Why is the embryo not implanted? Embryo implantation after IVF, signs

Every fourth woman has certain problems with childbearing: some fail to conceive for a long time, others cannot endure.

Spontaneous miscarriage can lead to deep depression. To prevent this from happening, it should be remembered 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). Among other causes that cause the so-called accidental, single miscarriage are infectious diseases (rubella, chicken pox), high temperature that harms the placenta, temporary hormonal deficiency or aggressive external influences such as chemical poisoning, too hot bath, anesthesia.

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

Habitual miscarriage.

As a rule, the cause of a habitual 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 the body of a woman. 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 with a blood test. In some cases, injections of white bodies obtained from the father's blood are used, which help the body future mother produce the right amount of antibodies that block the attack on the embryo. 2 weeks after the procedure, the pregnant woman is given another blood test. In half of the cases, the level of antibodies becomes normal and no other treatment is required. If the analysis shows that the desired result is not achieved, injections are made 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 that trigger 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 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 with a threatened miscarriage. Experts are sure that children's aspirin does not harm the fetus, while "adult" (high concentration) can be dangerous.

If a woman has high antibody levels, she is given heparin (a strong anti-clotting agent) for the duration of her pregnancy.

Killer cells.

Their presence is also clearly seen in the blood test. These cells, within the framework of ordinary life, benefit by fighting cancer and viral infections. But sometimes they begin to actively fight healthy, normal cells, including those that make up the embryo, taken for a foreign body. For treatment, venous immunoglobulin is used - an antibody that occurs in the body in response to an infection. It reduces the aggression of the killer cell. Up to 80% of women who resorted to such treatment were able to carry a child.

Hormonal imbalance.

The most common hormonal disorder is luteal phase deficiency (LFP). While the egg is released from the ovary, hormones "prepare" the body for pregnancy. With NLF, the level of progesterone, a hormone that helps a fertilized egg to implant in the uterus, is low. Therefore, the egg cannot be firmly fixed, which causes early miscarriages (sometimes two weeks after fertilization, when most pregnant women are not even aware of their happiness). NLF is treated with high estrogen and progesterone drugs or progesterone injections.

SVETLANA LEBEDI, PhD, obstetrician-gynecologist, senior product manager for gynecological preparations of the representative office of Schering AG in Moscow:

“Women with recurrent miscarriage are quite often obese. This is not a consequence of overeating or insufficient physical activity, but of neuroendocrine disorders. It is known that adipose tissue contains enzymes involved in the exchange of sex hormones and the corresponding receptors. A balanced diet is extremely important for such women.
Fat burning is facilitated by systematic training: brisk walking, light running, aerobics with a load of medium intensity. Unfortunately, fat deposits in the abdomen, characteristic of women with recurrent miscarriage, are very difficult to correct, so additional strength exercises for the oblique abdominal muscles are often necessary.

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

Other reasons.

A number of some anatomical deficiencies of the female reproductive system - uterine malformations (eg, hypoplasia, saddle deformity, septa) - are corrected surgically.

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

Healing mental wounds due to the loss of a fetus can be a painful and long process if others do not show enough tact and attention.

With faith in victory.

It is customary to keep silent about the fact that a miscarriage has occurred, and this does not contribute to the “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?

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 use the advice of professional psychologists and doctors to restore peace of mind.

Down with blinders! It is traditionally believed that the fact of pregnancy should be kept under the strictest confidence for the first few months, especially if the first experience ended unsuccessfully. This custom is fraught with the fact that you 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 set you in an optimistic mood. At the same time, don't draw too much attention to yourself. In a friendly atmosphere, but without too much excitement, you will feel natural.

Restore the strength of the spirit. 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 spiritual 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 close to you has had a miscarriage, forget all the standard forms of condolence. Express sympathy with any specific help. Do the best you can - that's what you need to take care of. Activity and a healthy lifestyle will make you believe in further success. Longing will be dispelled by travel, knowledge of the world, the joy of communication.
Unite your efforts. There is no need to be ashamed of suffering.

Often couples fantasize a lot about their unborn 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 the family. When two people are grieving together, it is difficult for them to support each other. It is worth looking for help on the side. 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 misfortune.

Contrary to the beliefs of many, physical activity cannot cause a miscarriage. On the contrary, sometimes they help to become a mother.

FOR THE RIGHT TO BE A MOM
I run after the child.

Oksana and her husband were delighted when she became pregnant. But the ultrasound showed that the fetus is dead. After 6 months, she was again expecting a child. “But I did not even hope, believing that I was not able to endure. And in fact, at the 8th week, the pregnancy was interrupted. I was shattered, slept badly, ate little and looked terrible. And then I found out about the running clinic: they alternate fast running with walking. I decided to try. Gradually, I began to enjoy the activities and from my body.

