The topic of pregnancy is always relevant for women of reproductive age.
In order to learn about a special situation as early as possible, they begin to listen to the unique changes in their own body.
In order to determine on what day after fertilization the implantation of the egg occurred, you should find out the exact date of ovulation.
This period will be taken as the starting point. Most often, the introduction of the embryo occurs on the 9-10th day after fertilization.
But depending on individual features female body terms can be shifted by 1-6 days up or down. It turns out that implantation can occur 8-14 days after the fertilization of the egg.
When do signs of pregnancy appear?
The first trimester of pregnancy is characterized by the manifestation of specific symptoms such as:
They can appear a certain number of days after the intended conception.
- Implantation bleeding.
These are, which are scarce and plentiful, depending on physiological features female body.
It appears 8-10 days after fertilization, when the embryo attaches to the wall of the uterus. This is one of the important signs of pregnancy.
- Slight uterine pain of a pulling nature.
Pain is provoked by the process of planting the embryo on the epithelium of the uterus.
On the 8-10th day after the alleged conception, slight pains in the lower abdomen may appear.
This is a standard phenomenon, but in case of an increase, you should consult a doctor to avoid termination of pregnancy.
- Allocations.
The appearance may be associated with, or other infectious processes.
Observed 8-10 days after conception.
- Raise basal body temperature.
Basal temperature is measured rectally in the morning, immediately after waking up.
Basal temperature rises to 37.1-37.3 ° C the day before ovulation. At this level, it remains until the replanting of the embryo.
At the moment of egg attachment, the basal temperature drops to 36.8-36.9 °C. This is due to a sharp increase in estrogen in the body of a woman.
After implantation of the ovum the basal body temperature again rises above 37.1 ° C and remains at this level until the 14-16th week of pregnancy.
Then the rectal temperature drops to 36.8-36.9 °C.
Increased sensitivity of the mammary glands may occur in the first or second week after the alleged conception (7-14 days).
Changes in the hormonal background lead to such manifestations.
Some pregnant women experience swelling and pain in the breasts only 20-30 days after the fertilization of the egg.
- Sudden mood swings.
Depression, replaced by joy, is also due to a hormonal surge. Usually appear on the 10-14th day after the onset of pregnancy.
Human chorionic gonadotropin in the blood is usually determined as early as 9-12 days after the conception of the child has taken place.
- The second strip on the test.
Many women use special tests to confirm their "interesting" position.
The test will show a second strip, that is, it will give positive result only 12-14 days after the intended conception of the fetus.
It determines the amount of the hCG hormone, the level of which in the urine does not appear immediately, but only 11-14 days after the expected date of conception.
- Diarrhea and other disorders of the gastrointestinal tract.
Heartburn, bloating, flatulence, diarrhea are characteristic signs of pregnancy that can occur 14-20 days after the alleged fertilization.
- Toxicosis.
This is one of the main signs of the imminent birth of a child.
It usually occurs 5-7 weeks after the fertilization of the egg.
- Increased fatigue, drowsiness, dizziness.
These are important signs of a special state of the female body. The reason lies in the sharp drop in blood pressure.
2-3 weeks after the intended conception, some women may begin to periodically lose consciousness.
But this phenomenon is considered normal.
Conception is a complex physiological process that goes through several stages. The result is the fertilization of the egg and the formation of an embryo that continues to develop in the uterus until the onset of childbirth.
You can determine pregnancy by numerous signs that appear in the first trimester. But for each symptom, a certain time period of manifestation is characteristic. All of the above signs are quite specific and appear within 2-14 days after conception.
Artificial insemination is an assisted reproductive technology method that has been successfully used for hundreds of years to treat infertility. The procedure involves the introduction of prepared sperm into the uterus of a woman during ovulation using a thin catheter, where the egg is then fertilized.
Before and after the procedure, a woman can be prescribed hormone therapy, which has some effect on her condition. As a rule, the process of fertilization and implantation should occur asymptomatically, according to doctors. Consider what sensations a woman can experience after insemination, and what they are associated with.
