, and then went to take a nap.
- John Rockefeller - industrialist, philanthropist and first billionaire - slept every day in his office.
- Afternoon naps were a must on Winston Churchill's schedule. He believed that thanks to this habit he managed to do twice as much in a day.
From personal observations: when I began to sleep 7-8 hours a day, I noticed positive changes. I became more productive and managed to do a lot more than during a 16-hour work day. Who would have thought that sleep is such a great tool for a marketer?
3. Don't say yes too often
According to the Pareto principle, 20% of the efforts give 80% of the results. Instead of working harder, we should focus on those efforts that give us 80% of the result, and discard the rest. You will have time to concentrate on the most important tasks.
Stop taking on tasks that bring low or almost zero results.
A logical question arises: when to say “yes” and when to say “no”? If you can't figure out what to spend your time on, take a simple test. Keep track of everything you do, and then try to optimize this process.
In 2012, scientists conducted a study, the results of which were published in the Journal of Consumer Research “I Don’t” versus “I Can’t”: When Empowered Refusal Motivates Goal-Directed Behavior ..
The researchers divided the students into two groups. In one, subjects had to say "I can't" and in the other, "I won't." The results were interesting. Students who told themselves "I can't eat chocolate" ate a candy bar 61% of the time. Students who told themselves "I won't eat chocolate" or "I don't eat chocolate" ate something sweet only 36% of the time. The simple change in wording greatly increased the likelihood that each person would make healthier food choices.
4. Don't be a perfectionist
Dr. Simon Sherry, professor of psychology at Dalhousie University, has done a study on how it affects productivity. It turned out that the more perfectionist the professors were, the less productive they were.
Here are a few problems that perfectionists often face:
- They spend more time working on a task than they need to.
- They procrastinate and wait for the right moment. In business right moment usually comes too late.
- They don't see the whole picture because they focus on the little things.
The perfect moment is now.
5. Automate repetitive tasks
According to a study conducted by Tethys Solutions, a team of five people who spend 3, 20, 25, 30, and 70% of their working time on routine, repetitive tasks, productivity drops by 3, 20, 25, 30, and 70% respectively.
You don't have to be good at programming to automate a routine. Of course, it's great if you have the necessary skills or resources. If you can't make something yourself, find out if it can be bought or ordered.
People continue to do a lot by hand, because it's easier and you don't need to study and search for anything. It is normal to manually check 30 photos for Instagram. But if you have to manage 30,000 photos and videos from five different platforms, then you just need a good software to work with content.
If you cannot find a solution to your problem on your own, contact an expert who can help you. Be prepared to spend money. Time is your most valuable commodity.
Also, you can always check out GitHub or Google app script library. There you can find a free and ready-to-use open source program.
6. Make decisions based on facts and data
There are dozens useful research, the results of which you can apply in your work. For example, did you know that the vast majority of people are easily distracted by other things before 4:00 pm? This is a random fact from a study conducted by Robert Matchock, professor of psychology at the University of Pennsylvania.
Even if you don't find the data you need, you can always do some simple testing yourself. Ask yourself how you can measure and optimize everything you do.
7. Break away from work and relax
What most people don't realize is that we essentially lock ourselves up when we're focused on something. It is very important to periodically break away from work and be alone. During such breaks, the head rests, and the mood improves.
Nobody disputes that complete isolation not in the best way affects the well-being of a person, but some time alone is necessary for everyone. For example, teenagers who can be alone with themselves noticeably improve their grades in school.
Everyone needs time to think. We often find right decisions when not looking for them.
You can't become more productive overnight. Like everything important in life, it takes effort. But nothing will change if you just sit and wait. Therefore, we need to learn to better understand ourselves, our body, find a way to optimize our strength and move towards a more successful and happy life.
Systematic actions lead to results. It is important to consciously approach the planning of weight loss, and then consolidate the resulting physical form on the same level.To prevent the weight lost from returning, you should follow certain rules:
An individual approach includes personal features and nuances that will help you more lose weight effectively.
You can also use drugs for weight loss. One of the safe and effective means is Guarem. 
It is developed on the basis of guar gum, which controls the feeling of hunger, satiety. It is used even by pregnant and breastfeeding women. "Guarem" is an excellent assistant for obesity at various stages.
How to create an effective weight loss program?
Developing a program on your own provides a number of advantages:- uniqueness;
- individuality;
- performance.
By systematically completing the tasks, the result will not be long in coming.
How to keep fit after effective weight loss?
Pin new image can be done with the following steps:- last meal four hours before bedtime;
- exclude semi-finished products;
- drinking regime up to 2 liters per day;
- eat more vegetables, herbs, fruits;
- minimize sweet pastries, white bread, fatty foods;
- full sleep;
- arrange a day out.
