IVF: Ovulation induction
If you’re using your own eggs during IVF, at the start of a cycle you’ll begin treatment with synthetic hormones to stimulate your ovaries to produce multiple eggs — rather than the single egg that normally develops each month. Multiple eggs are needed because some eggs won’t fertilize or develop normally after fertilization.
You may need several different medications, such as:
- Medications for ovarian stimulation. To stimulate your ovaries, you might receive an injectable medication containing a follicle-stimulating hormone (FSH), a luteinizing hormone (LH) or a combination of both. These medications stimulate more than one egg to develop at a time.
- Medications for oocyte maturation. When the follicles are ready for egg retrieval — generally after eight to 14 days — you will take human chorionic gonadotropin (HCG) or other medications to help the eggs mature.
- Medications to prevent premature ovulation. These medications prevent your body from releasing the developing eggs too soon.
- Medications to prepare the lining of your uterus. On the day of egg retrieval or at the time of embryo transfer, your doctor might recommend that you begin taking progesterone supplements to make the lining of your uterus more receptive to implantation.
Your doctor will work with you to determine which medications to use and when to use them.
Typically, you’ll need one to two weeks of ovarian stimulation before your eggs are ready for retrieval. To determine when the eggs are ready for collection, your doctor will likely perform:
- A vaginal ultrasound, an imaging exam of your ovaries to monitor the development of follicles — fluid-filled ovarian sacs where eggs mature
- Blood tests, to measure your response to ovarian stimulation medications — estrogen levels typically increase as follicles develop and progesterone levels remain low until after ovulation
Sometimes IVF cycles need to be canceled before egg retrieval for one of these reasons:
- Inadequate number of follicles developing
- Premature ovulation
- Too many follicles developing, creating a risk of ovarian hyperstimulation syndrome
- Other medical issues
- How many embryos will be transferred? The number of embryos transferred is typically based on the age and number of eggs retrieved. Since the rate of implantation is lower for older women, more embryos are usually transferred — except for women using donor eggs. Most doctors follow specific guidelines to prevent a higher order multiple pregnancies — triplets or more — and in some countries, legislation limits the number of embryos that can be transferred at once. Make sure you and your doctor agree on the number of embryos that will be transferred before the transfer procedure.
- What will you do with any extra embryos? Extra embryos can be frozen and stored for future use for several years. Not all embryos will survive the freezing and thawing process, although most will. Cryopreservation can make future cycles of IVF less expensive and less invasive. However, the live birth rate from frozen embryos is slightly lower than the live birth rate from fresh embryos. Or, you might be able to donate unused frozen embryos to another couple or a research facility. You might also choose to discard unused embryos.
- How will you handle a multiple pregnancy? If more than one embryo is transferred to your uterus, IVF can result in a multiple pregnancy — which poses health risks for you and your babies. In some cases, a fetal reduction can be used to help a woman deliver fewer babies with lower health risks. Pursuing fetal reduction, however, is a major decision with ethical, emotional and psychological consequences.
- Have you considered the potential complications associated with using donor eggs, sperm or embryos or a gestational carrier? A trained counselor with expertise in donor issues can help you understand the concerns, such as the legal rights of the donor. You also may need an attorney to file court papers to help you become legal parents of an implanted embryo.
When choosing an in vitro fertilization (IVF) clinic, keep in mind that a clinic’s success rate depends on many factors, such as patients’ ages and medical issues, as well as the clinic’s treatment population and treatment approaches. Ask for detailed information about the costs associated with each step of the procedure.
Before beginning a cycle of IVF using your own eggs and sperm, you and your partner will likely need various screenings, including:
- Ovarian reserve testing. To determine the quantity and quality of your eggs, your doctor might test the concentration of follicle-stimulating hormone (FSH), estradiol (estrogen) and antimullerian hormone in your blood during the first few days of your menstrual cycle. Test results often used together with an ultrasound of your ovaries, can help predict how your ovaries will respond to fertility medication.
- Semen analysis. If not done as part of your initial fertility evaluation, your doctor will conduct a semen analysis shortly before the start of an IVF treatment cycle.
- Infectious disease screening. You and your partner will both be screened for infectious diseases, including HIV.