The most common complaint that doctors hear from patients after intrauterine insemination- aching pain in the lower abdomen. If the stomach hurts immediately after insemination or in the first couple of days, then this is considered a variant of the norm. This condition is associated with the reception hormonal drugs and changes in the female body.
After fertilization, the ovaries begin to produce a large number of sex hormones, which are necessary for the normal attachment of the fetus to the wall of the uterus and improve its nutrition. Often after insemination, the abdomen hurts as before menstruation, and it swells, swells and hurts the chest.
It should be noted that such a condition is the norm only if there are no abundant bloody issues and the pain is tolerable. If the stomach after insemination hurts unbearably badly, then you need to urgently consult a doctor. It is possible that there were some complications.
To relieve pain after insemination, it is recommended to rest more, spend time in bed. Doctors also advise eating light protein foods, avoiding gas-producing foods, fatty and spicy foods. It is very important to drink enough fluids and not to worry.
After insemination, it is strongly recommended to stop taking painkillers and steroidal anti-inflammatory drugs, these drugs do not have the best effect on the development of the fetus. But if a woman nevertheless decided to take painkillers, it is necessary to consult with her doctor. Do not self-medicate, it can lead to severe consequences, up to the deformity of the fetus and miscarriage in the early stages.
Allocations
Another symptom that greatly worries women after insemination is brown and bloody discharge. Every woman knows that during pregnancy there should be no blood, therefore, menstruation after successful insemination does not normally occur, because the egg is fertilized and begins to actively develop.
Bleeding after insemination can occur for a number of reasons:
- fetal implantation has occurred;
- during the procedure, the doctor damaged the walls of the vagina;
- an ectopic pregnancy has occurred;
- a miscarriage has occurred;
- menstruation began, which indicates unsuccessful insemination.
In each case, bleeding looks different, but in any case, a woman is advised to talk to her doctor if she sees blood on her underwear after insemination or IVF.
The most favorable bleeding is implantation, which occurs 5-7 days after the procedure. This happens in some women at the time when the embryo grows into the wall of the uterus. When the fetus attaches, it damages small capillaries that begin to bleed. In this case, the discharge is scanty, light, most often pink. With an injury to the genital tract, the discharge is also very scarce, the blood is light, scarlet.
Spotting after insemination can also be a bad symptom, for example, ectopic pregnancy. In this case, bleeding can be moderate or profuse, and the condition is usually accompanied by severe pain in the lower abdomen. If a woman experiences symptoms such as pain and blood after insemination, she should immediately consult a doctor.
Menstruation after insemination in case of failure occurs on the 11-15th day. Menstrual bleeding suggests that the pregnancy did not occur, and the procedure was unsuccessful. Abundant bleeding before menstruation, that is, on the 5-10th day, may indicate that fertilization has occurred, but for some reason the embryo has been rejected.
Temperature
Often after insemination, women complain of fever and weakness. This condition is a variant of the norm, it is associated with the hormonal system, in particular with an increase in the level of progesterone in the body.
Normally, the temperature rises to 37.5 degrees and does not last long, only the first couple of days. At this time, a woman may feel drowsiness, weakness, aching pain in the lower abdomen and bloating. It is recommended during this period to rest more and worry less.
If the body temperature has risen above 38 degrees, the woman has questionable discharge, her head hurts, she is sick, then you need to contact a therapist. After insemination, there should not be such symptoms; most likely, the woman fell ill with an infectious pathology.
Nausea
Often, doctors have to hear from patients that they feel nauseated after insemination. Normally, nausea after insemination should not occur, no hormones can provoke the appearance of such a symptom, and it is too early for the onset of toxicosis.
If a woman is sick after insemination, this may be due to a strong experience, poor nutrition. First of all, it is recommended to remember what the woman ate today, whether she is starving herself due to a nervous condition. After the procedure, you must follow proper nutrition, starve and overeat is strictly prohibited.
If nausea is accompanied by vomiting, fever and abdominal pain, this may be a sign of a serious pathology, for example, an exacerbation of gastritis or an intestinal infection. In this case, you should immediately consult a doctor.
