Could there be a delay in embryo implantation? Embryo implantation after IVF, signs

A fertilized egg travels a complex path to reach the uterus, the place where it will develop throughout pregnancy. The egg enters the uterus at the blastocyst stage. A blastocyst is a fluid-filled ball. The outer layer of the blastocyst will eventually grow into the placenta, and the cells inside will become the embryo. Now she will have to go through the process of implantation, which means the embryo is attached to the uterus. It is after implantation is completed that pregnancy is considered to have occurred.

Timing of embryo implantation

Once in the uterus, the embryo floats freely for several days, and then the implantation process begins. The so-called implantation window occurs 6-8 days after ovulation. The implantation of the embryo into the uterine wall occurs 5-10 days after fertilization. The embryo must completely fuse with the mother's body. On average, it takes approximately 13 days for an embryo to become firmly established in the uterus. During the period when the embryo attaches to the uterus, the woman may experience slight bleeding. This is due to the attachment of the embryo to the uterus. Throughout this period, there is a high probability of miscarriage.

For successful conception in a woman’s body, the implantation window, the readiness of the uterus to accept the embryo, and the presence of an egg that has reached the blastocyst stage must coincide. After the blastocyst has attached, the formation of the embryo directly depends on the mother’s body. Now they have a very close connection with each other.

Why doesn't embryo implantation occur?

As is known, about 40% of blastocysts that successfully enter the uterus are not implanted. One of the reasons that the embryo is rejected is disturbances in the endometrium - the so-called lining of the uterus. This shell may not be nutritious enough for the blastocyst. Or does it have any deviations. Very often, the cause of endometrial disorders is abortion. As a result of such deviations, miscarriages occur. In this case, many women do not even know about conception, because the fertilized egg is released with the next period.

Embryo classification

The classification of embryos is used by clinics that engage in artificial insemination IVF. Each clinic has its own classification. However, the most common of them is the alphanumeric classification.

The classification mainly evaluates the quality and appearance embryo. The main characteristic in the classification of embryos on days 2 and 3 of development is the number of cells, as well as their quality.

A high-quality embryo must contain the following number of cells:

• on day 2 – from 2 to 6 cells;
• on day 3 – from 4 to 10 cells;
• on day 4 – more than 8 cells.

The numbers in the classification indicate the size of the blastocyst, as well as the stage of expansion. There are stages 1 to 6. In some clinics, I also indicate the number of cells in numbers.

The first letter used in the classification indicates the quality of the internal mass of the cell from which the embryo develops. It is customary to distinguish the following stages - A, B, C, D, of which A is the most favorable.

The second letter indicates the quality of the trophoblast - this is the outer layer of the blastocyst. It is this layer responsible for implantation of the embryo into the wall of the uterus. There are also four stages - A, B, C, D, where A indicates best condition trophoblast.

Using the classification of embryos, artificial insemination centers determine exactly the cell that is capable of in the best possible way attach to the epithelium of the uterus. It is from this that a healthy and full-fledged embryo will subsequently develop. After the implantation process is completed, the active process of embryo growth inside the mother begins.

In vitro fertilization is a complex multi-stage procedure, the final stage of which is the implantation of embryos into the uterus. Next comes the time for implantation, that is, the attachment of an egg fertilized in the laboratory to a prepared one. medicines endometrium. About the importance this process and its features during IVF will be discussed in this article.

Timing of embryo implantation after IVF

Sometimes the above dates may shift, in which case they speak of early and late implantation.

Implantation is called early when the embryo is introduced into the uterus 6-7 days after ovulation. This is rare, since at this time the endometrium is not yet sufficiently prepared for implantation.

Late implantation occurs on the 10th day after fertilization. The implantation process takes up to 3 days.

After IVF, as a rule, late implantation occurs. This type of implantation is favorable for fertilization in artificially created conditions.

Embryo implantation after IVF: signs, symptoms and sensations

After embryo transfer, the woman anxiously awaits the first signs that everything went well and the embryo has successfully implanted into the uterine cavity. Indeed, this stage is extremely important, because the outcome of the pregnancy largely depends on it.

