Since 1981 Health School

Chapter 794 Difficulties of IVF

 Many women still have misunderstandings about fertility, thinking that they can wait when they are young and have children as soon as they ovulate XX eggs.

 So when I was young, I smoked, drank, made friends, and played as crazy as I wanted, hoping to enjoy my youth to the fullest.

As everyone knows, women’s fertility varies greatly among individuals. The aging of egg cells does not match a person’s biological age. Some women may no longer have fertility by the age of 35.

 Advanced age not only reduces the fertility rate but also increases the risk of pregnancy.

 Although human assisted reproductive technology can help some couples who are unable to conceive to have a baby as they wish, the possibility of chromosomal abnormalities in their offspring is very high.

 Especially after the age of 40, the probability of offspring having chromosomal abnormalities exceeds 1/100, which means that one in 100 mothers may give birth to a fetus with chromosomal abnormalities, such as Down syndrome.

They are also common "sugar babies". You can tell by the width of their eyes and they all have the same appearance.

Therefore, women who want to have children should complete the important task of pregnancy during the best fertile period of 25 to 29 years old.

Chen Qi nodded at several young doctors present:

"Hey, did you guys listen? Yu Shanshan, I heard that you rejected all the blind dates that everyone introduced to you. This is not okay. A woman's career is important, and her family is also important. Otherwise, you look at Dr. Tao and you are so young. If you want to do in vitro fertilization, you can’t say whether it will be successful or not.”

 Everyone chuckled again.

Yu Shanshan was not afraid of Chen Qi and retorted:

“Dean, the main reason is that there are more and more patients now, so many that we can’t even guarantee days off. How do you ask me to fall in love and find a partner? It’s all your fault, the dean.”

Since Chen Qi became the president, the business growth of Yuezhong Hospital has doubled every year. The income of medical staff has grown rapidly, but the workload is indeed very heavy.

 Chen Qi was not angry and comforted:

“Don’t be anxious, don’t be anxious. I have already recruited 300 college students this year. You will be relieved when these people come back from further studies. I will continue to expand enrollment next year and ensure that no one becomes a medical migrant worker.”

Professor Ding then interrupted with a smile:

"Dean Chen, most of what you said about implant medicine is very new. Not to mention they haven't heard of it, even I haven't heard of it. So if you don't stop, you can give everyone some information. Let’s take class.”

 Dean Chen has not attended classes for a long time. His previous classes were all about surgery and rarely involved internal medicine and gynecology.

 But the old employees of the People's Hospital all know that Director Chen either doesn't give lectures, but talks about groundbreaking content, which is of great clinical help. Every time he gave lectures in the past, the conference room was always full.

"Okay, since you want to listen, I will talk about it. The main content of the talk is about the cases of elderly women like Teacher Du Yafang. If the test tubes of these elderly women are done well, then the test tubes of young girls will not be a problem at all.

 The first thing to talk about is the factors that affect the success of IVF, such as age, uterine environment, embryo quality, etc.

 The first one is age. As I said before, this is one of the most important factors affecting the success rate of IVF.

 Because as age increases, women’s ovaries will gradually age and their functions will gradually decline, and the quality of men’s gold will also decrease significantly.

 Therefore, the best age for IVF should be no more than 35 years old, otherwise miscarriage or premature birth may easily occur due to poor physical function.

 The second factor is the environment of the uterus.

After the embryo is transplanted into the uterus, if the uterine environment is not good, such as endometritis, endometrial polyps, endometrial cancer and other lesions, it will change the uterine environment and easily affect embryonic development, thus leading to IVF failure.

 The third one is embryo quality.

If the gold or egg you choose has congenital abnormalities, such as an abnormal number of chromosomes or a missing chromosome structure, the survival rate of the embryo will be greatly affected.

 Once the quality of the embryos is poor, it is easy for the embryos to stop fertilizing after embryo transfer.

In order to improve the success rate of IVF, both couples need to conduct systematic and comprehensive pre-pregnancy screening in advance, especially genetic tests. It is helpful to eliminate adverse factors as much as possible before proceeding with IVF, which will help to increase the success rate. "

Yu Shanshan raised her hand and asked:

“Dean Chen, you said that the aging of the body is mainly due to ovarian factors. How do you understand it specifically?”

Chen Qi nodded and drew an anatomy diagram on the paper:

“The ovary is like a female reproductive bank, and the wealth reserve of the egg follicle pool can be divided into two parts: the original pool (resting primordial egg follicle pool) and the dynamic pool (growing egg follicle pool).

This is like the deposits in the bank and the cash on hand. The primordial follicles in the original pool are activated and become growing follicles and enter the dynamic pool. However, only one follicle in the menstrual cycle can be advantageously selected. discharge.

Since birth, there are about 1 to 2 million primordial follicles. As the only form of follicle reserve, they naturally decline and die every day.

