We are launching a series of articles for and about mothers who have had a hysterectomy. This first part deals with the basics of fombies and the relationship between stress and the success of a fombie. The second part will be about the psychological aspects of abortion for mothers - please note that the order does not reflect the order of importance of the topics!:-)
Assisted reproduction in a broader sense means that medical assistance is needed to procreate, to reproduce. There are several forms, the range of options is wide and the method chosen depends on the diagnosis and the form of infertility diagnosed.
Assisted reproductive techniques are not the first choice for infertility treatment.If assisted reproductive methods seem to be the right choice, the available options include ovulation induction (with drugs), in vitro fertilisation (IVF), gamete intrafallopian transfer (GIFT), heterologous insemination (AID), intrauterine insemination with or without superovulation (IUI), egg donation and IVF and intracytoplasmic sperm injection (ICSI).
The success rate in IVF varies from clinic to clinic, ranging from 10-20% per treatment, but this success rate includes a large number of cases where the cause of infertility is indeed "only" organic. In such cases, IVF is much more successful because there were in fact physical obstacles to fertilisation until treatment which could be overcome by IVF.
The success rate depends not only on the institution, but also on the couple and the age of the woman being treated. 100/20 success is statistically reported if the woman is 23-35 years old, 100/15 if the woman is 36-38 years old, and 100/6 if the woman is over 40. Bernstein et al. (1979), reviewing 11 years of results, found that in organic cases, treatment resulted in 73% successful pregnancies, while in infertile women of unknown origin the rate was only 6.6%.
What happens during IVF?
It depends on the procedure, but the basics are the same.Several eggs are retrieved at a time for fertilisation. As normally only 1 matures per month, hormonal preparation is needed. They inject themselves with clomiphene, hMG (human menopausal gonadotropin) and visit the treatment centre every day for 1-2 weeks to check the maturation of the eggs. If they understand you, they will check your oestrogen levels with a blood test. Eggs are collected using UH or a laparoscopically guided probe and mixed with the partner's sperm in a Petri dish. The partner must donate sperm on the day of egg collection.
You can do this at home, but it is more common to do it while the eggs are being retrieved from the woman.After mixing, you head to the lab where the process is closely monitored. After 18 hours, they check how many eggs have fertilised. It is common for only 2-3 embryos to develop.The fertilised eggs are incubated in the laboratory for a few days and observed.
The technician watches the cells divide under a microscope to develop into two or more cells, called blastocysts.If one or more embryos develop in the lab, the woman is called in for an embryo transfer.
In this case, the fertilised eggs are introduced into the uterus through a catheter. The procedure is like a swab from the uterine cavity, no anaesthesia is needed. No more than 2 should be implanted, the rest are frozen.
Follow-up of IVF pregnancies is slightly closer than for pregnancies conceived spontaneously.
The impact of stress on reproduction and the success of IVF treatment
Getting pregnant and giving birth in a dangerous environment is evolutionarily risky, for both mother and child. Evolution has developed mechanisms that, under intense stress, can inhibit the reproductive system or, if the cost/benefit analysis shows that it is more profitable to lose the foetus, to "abort" the foetus.
Studies indicate that psychologically experienced stress is linked to disturbances of the gonadal functional axis, which may lead to infertility.
This effect has also been clearly shown in men: psychological stress inhibits sperm production. The success of IVF (in vitro fertilisation) depends on whether the eggs from the woman, fertilised with sperm taken from her husband or donor and transferred back into the uterus, will attach.
Women undergoing IVF treatment usually already suffer from severe anxiety and depressive symptoms which in themselves can prevent them from getting pregnant. Women with high levels of anxiety or depression are the most unsuccessful in IVF treatment. This shows that medical methods cannot break through the evolutionary barriers.
Boivin and Takefman (1995) found that those who were unsuccessful in an IVF programme in a given cycle experienced significantly greater stress during treatment, with a weaker biological response to treatment. The authors suggest that stress impairs the biological response and may result in poorer conception rates.So even women who do not otherwise show symptoms of anxiety during IVF have increased anxiety: on the one hand, the delay in conception itself is stressful, and on the other hand, fears of treatment and failure greatly increase anxiety.
Risks of assisted reproductive techniques
These are also things to be aware of. As the chances of having a child using assisted reproductive methods are around 20-25% for each cycle of treatment, the greatest risk for those on the programme is disappointment and failure. The most common 'side-effect' of treatment is multiple pregnancies, which can lead to compromised pregnancies, more frequent miscarriages and lower birth weight. Sometimes, foetuses that have started to develop have to undergo foetal reduction, which is a great emotional burden for the parents. The most frequently mentioned risk of artificial insemination is the so-called ovarian hyperstimulation syndrome (OHSS), which in some cases can develop as a result of medication at the pre-suction stage of the egg. As the fombic generation is only 30 years old, the long-term effects of fombic treatments are not yet known. Research has shown that hormonal stimulation can increase the risk of malignant tumours in mothers after many years of treatment.
How can I help you if you are about to have IVF?
- Transfer of information: in infertility centres you are often treated on a conveyor belt, you don't have time to ask your questions
- We can talk through any fears or doubts you may have about the procedure, so you can start with confidence and confidence.
- By the time you get to IVF, you've been through a lot, helping you to deal with any trauma, loss
- Solving self-esteem and relationship problems resulting from the failures of the pre-IVF period
- Being balanced and learning positive suggestion techniques will help you avoid possible side effects and complications
- IVF pregnancies often cause more worry for the mother, but by accompanying the pregnancy, the 9 months can be spent not in fear but in joyful anticipation
- Contact with the child conceived in a fomb, avoiding the "precious child syndrome"
- Don't be taboo! Talk to the child about the conception. Check out I am a Lombikbaba my storybook!
- More information on this topic: www.noraarvai.com
I gave an interview on the subject to M1 Television, the programme will be broadcast on 18 October 2015 after the 8:00 and 15:00 newscast, in the programme Family and Home.
Nóra Árvai is a psychologist, perinatal counsellor and writer,
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