The main subjective criteria for the implantation that has occurred are:

• small beige or pink discharge. The fact is that the embryo, during the process of implantation, destroys the endometrium, which contains a large number of blood vessels. If implantation is active, discharge may appear;
• minor aching or nagging pain in the lower abdomen similar to menstrual pain;
• feeling of nausea or change in taste. Most often - a metallic taste in the mouth;
• the appearance of low-grade fever, which ranges from 37.0 - 37.2 0 C and rarely rises above;
• general symptoms in the form of weakness, dizziness, feelings of irritability, increased excitability.

In case of any deviations from the norm in the presence of bloody discharge from the genital tract or pain in the lower abdomen after IVF, it is necessary to consult with your doctor to exclude the development of pathology or a threatening spontaneous miscarriage.

Pregnancy is considered clinically confirmed:

• when increasing, the study is carried out after 14 days;
• at high rates basal temperature. Read more about ;
• according to the results of ultrasound, which is performed on the 5th day after embryo transfer, and then 10 days later for dynamic monitoring of fetal development.

Why embryo implantation does not occur after IVF

In order to understand the reasons why implantation may not have occurred, it is necessary to understand what conditions must be met for the successful attachment of the embryo. So, successful implantation occurs when:

• endometrial thickness not more than 13 mm;
• serum progesterone is within normal limits;
• There is a sufficient amount of nutrients in the endometrium.

Lack of implantation during IVF may be caused by:

• genetic defects on the part of the embryo;
• pathological condition of the endometrium;
• congenital malformations of the embryo;
• the presence of a thick shiny membrane of the egg, which prevents its attachment in the uterine cavity.

Even if there is no positive result, you should not despair, because one failure is not a death sentence. Each case requires careful medical analysis, after which the IVF procedure can be repeated.

Is it possible to improve embryo implantation during IVF?

The question of whether a woman can, through her actions, help the embryo implant into the uterine cavity is of interest to many expectant mothers. Of course, the very process of establishing the embryo in the uterus is physiological, but certain behavior of a woman can both contribute to its successful completion and provoke complications. Here simple rules that will help reduce the risk of failure:

• limiting physical activity;
• sexual rest;
• absence of stressful situations;
• no hypothermia;
• exclusion of medications unless they were prescribed by a doctor;
• absence of thermal effects on the body, such as baths, saunas, baths;
• compliance with the work and rest regime.

These rules are valid for the entire period of growth and development of the baby in the womb, but special care should be taken during the first 10-12 days after replantation. During this time, you should lie down more and, if possible, avoid any work, including cooking, cleaning, washing, ironing, etc. Time on a laptop and tablet should be kept to a minimum. Remember that after the transplant, the woman is no longer alone, and, among other things, it depends on her actions whether the embryo can grow into a healthy, full-fledged baby and receive that portion of affection and love that the parents are ready to give it.

Every fourth woman experiences certain problems with childbirth: some cannot conceive for a long time, others cannot bear it.

Spontaneous miscarriage can lead to deep depression. To prevent this from happening, you should remember that the main thing is faith in success. And, of course, medical help.

TYPOLOGY OF LOSSES.
An incident that will not happen again.

A quarter of all spontaneous abortions occur before the 8th week of pregnancy due to chromosomal abnormalities in the fetus (for example, Down syndrome). Other reasons that cause a so-called accidental, single miscarriage include infectious diseases (rubella, chickenpox), high temperature that harms the placenta, temporary hormonal deficiency or aggressive external influences, such as chemical poisoning, too hot a bath, anesthesia.

After such a truly accidental termination of pregnancy, doctors do not prescribe special treatment, only psychotherapeutic and restorative treatment. 70% of couples soon have completely healthy children.

Habitual miscarriage.