Pregnancy
The most important question is what are the symptoms of pregnancy after insemination? No matter how sad it may sound, there can be no symptoms in the first days. All signs are associated only with hormonal changes in the body or with taking drugs to stimulate ovulation and maintain pregnancy.
It is possible to say exactly whether pregnancy has occurred only 2 weeks after insemination. To do this, a woman is recommended to take a pregnancy test for home use, as well as to be tested for the hCG hormone.
Therefore, if a woman does not bother at all after insemination, there is no need to be upset, this condition is an absolute norm. It must be remembered that the body of each woman is individual, like pregnancy. The best thing a mom-to-be can do is relax and hope for the best.
How to increase the chances of pregnancy with IUI (Video)
Every year becomes more urgent problem infertility, both female and male. Not all couples succeed in getting pregnant “on the go”, which is associated with an increase in the incidence, environmental degradation, and a frantic pace of life. Artificial insemination is one of the ways out of this situation. Despite its low efficiency (from 15 - 20 to 30% of pregnancies after the procedure), it has a number of advantages, an important of which is the low price (compared to IVF).
Artificial insemination: what is it, types
Intrauterine insemination or artificial insemination is the procedure for introducing sperm (husband or donor) into the genital tract of a woman for pregnancy. This medical manipulation belongs to assisted reproductive technologies and is carried out in a clinic, after the procedure is completed, the woman goes home. Artificial insemination began to be used about 200 years ago; in Russia, the AI method was first used by Shorokhova in the 25th year of the last century. This technology began to be used more widely in the 1950s and 1960s.
Options for conducting AI
The artificial insemination method includes 2 options:
Homologous technique
In this case, artificial insemination is carried out with the husband's sperm. To perform the procedure, both freshly obtained sperm, immediately before its introduction, and cryopreserved are used. Cryopreservation of the husband's sperm is carried out before the sterilization of the man, before the start of the course of treatment with cytostatics and on the eve of irradiation.
Heterologous technique
Artificial insemination is performed with donor sperm according to absolute and relative medical indications. It is not allowed to mix the sperm of the donor and the spouse, since the chances of fertilization of the egg by the husband's sperm will not increase, and the quality of the donor sperm will deteriorate. Before conducting AI with donor sperm, a test is performed for the penetration of the husband's and donor's sperm into the cervical mucus. If there are significant differences in the penetration abilities of the husband's and the donor's sperm, the issue of AI is decided in favor of the donor.
According to the technique of performing the procedure, artificial insemination is divided into:
Intracervical (subspecies - vaginal)
This is the simplest procedure, performed without any special technical difficulties. Intracervical AI according to the technique of conducting is most consistent with natural sexual intercourse. Special preparation before the manipulation is not required. Artificial insemination is carried out with freshly obtained purified sperm (no later than three hours before the procedure), and with cryopreserved sperm. The essence of the vaginal method is the introduction of sperm into the woman's vagina, and the intracervical (intracervical) method is as close as possible to the cervix.
Intrauterine
This method of introducing sperm is more effective than intracervical insemination. The technical essence lies in the introduction of specially prepared and purified sperm into the uterine cavity through the cervical canal. If fresh and unpurified seminal fluid, then its reduction or the development of an allergic reaction are possible, which will not only significantly reduce the chances of fertilization, but also pose a threat to the patient's life.
In-pipe
Before the procedure, spermatozoa undergo special preparation. The seminal fluid is then injected into the fallopian tube from which ovulation occurred. It has been proven that the effectiveness of intratubal insemination is not higher than that of intrauterine insemination.
Intrauterine intraperitoneal
Some of the processed semen is combined with a few milliliters of a special fluid that increases sperm motility. Then the resulting solution (about 10 ml) is injected into the uterine cavity under pressure. As a result, spermatozoa with fluid will almost immediately enter the tubes and from there into the abdominal cavity. The chances of fertilization of an egg that is currently in abdominal cavity much higher than during natural intercourse. This method of AI is used for an unknown cause of infertility and in case of failure of intracervical and intrauterine insemination.
