In vitro fertilization (IVF) involves fertilization outside the body in an artificial environment. IVF was first successfully used for human infertility in 1977 at Bourne Hall in Cambridge, England. To date, tens of thousands of babies have been delivered worldwide as a result of IVF treatment. 在过去的几年里, 试管婴儿怀孕的程序变得越来越简单, 更安全更成功.

体外受精(IVF)
试管受精的过程有几个步骤:
- 刺激卵巢 产生若干可受精的卵母细胞(卵)
- 从卵巢提取卵母细胞
- 卵母细胞的受精和体外受精实验室胚胎的培养
- 胚胎植入子宫(胚胎移植或ET)
试管受精可能对以下类型的问题有用:
- Absent fallopian tubes or tubal disease that cannot be treated successfully with surgery
- 子宫内膜异位 手术和药物治疗都没有效果
- 男性不育 精子数量或活力低, 但要有足够的活跃精子在实验室里受精
- 严重的男性不育因素,精子必须通过手术获得
- 其他治疗无效的不明原因的不孕症
- 导致流产或异常分娩的遗传疾病
除了标准的体外受精程序,包括 intracytoplastmic精子注射, 辅助孵化, 囊胚培养——我们提供了一种更独特的技术, 被称为胚胎培养. 在胚胎培养, embryos are grown in "feeder layers" of 细胞 from the patient that enhance development. This technique appears to improve embryo growth for patients who have had poor embryo development and unsuccessful IVF cycles.
辅助孵化
在辅助孵化, a laser is used to thin the zone pellucida (outer shell) of the fertilized egg before it is transferred into the uterus. This outer shell is believed to become thicker and hardened with aging of the oocyte (egg).
老年妇女, 或者在第三天卵泡刺激素(FSH)水平升高, 可能降低了胚胎植入的机会. The embryos of women with endometriosis and poor quality embryos may also have this problem. The 辅助孵化 technique was introduced to enhance the embryos' ability to hatch, 因此植入, 转让后.
如果您年龄在38岁或以上,您可能是辅助孵化的候选人, 基底卵泡刺激素水平升高, or if you have previously had one or more IVF cycles in which your embryos failed to implant, 尽管结果很好.
囊胚培养
Blastocyst culturing is a technique to grow embryos beyond the third day of culture. Typically with IVF, embryos are transferred into the uterus about three days after the egg retrieval. 第三天,胚胎通常有6到8个细胞. 在过去的几年里, improved culture environments have allowed us to culture the embryos two additional days. During this additional culture period, the embryos continue to grow to become "blastocysts."
The natural process of embryo development begins with the fertilization of the egg in the outer aspect of the fallopian tube. 随着新形成的胚胎的发育, 它慢慢地向宫腔移动,最终会在那里植入. 这个过程大约需要6到7天. 当胚胎到达“囊胚”阶段时,就可以进行植入了.
在某些病人, 囊胚培养可以选择最佳的胚胎进行移植, 结果增加了每个移植胚胎的植入率. 然而, it is important to understand that this technology may not necessarily increase your chance for pregnancy. The main advantage is that fewer embryos may be transferred to eliminate the possibility of multiple pregnancies, 同时保持较高的怀孕率.
一般来说, this procedure should be limited to patients with excessive numbers of embryos – more than five – in which case further selection of embryos beyond the day three stage would be advantageous. As a general rule, patients under age 37 are candidates for this culturing technique.
For younger patients, up to 50 percent of all embryos will continue to grow to the blastocyst stage. 然而, 10 percent of patients won't have an opportunity for embryo transfer due to the absence of blastocyst development. 随着患者年龄的增长, fewer and fewer numbers of embryos are capable of developing in culture to the blastocyst stage.
胚胎与子宫内膜或颗粒细胞共培养
Embryo co-culturing is a technique used to improve the overall quality of embryos before transferring them into the mother's uterus. 它是由UCSF试管受精实验室发起的, 但自1996年以来,利来登录上其他几个体外受精项目已经使用了这项技术. Co-culturing uses human granulosa or endometrial 细胞 that may secrete nutritional products that help growing embryos improve their chances for survival.
使用共培养, we have seen an improvement in embryo quality and relative growth 72 hours after egg retrieval. 卵子在取卵后18 - 24小时内受精.
We only recommend this technique to patients who have had previous unsuccessful IVF cycles with poor embryo quality, 要么在加州大学旧金山分校,要么在其他项目. 我们不建议从未接受过体外受精的患者使用, 或者在过去有过良好胚胎质量的治疗周期.
一个需要理解的重要概念是你怀孕的可能性, 不管你的年龄, 这取决于你胚胎的整体质量. 如果你有良好的胚胎质量, 那么你在体外受精治疗周期中受孕的几率就会更高. Conversely, if you have generally poor embryo quality, then your chance for success diminishes.
与共培养相关的风险目前尚不清楚. 因为它从未被广泛测试过, there is no information regarding children born of co-culture using these specific 细胞. 因为这个事实, we remain cautious about using this technique on patients who clearly may not benefit from it. It is important to understand that some patients may not have improved embryo quality, 尽管使用了共培养.
如果你和你的利来登录同意在你的体外受精治疗周期中使用共培养, then we will incubate all your embryos in the co-culture environment as soon as our embryologists confirm fertilization. 我们会继续共培养直到你的胚胎移植那天.
冷冻共培养胚胎是可能的. 共培养不会影响胚胎的冷冻能力. We use the same standards for freezing co-cultured embryos as we do for standard cultured embryos. 如果你的胚胎质量通过共培养得到改善, 我们更有可能为你冷冻更多的胚胎.
加州大学旧金山分校健康医学专家已经审阅了这一信息. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.