As a rule, the cause of recurrent miscarriage is a deficiency of blocking antibodies in the mother's body. Our immune system is programmed to destroy foreign elements, such as cancer cells. But during pregnancy, specific blocking antibodies appear in a woman’s body. They “turn off” this “destruction system” so that the embryo can develop freely. If enough antibodies are not produced, the fetus is perceived as a foreign object and is rejected.

Antibody levels can be determined using a blood test. In some cases, injections of white cells obtained from the father's blood are used, which help the body expectant mother produce the required amount of antibodies that block the attack on the embryo. 2 weeks after the procedure, the pregnant woman undergoes another blood test. In half of the cases, the antibody level becomes normal and no other treatment is required. If the analysis shows that the desired result is not achieved, the injections are given 2 more times. This treatment helps in 80% of cases.

Blood clots in the placenta.

Another obstacle to the intrauterine life of the unborn child is antiphospholipid syndrome (APS), when antibodies are formed in the body, triggering the formation of small blood clots.

In general, clots are absolutely harmless, however, if one of them ends up in the placenta, a miscarriage is inevitable. The syndrome was discovered in 1983 and is diagnosed by a blood test.

APS is a common problem in the second and third trimesters of pregnancy, as it takes several months for the clots to settle in the placenta. In 75–80% of cases, APS is treated with available means, and pregnancy proceeds without complications.

To thin the blood somewhat, doctors prescribe small doses of baby aspirin, which reduces clotting, to patients at risk of miscarriage. Experts are confident that baby aspirin does not harm the fetus, while “adult” (high concentration) can be dangerous.

If a woman has high levels of antibodies, she is prescribed heparin (a strong anti-blood clotting agent) for the entire duration of pregnancy.

Killer cells.

Their presence is also clearly visible in a blood test. These cells provide benefits in everyday life by fighting cancer and viral infections. But sometimes they begin to actively fight with healthy, normal cells, including those that make up the embryo, which is mistaken for a foreign body. For treatment, venous immunoglobulin is used - an antibody that arises in the body in response to infection. It reduces the aggression of the killer cell. Up to 80% of women who resorted to this treatment were able to bear a child.

Hormonal imbalance.

The most common hormonal disorder is luteal phase deficiency (LPF). While the egg is released from the ovary, hormones “prepare” the body for pregnancy. In NLF, the level of progesterone, a hormone that helps a fertilized egg implant into the uterus, is low. Therefore, the egg cannot implant thoroughly, which causes early miscarriages (sometimes two weeks after fertilization, when most pregnant women do not even suspect their happiness). NLF is treated with drugs with high levels of estrogen and progesterone or progesterone injections.

SVETLANA LEBED, Ph.D., obstetrician-gynecologist, senior product manager for gynecological drugs at the representative office of Schering AG in Moscow:

“Women with recurrent miscarriage are quite often obese. This is not a consequence of overeating or lack of physical activity, but of neuroendocrine disorders. It is known that adipose tissue contains enzymes involved in the metabolism of sex hormones and corresponding receptors. A balanced diet is extremely important for such women.
Systematic training promotes fat burning: brisk walking, light jogging, aerobics with moderate intensity exercise. Unfortunately, fat deposits in the abdominal area, characteristic of women with recurrent miscarriage, are very difficult to correct, so additional strength exercises on the oblique abdominal muscles are often necessary.

Most of these women are in a state of increased psychological stress and suffer from depression or anxiety disorders. After playing sports, your mood improves, a surge of strength and energy appears, which contributes to the formation of a positive outlook on the future.”

Other reasons.

A number of some anatomical defects of the female reproductive system - malformations of the uterus (for example, hypoplasia, saddle deformity, septum) - are corrected surgically.

Pathogenic bacteria living in the vaginal microflora are suppressed by antibiotics (erythromycin during pregnancy, tetracycline before). Chronic diseases such as diabetes or hypertension are also a risk factor for spontaneous miscarriage. Genetic disorders in one of the partners that have never previously been encountered can become a serious problem.

Healing emotional wounds due to the loss of a fetus can be a painful and lengthy process if those around you do not show enough tact and attention

With faith in victory.