- Practice (mock) embryo transfer. Your doctor might conduct a mock embryo transfer to determine the depth of your uterine cavity and the technique most likely to successfully place the embryos into your uterus.
- Uterine cavity exam. Your doctor will examine your uterine cavity before you start IVF. This might involve a sonohysterography — in which fluid is injected through the cervix into your uterus — and an ultrasound to create images of your uterine cavity. Or it might include a hysteroscopy — in which a thin, flexible, lighted telescope (hysteroscope) is inserted through your vagina and cervix into your uterus
Specific steps of an in vitro fertilization (IVF) cycle carry risks, including:
- Multiple births. IVF increases the risk of multiple births if more than one embryo is implanted in your uterus. A pregnancy with multiple fetuses carries a higher risk of early labor and low birth weight than pregnancy with a single fetus does.
- Premature delivery and low birth weight. Research suggests that the use of IVF slightly increases the risk that a baby will be born early or with low birth weight.
- Ovarian hyperstimulation syndrome. Use of injectable fertility drugs, such as human chorionic gonadotropin (HCG), to induce ovulation can cause ovarian hyperstimulation syndrome, in which your ovaries become swollen and painful. Signs and symptoms typically last a week and include mild abdominal pain, bloating, nausea, vomiting, and diarrhea. If you become pregnant, however, your symptoms might last several weeks. Rarely, it’s possible to develop a more severe form of ovarian hyperstimulation syndrome that can also cause rapid weight gain and shortness of breath.
- Miscarriage. The rate of miscarriage for women who conceive using IVF with fresh embryos is similar to that of women who conceive naturally — about 15 to 25 percent — but the rate increases with maternal age. Use of frozen embryos during IVF, however, may slightly increase the risk of miscarriage.
- Egg-retrieval procedure complications. Use of an aspirating needle to collect eggs could possibly cause bleeding, infection or damage to the bowel, bladder or a blood vessel. Risks are also associated with general anesthesia is used.
- Ectopic pregnancy. About 2 to 5 percent of women who use IVF will have an ectopic pregnancy — when the fertilized egg implants outside the uterus, usually in a fallopian tube. The fertilized egg can’t survive outside the uterus, and there’s no way to continue the pregnancy.
- Birth defects. The age of the mother is the primary risk factor in the development of birth defects, no matter how the child is conceived. More research is needed to determine whether babies conceived using IVF might be at increased risk of certain birth defects. Some experts believe that the use of IVF does not increase the risk of having a baby with birth defects.
- Ovarian cancer. Although some early studies suggested there may be a link between certain medications used to stimulate egg growth and the development of a specific type of ovarian tumor, more recent studies do not support these findings.
- Stress. Use of IVF can be financial, physically and emotionally draining. Support from counselors, family, and friends can help you and your partner through the ups and downs of infertility treatment.
Why it’s done
Sometimes, IVF is offered as a primary treatment for infertility in women over age 40. IVF can also be done if you have certain health conditions. For example, IVF may be an option if you or your partner has:
- Fallopian tube damage or blockage. Fallopian tube damage or blockage makes it difficult for an egg to be fertilized or for an embryo to travel to the uterus.
- Ovulation disorders. If ovulation is infrequent or absent, fewer eggs are available for fertilization.
- Premature ovarian failure. Premature ovarian failure is the loss of normal ovarian function before age 40. If your ovaries fail, they don’t produce normal amounts of the hormone estrogen or have eggs to release regularly.
- Endometriosis. Endometriosis occurs when the uterine tissue implants and grows outside of the uterus — often affecting the function of the ovaries, uterus and fallopian tubes.
- Uterine fibroids. Fibroids are benign tumors in the wall of the uterus and are common in women in their 30s and 40s. Fibroids can interfere with implantation of the fertilized egg.
- Previous tubal sterilization or removal. If you’ve had a tubal ligation — a type of sterilization in which your fallopian tubes are cut or blocked to permanently prevent pregnancy — and want to conceive, IVF may be an alternative to tubal ligation reversal.