Preparing for AI
Before insemination, the woman (recipient), the man (husband or donor), and the sperm itself are prepared. Married couple must undergo a full examination, and in case of detection of any diseases, their treatment (for example, genital infections). Also, spouses must follow all the recommendations for the planning period for pregnancy (within six months). These include: giving up bad habits, maintaining healthy lifestyle life, stimulation of immunity, rational nutrition, intake of vitamins and so on.
Expert advice
Both spouses need to visit the following doctors:
- therapist - identification of chronic somatic pathology and its correction;
- gynecologist (women) – detection of gynecological diseases;
- andrologist (men) – determination of dysfunctions in the male reproductive system;
- urologist - exclusion of the pathology of the urogenital system;
- mammologist (women) – detection of breast diseases;
- endocrinologist - exclusion of endocrine disorders.
According to indications, additional consultations of related specialists (cardiologist, oncologist, ENT doctor and others) are prescribed.
Analyzes and instrumental diagnostic methods
On the eve of the AI, a married couple is assigned to take tests and instrumental diagnostic methods:
- general blood and urine tests - exclusion of anemia, inflammation, allergic reactions, infections and other pathologies of the urogenital system;
- blood biochemistry (women) - assess the condition of the liver and kidneys, pancreas and heart, exclude metabolic disorders;
- coagulogram (women);
- examination for STIs - to identify and treat hidden sexual infections (chlamydia, ureaplasmosis, cytomegalovirus and herpetic infection and others);
- swabs for gonorrhea (men and women);
- blood for viral hepatitis, syphilis and HIV infection;
- blood for hormones (women) - sex, prolactin, FSH, LH, thyroid and adrenal hormones;
- blood group and Rh factor (exclude isoserological incompatibility of spouses);
- spermogram (men) - the number of live spermatozoa and their activity, the volume of seminal fluid, its density and color are estimated;
- Ultrasound (women) - gynecological sphere, kidneys, thyroid gland, mammary glands;
- fluorography, ECG.
Semen preparation
Before conducting AI, it is necessary to prepare the sperm. For this purpose, it is processed - seminal plasma is separated from active spermatozoa. This prevents proteins and prostaglandins from seminal fluid from entering the uterine cavity (may cause uterine spasm and allergic reaction). In addition, seminal plasma has factors that reduce the fertilizing ability of male germ cells. Also, the preparation of sperm includes the rapid and high-quality removal of not only seminal plasma, but also dead spermatozoa, epithelial cells, leukocytes and various microorganisms. Today, several options for sperm preparation are used:
- sperm float method
The essence of the method is the spontaneous movement of mobile spermatozoa in the washing solution. The emergence of male germ cells from the seminal fluid avoids the centrifugation method, during which spermatozoa can be damaged by reactive oxygen species. But this method is only suitable for ejaculate with a high concentration of active sperm. The duration of the procedure is 2 hours.
- sperm washing
The simplest technique. It is based on the removal of the liquid part of the ejaculate, which somewhat improves sperm motility. The resulting ejaculate is suspended in a washing solution containing antibiotics and dietary supplements in a centrifuge tube. Then the seminal fluid is subjected to centrifugation, as a result of which the cells are deposited, and the excess solution is drained. The precipitate obtained is washed again and centrifuged. Then the solution is drained off and washed a third time and the precipitate is centrifuged. The duration of sperm cleaning is about 1 hour.
- Semen centrifugation
Washing the semen, which removes the liquid part of the seminal fluid, and separates the active spermatozoa from the "garbage" (leukocytes, microbes, dead epithelial and sperm cells). Centrifugation is repeated twice, the resulting precipitate is again diluted in washing medium and used for intrauterine insemination. The duration of the procedure is 1 hour.
- Sperm filtering through fiberglass
This variant of semen purification includes washing the ejaculate, centrifugation, repeated washing and placing the resulting sediment on glass fibers. The solution of the washed precipitate is filtered, the resulting filtrate is collected for AI.