It is customary to remain silent about the fact that a miscarriage has occurred, and this in no way contributes to “healing of wounds.” Those who so dreamed of the happiness of motherhood often have no one to talk to about their grief. Why did “natural selection” affect you specifically?

Will further attempts be successful? These questions torment failed parents. Of course, if you set a goal, you can get out of a state of depression or prevent its onset. Friends, relatives and spouses themselves should take the advice of professional psychologists and doctors to restore peace of mind.

Down with the blinders! Traditionally, it is believed that the fact of pregnancy should be kept a closely guarded secret for the first few months, especially if the first experience ended unsuccessfully. This custom can cause you to mentally attract negative energy to the event.

Share the joy of future motherhood calmly and without much fear. This will relieve you of anxiety and put you in an optimistic mood. At the same time, you should not attract too much attention to yourself. In a friendly atmosphere, but without unnecessary fuss, you will feel natural.

Restore your fortitude. While a woman’s body is already ready for a new pregnancy, psychologically she often “does not catch up” with her physiology. A miscarriage is a great grief, almost the same as the death of an already born child. It is better not to force the next conception until the emotional wounds have healed. It is necessary to feel the thirst for a new life, not in spite of death, but in the name of love.

More tact. If you find out that someone you love has suffered a miscarriage, forget all the standard forms of condolences. Express your sympathy with any specific help. Doing the best you can is what's worth taking care of. Activity and a healthy lifestyle will make you believe in further success. Melancholy will be dispelled by travel, knowledge of the world around us, and the joy of communication.
Join your efforts. There is no need to be ashamed of suffering.

Often married couples fantasize a lot about their future child; it seems to them that he has already been born and grown up before their eyes - and these people have the hardest time. Such a loss is a test for a family. When two people grieve together, it is difficult for them to support each other. It's worth looking for outside help. You can easily meet people like you - for example, in a hospital or on an Internet forum dedicated to motherhood and the difficulties of childbearing. In any case, you will not be left alone with your trouble.

Contrary to what many people believe, physical activity cannot cause a miscarriage. On the contrary, sometimes they help to become a mother.

FOR THE RIGHT TO BE A MOTHER
Run after the child.

Oksana and her husband were delighted when she became pregnant. But an ultrasound showed that the fetus was dead. 6 months later she was expecting a child again. “But I didn’t even hope, thinking that I couldn’t bear it. And in fact, at the 8th week the pregnancy was terminated. I was exhausted, slept poorly, ate little and looked terrible. And then I learned about a running clinic: they alternate fast running with walking. I decided to try it. Gradually I began to enjoy the activities and my body.

I have become slimmer. One day I ran a lot without even noticing slight nausea. But my period was late, so I bought a pregnancy test. He gave a positive result! I tried to maintain my presence of mind. Started new life, and there was a place for normal pregnancy and childbirth. The first ultrasound showed a weak heartbeat. Due to the risk of miscarriage, the doctor forbade running. But I continued to walk - very quickly. In April the child was born. The classes helped me carry and give birth! I am confident that my precious boy is the result of a love of running."

WE WANT CHILDREN!

Katya, 30 years old, had difficulty conceiving. In 1991, she became pregnant; at the 8th week, an ultrasound showed that the fetal heartbeat could not be heard. A year later, Katya became pregnant again - this time with twins. Every time she went for an ultrasound, she suppressed the feeling of anxiety. At 10 weeks, one of the twins died and was absorbed into the placenta, which is extremely rare. At the 16th week, the heart of the second one stopped and an artificial interruption was performed.

Catherine and her husband were adamant. “I was advised to wait two full menstrual cycle. But emotionally it takes much more time...” Tests showed that Katya needs special treatment - a course of injections. Over the course of 3 months, she received two portions of her husband’s white corpuscles. Soon she gave birth to a son, and then, without additional therapy, twins. Now Katya wears fourth child: “Did the vaccinations have an effect or did it happen on its own? Don't know...".

In order for the next attempt to be successful, future parents need to fully restore physical and emotional health.