- Impaired sperm production or function. Below-average sperm concentration, weak movement of sperm (poor mobility), or abnormalities in sperm size and shape can make it difficult for sperm to fertilize an egg. If semen abnormalities are found, your partner might need to see a specialist determine if there are correctable problems or underlying health concerns.
- Unexplained infertility. Unexplained infertility means no cause of infertility has been found despite evaluation for common causes.
- A genetic disorder. If you or your partner is at risk of passing on a genetic disorder to your child, you may be candidates for preimplantation genetic diagnosis — a procedure that involves IVF. After the eggs are harvested and fertilized, they’re screened for certain genetic problems, although not all genetic problems can be found. Embryos that don’t contain identified problems can be transferred to the uterus.
- Fertility preservation for cancer or other health conditions. If you’re about to start cancer treatment — such as radiation or chemotherapy — that could harm your fertility, IVF for fertility preservation may be an option. Women can have eggs harvested from their ovaries and frozen in an unfertilized state for later use. Or the eggs can be fertilized and frozen as embryos for future use. Women who don’t have a functional uterus or for whom pregnancy poses a serious health risk might choose IVF using another person to carry the pregnancy (gestational carrier). In this case, the woman’s eggs are fertilized with sperm, but the resulting embryos are placed in the gestational carrier’s uterus.
? What is IVF or In Vitro Fertilization
In vitro fertilization (IVF)(more…) is a process of fertilization where an egg is combined with sperm outside the body, in vitro (“in glass”). The process involves monitoring and stimulating a woman’s ovulatory process, removing an ovum or ova (egg or eggs) from the woman’s ovaries and letting sperm fertilize them in a liquid in a laboratory. After the fertilized egg (zygote) undergoes embryo culture for 2–6 days, it is implanted in the same or another woman’s uterus, with the intention of establishing a successful pregnancy.
IVF is the most effective form of assisted reproductive technology. The procedure can be done using your own eggs and your partner’s sperm. Or IVF may involve eggs, sperm or embryos from a known or anonymous donor. In some cases, a gestational carrier — a woman who has an embryo implanted in her uterus — might be used.
Your chances of having a healthy baby using IVF(more…) depend on many factors, such as your age and the cause of infertility(more…). In addition, IVF can be time-consuming, expensive and invasive. If more than one embryo is implanted in your uterus, IVF can result in a pregnancy with more than one fetus (multiple pregnancies).
: Rhinoplasty methods
As mentioned above, nowadays rhinoplasty is being performed with various methods all around the world, here are these methods:
- Open procedure:
In this procedure rhinoplasty is applied to reshape the nose. This procedure can be used to change and resize different features of the nose such as span of the nostrils, angle between nose and upper lip, tip and/or bridg of the nose. It also can be applied to correct some breathing problems. People who has problem in Sinus or Polyp area, can be treated through rhinoplasty.
This procedure must be performed by doctors specialized in ear-throat-nose field (ENT) or plastic surgery or Maxillofacial surgery. Because only these specialist has the needed expertise to perform this surgical procedure. In this method, an incision is made across the narrow strip of tissue that separates the nostrils.
- Closed procedure:
Another method for rhinoplasty is the closed procedure. In this method the incisions are hidden inside a patient’s nose, with incision made into the nose. having access to the cartridge and bone portions of the nose, surgeon is able to perform changes that need to be made. This method is usually used to remove nose hump. It’s important to note that this procedure should only be performed on patients who aren’t dealing with polyp, sinus or any other breathing difficulties. Should patient sustained any injuries during this procedure, doctor will have to perform open rhinoplasty.
Open rhinoplasty and closed rhinoplasty surgery are different and each has its own traits, so it can’t be said for sure that one is superior to another. One of the advantages of open rhinoplasty is that it enables the surgeon to resolve nose problems easily and make various changes. But in case of closed rhinoplasty, surgeon can only remove nose hump and it might not eliminate the problem completely. Many doctors who perform rhinoplasty prefer the open procedure, unless patient is dealing with various health problems.Rhinoplasty In Iran , Rhinoplasty Cost In Iran ,Nose Job in Iran
? Why Rhinoplasty in Iran
We have the best plastic surgeons in Iran who are highly efficient and have high experience in cosmetic surgery. We are therefore ready to meet all medical needs in Iran for foreign customers from all over the world with free medical consultation service. The rhinoplasty surgeons in Iran is characterized by having excellent experience and excellence in the field of surgery and beauty and the doctor and medical staff to give the patient the beautiful natural appearance
How much does a nose job cost in Iran?
