Have you ever considered the possibility of a pregnancy without fallopian tubes? Have you even known that this is possible?
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What Role Play the Fallopian Tubes in Conception?
The fallopian tubes are essential for the process of conception:
- They ensure and support the egg`s capture in the peritoneal cavity;
- They transport the egg to the uterus;
- They lead the sperm to the egg where the fertilization will take place.
Considering a Pregnancy without Fallopian Tubes
On the other hand, women without fallopian tubes can use the IVF treatment. In vitro fertilization, shortly known as IVF, is applied since 1978. The principle of the method can be briefly outlined.
After the hormonal stimulation of the ovaries, the oocytes (the oocyte is the female germ cell) are extracted and put in contact with the male sperm in a container. The sperm will fertilize the oocytes from which will result the embryos which will be inserted in the future mother`s uterus, where they`ll continue to develop in ideal conditions, leading to pregnancy.
As it shows from the above brief description, the fallopian tubes are no longer necessary because the fertilized oocytes are reinserted in the uterine cavity, as embryos, after a previous passage through a container or tube. This way, the method can also be applied for women with clogged fallopian tubes, who have tubes that are no longer functional or it isn`t possible to have this cause of sterility removed surgically.
This method has known a wide spread in the last 20 years after the birth through IVF treatment in 1978. Today, this is applied as treatment for other causes of sterility as well. Now, only half from all IVF treatments are addressed to sterility causes from diseases that involve the fallopian tubes.
This method is also popularly known as “artificial fertilization,” but this expression isn`t correct because the fertilization of the oocyte by the sperm takes place just as it would normally would, the only difference being that it takes place in a special container. So, not the fertilization itself, but only the place where the process takes place is “artificial.”
The Stages of the Treatment
At first, a diagnosis will be placed along with the IVF indication. Usually, the couple receives all the details in a detailed discussion that involves all the procedures, risks and chances of success of the actual treatment. Then, all initial premises are controlled for performing the treatment and, if necessary, there`ll also be made some complimentary investigations.
The therapy includes a hormonal inhibiting stage and an ovarian stimulation stage. The therapy of ovarian hormonal inhibiting starts after a preliminary ultrasound examination and the exclusion of an infection in the male sperm. This stage lasts averagely for 2 weeks and has the role of preventing an early ovulation. Then will follow the ovarian stimulation stage.
The ovarian stimulation therapy includes in the first week infections of stimulation that are performed daily. Then the menstrual cycle will be monitored by performing ultrasound and hormonal examinations at certain intervals. The hormonal dose is then individualized depending on these results.
These investigations are performed until it will be obtained optimal values in terms of size and number of follicles, and respectively, hormonal blood values. When optimal conditions are obtained, a new hormone will be administrated to prepare the oocytes for harvesting. This hormone is known as hCG, an injection which will determine the follicles to break and the occytes to be released.
After 36 hours from the hCG administration, the oocytes will be harvested, a procedure that is known as follicular puncture. This technique is performed through the vagina under an ultrasound examination and anesthesia. The procedure of harvesting the oocytes lasts for 10 – 20 minutes. The oocytes are distinguished under the microscope and then placed in a special culture environment. On the day of follicular puncture, the male needs to offer the sperm. After a special preparation, the sperm are placed in contact with the oocytes.
After around 18 hours, the oocytes are controlled for fertilization. The fertilized oocyte shows 2 pronuclei, which represent genetic material which derives from the oocytes and sperm. This is the first stage of development of the embryo.
After 48 – 72 hours from the follicular puncture, the resulted embryos are introduced in the uterus, a technique known as embryo transfer. This procedure doesn`t require anesthesia because is extremely gentle. After the embryo transfer, a special treatment is required to sustain the embryo`s development. At 2 weeks from the transfer, there will be made a pregnancy test based on blood sample.
The pregnancy rate for IVF – ET is dependent on the causes that determine sterility. Another important factor is the patient`s age. In the entire world, it`s considered that the rate of success for an embryo transfer is of 25% to 35%. At some patients, the success rate is of even 50%.
In rare cases, (<1%) it may be encountered the following complications due to follicular puncture: damage of blood vessel, bladder, small intestine, large intestine.
The ovarian overstimulation syndrome occurs for a percentage of 5% to 10%, which required a close supervision of the patient after the embryo transfer. The rate of multiple pregnancies is of 5%, slightly increased at young patients and at those who receive more than 3 embryos. – Read more here!
A pregnancy without fallopian tubes performed by IVF treatment is exactly like a natural pregnancy.