Therefore, sticking to the new weight will help. medicinal product"Guarem", which includes fiber.
Its action normalizes stool, intestinal microflora. It dissolves in any liquid, and is compatible with a variety of types of food. As shows practical experience, "Guarem" helps in 2 months lose weight effectively for 15 kg.
About 3 years ago, I asked myself the question “Who am I? And can I be in business? And which way to go - with business or not. After a year of reflection, I decided that I would still moderate my ardor and moderated ... pretty much like that, to zero.
Today I was sitting at a master class and realized that the girl who is now broadcasting in front of me has started doing exactly what I quit exactly 3 years ago. Then the head worked and the clients were tearing me apart: “Only you can help here!”
And now she is out on the podium and explains to me everything that is already in my head without it. And I had everything on a steeper scale. But it was hidden own will deeply, since I lowered my hands to myself, saying: “No, I will not be on business, something else is a priority.” Lost ambition and collapsed.
This is a quote from private chat schools.
Elena exhaustively described how, after a year (!!!) of reflection, she did not dare to go further, and her resource future collapsed.
I regularly encounter long reflections and reflections from my students.
And the more the student thinks, the less likely the first step to a new future.
Body Schaefer in one of his books gives the rule of 72 hours - if you postpone the execution of your plan for more than 72 hours (or 3 days), most likely you will never do it again.
Almost all my statistics on students confirm this rule.
I have compiled a list of 10 tips to help you get started.
1. Remove uncertainty: fix your plans and schedule their implementation
The first movement stopper is the contradiction between the desire to eat a whole hippopotamus with a complete misunderstanding of how to do it. The mouth is small.
I want a million a month, but I still don’t understand how to do it, and therefore I stand still.
The first step from which training begins at my school is.
I'm teaching how to cut a hippopotamus into pieces.
Step by step I tell you how to specify your Wishlist and draw up a business plan to achieve them.
It's about the business plan, because the main task business to give resources to fulfill the desires of its owner.
We budget the desires of the student and draw up step-by-step business development parameters to achieve these desires.
One of my students has just opened a new office in Moscow. He had been nurturing this idea for a long time, but it happened after we sat down with him and outlined the steps and resources required for this.
One of the limiting beliefs that stopped my student was the large budget for implementation. When we laid out everything in detail and went through several options, it turned out that the budget was within his power.
2. Get Started Now
“I’ll start testing this sales channel later”, “I’ll work on this method of increasing the average check later”, “I’ll think about this marketing tool later”, “I’m in a bad energy state, I will launch this product later”, “great sales case – we need to implement it later”.
People are waiting for Monday, better times, lucky stars, a sign from above.
I give you a sign from above - start right now!
Do what you've been putting off right now.
Put in your calendar for the next 72 hours a clear date for the first step towards the goal.
Continuing the case of the student with the opening of the office - He went to reconnaissance in Moscow almost immediately after our conversation. He did it one day - he left in the morning Sapsan, returned in the evening. Collected a lot useful information, looked like competitors and looked after a place for an office. Based on what we collected, we made several hypotheses that he began to test.
An example of how to start right now with a complete breakdown from Evgenia from Petrozavodsk:
I took action and opened the first business in a state of complete breakdown. After a long illness, I sat all winter with my mother and watched TV shows, and somehow in the spring I thought “to hell with him, let's try”, since there was nowhere to fall lower, I just started doing it, and my appetite came while eating) ...
It was a year and a half ago and now I have two working businesses, the first (hairdresser) paid off and in the black, the second (coffee to go) has not yet).
3. Do it, for practice is the criterion of truth, not thought
No matter how carefully and in detail we work out the project, we will not be able to fully simulate the surrounding reality. Therefore, everything that we have in our heads is just hypotheses. There is only one way to check if they work - start implementing them.
Briefly about the teacher/coach:
- sets you a goal that you yourself would not set;
- he sees the whole picture, and not from the inside, like you;
- gives you permission for a new jump;
- helps with his experience, resources and connections;
- takes into account your strengths and weak sides;
- distributes magic pendels and gingerbread.
For those who have realized how much time they actually have left and want to use it as efficiently as possible, I recommend watching the webinar "How not to miss 2017".
What you will learn at the webinar:
How to identify growth areas for your life next year
- How to compose roadmap development of life up to 100 years
- How to compose step by step business plan achieving goals for 2017
- Why is it important and how to conduct a retrospective of the outgoing year
- How to learn to highlight and visualize correctly key points next year