I became leaner. Once I ran a lot without even noticing a slight nausea. But my period was delayed, and I bought a pregnancy test. He gave a positive result! I tried to keep my presence of mind. started new life, and in it there was a place for normal pregnancy and the birth of a child. The first ultrasound showed a weak heartbeat. Due to the risk of miscarriage, the doctor forbade running. But I kept walking - very fast. In April, the child was born. Classes helped me endure and give birth! I am sure that my precious boy is the result of a love of running.”

WE WANT CHILDREN!

Katya, 30, had difficulty conceiving. In 1991, she became pregnant, at the 8th week, an ultrasound scan showed that the fetal heartbeat was not audible. A year later, Katya became pregnant again - this time with twins. Every time she went for an ultrasound, she suppressed her feelings of anxiety. At week 10, one of the twins died and was absorbed by the placenta, which is extremely rare. On the 16th week, the heart of the second stopped, and an artificial interruption was made.

Catherine and her husband were adamant. “I was advised to wait two full menstrual cycle. But emotionally it takes much more time...” The tests showed that Katya needed special treatment - a course of injections. For 3 months she received two portions of her husband's white bodies. 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 just 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.

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 the egg fertilized in the laboratory to the prepared medicines endometrium. About the importance this process and its features in IVF will be discussed in this article.

Terms of embryo implantation after IVF

Sometimes the above terms can be shifted, in this case they speak of early and late implantation.

Implantation is called early, when the introduction of the embryo into the uterus takes place 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 the moment of fertilization. The implantation process takes up to 3 days.

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

Embryo implantation after IVF: signs, symptoms and sensations

After replanting the embryos, the woman anxiously waits for the first signs that everything went well and the embryo has successfully implanted into the uterine cavity. Indeed, this stage is extremely responsible, because the outcome of 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 implantation destroys the endometrium, which contains a large number of blood vessels. If implantation is active, discharge may occur;
• slight aching or pulling pains in the lower abdomen similar to menstrual;
• feeling sick or having a change in taste. Most often - a taste of metal in the mouth;
• the appearance of subfebrile temperature, which ranges from 37.0 - 37.2 0 С and rarely rises higher;
• 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 in order to exclude the development of pathology or threatening spontaneous miscarriage.

Clinically confirmed pregnancy is considered:

• with increasing, the study of which is carried out after 14 days;
• at high rates basal body temperature. 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 might not occur, it is necessary to understand what conditions must be met for the successful attachment of the embryo. So, successful implantation occurs when:

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

The lack of implantation during IVF can 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 shell of the egg, which prevents it from attaching to the uterine cavity.

Even in the absence of a positive result, do not despair, because one failure is not a 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 help the embryo to penetrate into the uterine cavity by her actions is of interest to many expectant mothers. Of course, the very process of substantiating the embryo in the uterus is physiological, however, a certain behavior of a woman can both contribute to its successful completion and provoke complications. Here are some simple rules to help reduce the risk of failure:

• limitation of physical activity;
• sexual rest;
• lack of stressful situations;
• lack of hypothermia;
• exclusion of medicines, unless they have been prescribed by a doctor;
• lack of thermal effects on the body, such as a bath, sauna, bath;
• observance of the regime of work and rest.

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

A fertilized egg makes a difficult journey to get into the uterus - the place where it will develop throughout the pregnancy. The egg enters the uterus at the blastocyst stage. The blastocyst is a fluid-filled sac. The outer layer of the blastocyst will eventually grow into the placenta, and the cells inside will become the embryo. Now she has to go through the process of implantation, which means attaching the embryo to the uterus. It is after the completion of implantation that pregnancy is considered to have occurred.

Timing of embryo implantation

Once in the uterus, the embryo is in free swimming for several days, and then the process of implantation begins directly. The so-called implantation window occurs 6-8 days after ovulation. The very implantation of the embryo into the uterine wall occurs 5-10 days after fertilization. The embryo must fully grow together 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 is attached to the uterus, a woman may have slight spotting. This is due to the attachment of the embryo to the uterus. Throughout this period, there is a high probability of miscarriage.

For a successful conception in the body of a woman, 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 bond with each other.

Why is the embryo not implanted?

As is known, about 40% of blastocysts that have successfully entered the uterus do not implant. One of the reasons why the embryo is rejected is a violation in the endometrium - the so-called uterine lining. This membrane may not be sufficiently nutritious 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 comes out with the next menstruation.

Embryo classification

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

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

A quality embryo should contain the following number of cells:

• on the 2nd day - from 2 to 6 cells;
• on the 3rd day - from 4 to 10 cells;
• on the 4th day - more than 8 cells.

The numbers in the classification indicate the size of the blastocyst, as well as the stage of expansion. Distinguish from 1 to 6 stages. In some clinics, I also indicate the number of cells with 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 the implantation of the embryo into the uterine wall. 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 the best way attach to the epithelium of the uterus. It is from it 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.