Timing for AI
On which day is it desirable to conduct AI? The choice of time for insemination is determined by the calculation of the day of ovulation. The success of the procedure depends on the exact determination of the date of ovulation. Not so long ago, intrauterine insemination was carried out after examination for 2-3 cycles and performing tests of functional diagnostics, measuring basal temperature and determining the concentration of progesterone in the blood in the middle of the second phase of the cycle. Using these studies, the estimated date of ovulation was calculated.
Today is the optimal day for the insemination procedure is calculated by the following methods:
- Determination of the level of urinary LH peak
When the concentration of LH in the urine reaches its peak, ovulation occurs after 40-45 hours. In this regard, AI is planned for the next day.
- Ultrasound control of follicle growth
Follicles are determined by ultrasound when they reach 2-3 mm in diameter. The rupture of the main follicle and the release of the egg occurs when the size of the follicle is 15-24 mm. The procedure is performed when the size of the dominant follicle is 18 mm or more and the thickness of the endometrium is 10 mm.
- The introduction of the ovulation factor - hCG.
The introduction of choriogonin stimulates ovulation and is advisable when the size of the dominant follicle is 17-21 mm. Insemination is carried out after 24 - 36 hours.
Before the AI procedure
It is necessary to start preparing for the proposed date of the AI 5-7 days in advance. Men refuse to visit saunas and baths, and also avoid hypothermia. If possible, eliminate stressful situations and limit physical activity. Before donating sperm, observe sexual rest, but longer than 2-3 days, since longer abstinence has a negative effect on sperm quality. Stop drinking alcohol and smoking, or reduce the number of cigarettes you smoke. On the day of the procedure, a man should arrive at the clinic 60 to 90 minutes in advance for sperm donation by masturbation. If the volume of ejaculate is too small, semen may "accumulate". To do this, the husband comes to the clinic several times and donates sperm, which is cleaned and frozen.
Women also need to follow certain rules. Stop drinking alcohol and smoking (ideally 6 months before the planned conception). Avoid anxiety and stress, exclude physical activity and heavy lifting. It is important to observe sexual rest for 3-5 days (sexual intercourse and orgasm can provoke spontaneous ovulation). Set yourself up for success.
How AI is done
How does the AI procedure work? The couple must appear at the clinic on the appointed day. While the ejaculate is being collected and the sperm is being processed, the woman is once again examined by ultrasound, the ovulation is confirmed and she is asked to take a seat on the gynecological chair. The processed sperm is drawn into a syringe without a needle, on which a blunt tip (for intracervical insemination) or a plastic catheter (for intrauterine insemination) is installed. After the introduction of the speculum into the vagina, the tip is placed as close as possible to the cervix and the piston pushes the sperm out of the syringe. When carrying out intrauterine insemination, the catheter is inserted through the cervical canal into the uterine cavity, and then they press on the piston, pushing out the sperm. For reliability, a cervical cap is put on the cervix, which will prevent sperm from leaking out of the uterus. After the procedure, a woman should remain on the chair for 60 - 90 minutes, after which she is allowed to go home.
After doing AI
After performing insemination, the doctor gives the patient a number of recommendations, the observance of which increases the chances of success. Not recommended:
- take a bath on the day of the procedure (water with detergent can penetrate the vagina, which will lead to the death of part of the spermatozoa and significantly reduce the likelihood of conception);
- have sex for three days after the manipulation (although many experts do not prohibit intimacy);
- lift weights and do heavy physical work within a week after IS (if the egg is successfully fertilized physical labor may disrupt the process of its implantation in the uterine mucosa);
- smoking and drinking alcohol (reduces the chances of fertilization, implantation and the normal course of pregnancy);
- accept medicines without a doctor's permission.
After the procedure, the patient is allowed to:
- take a shower on the day of the procedure;
- to walk outside;
- sunbathing.
In some cases, the doctor may recommend taking utrogestan or duphaston. These preparations contain progesterone, which prepares the endometrium for the successful implantation of the fetal egg, and supports further development pregnancy. 12-14 days after insemination, the patient should come to the clinic and donate blood for hCG, which will confirm the conception, implantation and development of the pregnancy.