The cost of doing nose job in Iran is divided into hospital expenses, surgeon expenses, and is variable based on the case, nasal specialist’s diagnosis and discussable.
The approximate price of a nose job in Iran is about 1000 to 5000 Euro.
Nowadays rhinoplasty aka nose job, is one of the surgical procedures that is widely used by many people around the world to reshape their nose. It’s worth to know that the nose is one of the most distinctive features of your face and its function is critical to your beauty. Many people use rhinoplasty because they aren’t satisfied with their nose’s appearance while others do it due to breathing difficulties. This surgical procedure is operated with different methods each having its own traits. Below we explain some of these methods.
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A brief summary of post-rhinoplasty recommendations given to patients is as follows:
- Prevent injury to your nose. Minimize all activities, and be very careful.
- Avoid blowing your nose. Wipe your nose gently with tissues. If you sneeze, try to keep your mouth open.
- Change the dressing (if you have one) under the nose as needed.
- Avoid extreme physical activity. Strive for more rest than usual, and avoid exertion.
- Brush your teeth gently with a soft toothbrush only.
- Avoid manipulating your upper lip, which helps keep your nose at rest.
- Avoid smiling or excessive facial movements for 1-2 weeks.
- Wear clothing that fastens in front or back for 1 week. Avoid slipover sweaters, tight tee shirts, and turtlenecks.
- Avoid foods that require prolonged chewing. This is the only dietary restriction related to the rhinoplasty.
- You may wash your face, but avoid getting the nasal cast wet.
- Do not wash your hair for 1 week, unless you have someone who can do it for you.
- Do not get your nasal dressing wet.
- Absolutely avoid tanning for 6 weeks after surgery.
- Do not wear regular glasses or sunglasses that rest on the bridge of the nose for at least 4 weeks. You may tape the glasses to your forehead.
- After the physician removes your nasal plaster cast, the skin of the nose may be cleansed gently with a mild soap or a hypoallergenic/mild skin lotion.
Rhinoplasty without Surgery
Rhinoplasty without surgery is a new process that began a few years ago in Iran. A lot of people like this surgery because of the lower price and less pain. But you should keep in mind that this is an augmentation procedure and it’s not used to reduce the size of the nose. In this procedure, plastic surgeons use injectable fillers to fill the depressed part of the nose and reshape it.
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Rhinoplasty is an operation to resize the nose. Many people don’t like the shape of the nose because it doesn’t look good on their face. Even a slight change in the nose can make it incredibly beautiful. Patients who want to do rhinoplasty in Iran usually don’t like the abnormal small or large nose that doesn’t fit the rest of their face. Other patients want to correct bridge that is crooked or has a bump. Rhinoplasty will provide a beautiful shape to the nose while keeping a natural look that is suitable for the face.
Rhinoplasty in Iran is very famous all over the world and people from all countries come to Iran to do rhinoplasty in Iran. The nose has a great effect on facial beauty. Scientists have found the nose is one of the first parts of the body that is seen by other people.
Period of operation Rhinoplasty in Iran 1-3 hours. It’s better to stay in Iran for 10 days after doing rhinoplasty in Iran. One day in the hospital and the rest in a hotel or house that we will provide for you. The recovery from rhinoplasty in Iran begins four days later. Bruising and swelling usually do not occur. Doctors will remove stitches after about 6 days. You should only do easy jobs for 2 weeks and intensive workout should be avoided for 2 months.
Best City for plastic and rhinoplasty surgeons in Iran
Best rhinoplasty surgeons are doing the operations in Tehran. You can find the best quality and hospital services for a nose job in this city.
Through the corresponding with the specialist, you will have the resume, IDs, and certificate of our recommended specialist.
Nose Job Tips and Advice
- Get some hints from those who have done this surgery, speak with them and ask about their feeling before and after the operation. They will tell you about their expectation and the result, their satisfaction with their nose job.
- Have an updated medical checkup and send it to your specialist
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