IVF with PGD

IVF with Preimplantation genetic diagnosis PGD is one of the most commonly used techniques in the world recently, it is considered to be the best solution in cases of having family medical history of hereditary disorders. Therefore, the technique of genetic diagnosis (PGD) before embryo return depends on the examination of genes by taking a single cell from the fertilized egg after division and laboratory examination, then return the healthy certain number of embryos to uterus within a and freeze the remaining embryos for use in future cycles, especially if the pregnancy is not successful within this course.

The time needed to complete IVF with PGD is "approximately 34 days."

It is preferred to rely on IVF with PGD in the following cases:

• The wife's age is over of thirty-five; because the probability of developing embryos with chromosomal deformities rises with age.
• Some wives have frequent abortions as a result of certain genetic disorders.
• Severe semen weakness.
• Hereditary diseases in the family, such as sickle cell anemia and thalassemia.
• Fetal implantation failure in the uterus repeatedly.

One or both of the spouses undergo some of the previous tests to begin the procedure for IVF. These include the following:

• Experience the steps of embryo transfer to the uterus; to determine the depth of the uterus and choose the most appropriate method to use after the actual laboratory insemination.
• AMH test (Anti-Müllerian Hormone); to assess ovarian function and the ability to produce mature eggs for fertilization.
• FSH test (Follicle-stimulating hormone); to assess the wife's ovaries disorders and testicular problems in the husband.
• AFC test (Antral follicle count); to assess the number of primary eggs in the ovary (ovarian reserves).
• Ultrasound examination of the uterus to ensure the integrity of the inner lining of the uterus.
• Examination of the uterus and vagina through the endoscope by inserting it through the vagina.
• Examination of the husband's sperm to check their number, size and shape

This technique consists of the following steps:

1. Obtain the eggs from the wife (10 to 12 days after taking stimulants to release the eggs from the ovary) and the semen of the husband.
2. Leave the eggs with the sperm together in optimal conditions to begin the process of fertilization and then division.
3. After approximately 5 or 6 days, a sample of cells is taken and examined to determine the genetic abnormalities that the embryo may carry on its genes. Results may require 24 to 48 hours.
4. The embryos are transferred to the uterus after two days (upon receipt of the results from the laboratory); the doctor will insert a speculum through the vagina to keep its walls open, then insert a catheter tube through the cervix into the uterus and then passes the embryos through this tube to reach the uterus, this process is carried out using ultrasound monitoring for greater accuracy.

After the sperm has been fertilized by the husband's sperm, the embryos are transferred to the uterus, but confirmation of pregnancy requires more time until the embryos are implanted in the uterus. Obstetricians and gynecologists often ask the wife to use a home pregnancy test after a certain period (1 to 2 weeks); the determination of this period depends on the stage at which the fertilized cells were transferred, as following:

• Embryo transfer to the uterus on the third day of fertilization: where embryos are transferred during the stage of "blastocyst" and continue to grow within the uterus for about two days (fourth and fifth) and then begin to implant inside the endometrium, to complete this implantation on the seventh day, and begins on the eighth day HCG secretion (human chorionic gonadotropin hormone), HCG secretion continues in the next two days (9 and 10) more intensively, so the wife can conduct a urine or blood test on the eleventh day (11) to detect pregnancy.

• Embryo transfer to the uterus on the fifth day of fertilization: After two days of embryo transfer to the uterus, the blastocyst begins to implant itself in the uterus and this implantation is completed on the fifth day. On the sixth day, the placenta cells begin to secrete HCG and continue to secrete more during the next two days (7th and 8th), so a home pregnancy test or blood test can be done on the ninth day to detect the pregnancy.

Some women after IVF can experience some symptoms, most of which are normal and not worrying, such as: 

• Cramps, tingling or perhaps severe pain; this is normal due to the expansion of ovarian follicles.
• Bleeding during this period is very common, and is often very mild blood of pink or red color; often due to the implantation of the fetus in the endometrium or during the process of transfer of the fetus to the uterus.

To be more reassured if pregnancy is confirmed, an ultrasound is recommended to check the fetus' health more often and the opportunity to complete the pregnancy with ample reassurance about the success of pregnancy with healthy embryos.

After the embryo is transferred to the uterus and until waiting for the pregnancy to be confirmed (maximum period of two weeks), the mother is advised to rest completely and not to carry out any hard or exhausting work, and the need to avoid hot tubs or Jacuzzi.

It is important to note that it is possible to do the usual daily work and avoid those exhausting or stressful only after the process of vitro fertilization, and does not mean the intended rest not absolute movement, also it is preferred to refrain from intercourse for about a week.