Pregnancy
If the AI procedure was successful, then after a certain time, but not earlier than after 7 days, the woman has signs of pregnancy: a change in taste and smell, emotional lability (tearfulness, irritability), weakness, drowsiness, mild nausea, possible vomiting, change taste preferences and appetite, engorgement of the mammary glands. The most reliable subjective sign of pregnancy after insemination is the absence of menstruation after 14 or more days. Confirming pregnancy will help to perform an express test 10 to 14 days after insemination and laboratory determination of hCG in the blood. Ultrasound is recommended not earlier than 3-4 weeks after the manipulation. With the help of ultrasound, the onset and development of pregnancy is confirmed and its ectopic implantation, for example, in the fallopian tube, is excluded.
Discharge and pain after AI
What should be the discharge after insemination? If the procedure was successful, then the discharge from the vagina is no different from the usual. There may be a slight cloudy discharge on the day of AI, which indicates a part of the semen that has flowed out of the genital tract. In case of violation of the rules of asepsis (use of non-sterile instruments) during the procedure, it is possible that a secondary infection may occur with the development of an inflammatory process in the vagina and cervix. In this case, colpitis / cervicitis will develop, accompanied by profuse leucorrhoea with an unpleasant odor and itching in the vagina. Also, after AI, pulling or aching pains in the lower abdomen may appear, which is explained by irritation of the uterus and cervix with a catheter and sperm that have not undergone high-quality cleaning.
Indications for AI
Insemination is carried out according to certain indications, both on the part of the woman and the part of her sexual partner. Indications for AI in case of women's problems:
- vaginismus;
- chronic endocervicitis;
- chronic endometritis;
- operations on the cervix or cicatricial deformity of the cervix;
- anomalies in the development and localization of the uterus;
- neck factor - high viscosity cervical mucus, the presence of antisperm antibodies;
- allergy to husband's sperm;
- gynecological diseases accompanied by anovulation;
- idiopathic infertility;
- mild endometriosis.
Indications for AI on the part of the husband:
- sexual impotence (lack of erection);
- hydrocele or inguinal-scrotal hernia of considerable size;
- hypospadias;
- pathological postcoital test;
- anomalies in the structure of the penis;
- retrograde ejaculation (ejaculate enters the bladder);
- sperm subfertility (reduced sperm fertility);
- transferred radiation, chemotherapy;
- bad habits;
- impotence after spinal cord injury.
Indications for AI with donor sperm:
- azoospermia (lack of sperm in the ejaculate);
- necrospermia (there are no live spermatozoa in the ejaculate);
- absence permanent partner in a woman;
- genetic diseases on the part of the husband;
- incompatibility of spouses by blood type and Rh factor.
Contraindications
Artificial insemination is inappropriate to carry out in the following situations:
- severe endometriosis;
- acute or exacerbation of chronic inflammatory processes female genital area;
- infectious diseases in the husband;
- tumors and ovarian cysts;
- cancer of any localization in a woman;
- the presence of contraindications to pregnancy;
- female infertility lasting more than three years;
- absence of the uterus, ovaries or tubes;
- mental illness in a woman;
- the possibility of eliminating infertility after treatment or surgery.
Question answer
Question:
Can I inseminate a woman aged 40 or older?
Yes, insemination can be done at a late reproductive age, but it should be borne in mind that the older a woman is, the less likely she is to become pregnant. A favorable outcome of the procedure is possible only in 5 - 15%.
Question:
How many times can an AI procedure be performed on one woman?
Question:
What are the chances of getting pregnant with AI with husband's sperm and AI with donor's sperm?
The effectiveness of AI with the husband's sperm does not exceed 10 - 30%. Insemination with donor sperm is more effective and pregnancy occurs in 30-60% of cases.
Question:
Does AI increase the chances of having multiple pregnancies?
No, the chances of having multiple pregnancies after AI are the same as after natural intercourse. But in the case of ovulation stimulation with drugs, it is possible that not one, but several eggs can mature, which will increase the chances of a multiple pregnancy.
Question:
Is the AI procedure painful?
No. You may experience discomfort when performing intrauterine insemination, when the catheter is inserted into the uterus.