 After the age of 35, the reserve capacity of the ovaries decreases, and the number of inferior follicles also increases.

After the age of 40, the ovarian follicles accelerate atresia, and the "stick breaking" phenomenon occurs, which is like a sudden steep **** on the way down the mountain.

So what mechanism controls reproductive ability? Speaking of which, please remember that Professor Ding, Director Xu, and others must pay attention to this key knowledge. What are the factors that regulate the ability to grow and plant?

This point is still controversial and is still under research. You can set up a research group. This is another international paper. Let me remind you first that the hypothalamic-pituitary-ovarian axis regulates the process of female reproductive aging through a classic feedback pathway. This is the most recent Mayo study that I am aware of.

I hope you can demonstrate this scientific research in advance through the case of Teacher Du Yafang. Cut off Humeo, then count on your ability. "

“Wow, Dean Chen, you are really good at being a traitor~~~”

 The doctors at the Implantation Center all applauded enthusiastically, because Director Chen gave them another big gift.

 In the past, working in their respective departments, these doctors had almost no exposure to good topics, and it was even more difficult to write papers.

 But after arriving at the Implantation Center, I felt that I couldn’t even finish the thesis. I couldn’t finish it at all. It turned out that there were too many subjects, which was a kind of happy worry.

Only Chen Qi himself knows that this "hypothalamic-pituitary-ovarian axis" theory had to wait until 2004 to be published by relevant experts. It is still blank at the moment, and it's nothing like the Mayo Clinic.

 So, following a cheating leader like Chen Qi, being a subordinate is so happy.

After careful inspection, on the third day, the Shengzhi Medical Center found out clearly that the main problem between Dr. Tao Peiliang and Teacher Du Yafang was with the woman.

Although the male's tadpoles are not energetic enough, they are still more than enough to give birth.

In addition to bilateral L-tube obstruction, Mr. Du also found uterine endometriosis lesions and pelvic adhesions in the pelvis.

Not only is he sick, Teacher Du’s ovarian reserve function AMH value is only 0.68ng/ml, which means that the key "luanzi" is difficult to mature and discharge normally.

 But this is the key point of IVF. You must have healthy and sufficient numbers of "luans".

Director Xu Anqin felt particularly uncomfortable after receiving this report card. She could feel how much her old colleague longed to have a child of his own.

Moreover, what happened in the Tao family was major gossip, and it actually spread to the hospital very quickly, which was actually quite irritating.

Tao Peiliang is also a doctor and can understand the results. After receiving the examination form, he also sighed:

“Well, it seems that it is fate. When my wife and I worked up the courage to do in vitro fertilization, God no longer gave us the chance.”

Professor Ding sat there and kept thinking, and suddenly she thought of a treatment method she had come across when she was a visiting scholar in Xiangjiang:

“No, actually there is no way. There is a latest drug abroad that can induce ovulation.”

 “What medicine?” everyone asked in unison.

 “Injectable chorionic gonadotropin shot!”

“Chormonal gonadotropin injection? I’ve never heard of it. Which domestic pharmaceutical factory produces it?”

Facing the confused colleagues, Professor Ding quickly explained:

“This drug is not currently available in China and was recently developed in the United States. It is made from chorionic gonadotropin extracted from the urine of pregnant women or the products of artificial abortion.”

Many doctors were a little surprised: "Wow, extracted from urine? This, this is too disgusting. Isn't it just like the 'Ren Zhong Huang' in traditional Chinese medicine?"

“Then you are wrong. This medicine has a very wide range of uses and its effects are very obvious.

For example, it can be used for the treatment of prepubertal cryptohypertension, male infertility caused by hypopituitarism, female anovulatory infertility, in vitro fertilization, luteal insufficiency, functional uterine bleeding, and pregnancy. Early threatened abortion, habitual abortion, etc. "

 “Wow, it’s so amazing...”

  In 1990, there was almost no domestic gynecological or infertility drugs, and most of them were dominated by traditional Chinese medicine.

 In addition, in this era, China is carrying out very strict family planning. What we are thinking about is how to have fewer children. How can we encourage childbirth?

 The domestic emphasis on implant medicine did not begin until 2005, and only entered the fast lane in 2010.

No matter how much the media brags about it, in fact our country is far behind in the area of ​​implantable medicine, such as genetics. Alas, I can’t say more about it. If I say too much, I will say that the author is providing negative energy.

Of course advertising is always far ahead. There are small infertility advertisements on those telephone poles and street corners...

 So in the 1980s and 1990s, domestic doctors did not have access to internationally advanced drugs, advanced treatment methods and equipment, and they lacked too much in terms of cognition.

 This is also the purpose of Chen Qi’s insistence on recruiting several professors from Haidong Medical University.

 Compared with those from overseas, the clinical skills and vision of those who studied abroad were much inferior.

 (End of this chapter)