23 dpo five days as seen on the ultrasound. Stages of embryo development after transfer by day

Much of a woman's knowledge of how pregnancy begins ends at the stage of ovulation and fertilization. Actually, the success or failure of the planning cycle is attributed to the fateful "meeting" of male and female germ cells. However, in the development of a new life in the body of a woman, there is another difficult and important point - embryo implantation. In order to increase the personal literacy of planning ladies, this issue should be given special attention.

A bit of theory

Implementation fertilized egg into the uterus called implantation. The villi of the embryo penetrate the lining of the uterus, which can cause minor bleeding.

In order for implantation to be successful, several conditions must be met at once:

• lush three-layer endometrium with a high content of substances that nourish the embryo;
• high amount of progesterone in the body (so that the embryo can develop and menstruation does not begin);
• normal microflora in the body.

The process of fertilization and development of the fetal egg- not one-time. And each of its stages is important for the onset of a normal pregnancy and the formation of a healthy fetus.

Timing of implantation

After ovulation and the meeting of the egg with the sperm, the fertilized zygote begins to move through the fallopian tubes. Her task is to get into the uterus as quickly as possible in order to gain a foothold in the endometrium specially prepared for this. On the way, the zygote continuously divides and grows. In stage blastocyte implantation and happens.

It is conditionally possible to distinguish middle, late and early implantation.

• Early. It occurs quite rarely. Usually, implantation is considered early if it occurs 6-7 days after ovulation (or 3dpo - 4dpo when it comes to IVF
• Average. 7-10 days pass between fertilization and implantation ( embryo implantation after transfer comes around 4-5 days). Doctors say that the introduction of morula takes about 40 hours, after which the body begins to produce the hormone hCG in the blood, it rises basal body temperature. Based on this, the so-called. the embryonic period of development, which lasts until about 8 weeks of gestation.
• Late. It occurs approximately 10 days after fertilization. This is what always gives women even a slight, but hope for a possible pregnancy - even when you almost do not expect it.

If pregnancy does not occur for a long time, then you need to be examined to identify the cause of infertility.

Subjective and objective signs

Both in the natural and in the artificial cycle, women are very excited and want to quickly open the veil of secrecy - is there a pregnancy or not? They start collecting symptoms and sensations, trying to find in their well-being some kind of relationship with reality. Experts took as a basis a simple classification, according to which all signs can be divided into subjective and objective.

Subjective:

• pulls the stomach;
• discharge;
• mood changes, emotional lability;
• tingling in the uterus after ovulation;
• feeling tired, etc.

Girls may even point out that after IVF, the stomach hurts like before menstruation. In this case, while there is no clear certainty, such pain may indicate both the onset of pregnancy due to successful implantation, and the approaching end of the cycle - and the beginning of a new one.

Objective:

• the basal temperature rises after the transfer (after a slight retraction in the natural cycle);
• body temperature after transfer can also increase from 37 to 37.9 degrees;
• detection of hCG hormone in urine and blood.

In this case, it is necessary to distinguish between the levels of pain, the abundance and saturation of secretions, an increase in body temperature. Sometimes what passes for implantation of the ovum signs are symptoms of some other disease. If you are in doubt whether your feeling 5 dpo signs fetal implantation or not, it is better to consult a doctor.

Embryo development by days after IVF

If everything is more or less clear with the natural cycle, then the question on what day does the implantation of the embryo occur in a successful protocol remains open. We bring to your attention a table by day:

0 DPP - transfer ( cryotransfer)

1DPP- the blastocyte comes out of the shell

2DPP- attachment of blastocytes to the wall of the uterus

3DPP- implantation begins

4DPP- Implantation of the morula into the uterus continues

5DPP- end of implantation

6DPP- the placenta begins to produce hCG

7DPP- an active increase in the level of hCG

8DPP- HCG continues to rise

9DPP-10 DPP- HCG levels reach the minimum of pregnancy tests

About Day 11 ( 11-12 DPP) after the transfer, it is possible to draw conclusions about whether it was successful IVF.

We trust nature

Women re-read tons of literature, trying to find the very ones 5 dpo feeling or 6 dpo sensations, which would indicate implantation and, accordingly, the onset of pregnancy. Actually, to worry about whether it worked out or not, expectant mothers begin to 3 DPO.

This question equally excites girls who have undergone IVF. supposed embryo implantation after IVF They try to catch by minimal changes in the body and well-being. The Internet is full of requests, like " 5 dpo three days», « 4 dpp five days ", « 7 dpo five days with which women look for positive stories.

A bitter disappointment is the absence of even a hint of a second strip on Day 8 or period after embryo transfer. But in fact, the answer to the question of whether why the embryo does not take root, may be an objective situation of natural selection. The unviable fetus was rejected, giving way to healthy offspring.

In fairness, it should be noted that if such rejection is repeated constantly, then this is an occasion for a full medical examination. The reason for the failure of a long-awaited pregnancy may be male infertility.

Implantation is a critical point, because a blastocyte is perceived by a woman's body as a foreign object, due to the presence of male genes in the cell. The speedy and successful introduction into the endometrium and the onset of a normal healthy pregnancy depend on how well the defense mechanisms of this cell work.

Features of hCG after IVF: how it affects the onset and maintenance of pregnancy. HCG table by day after IVF: norms

Pregnancy is a state, each stage of which is clearly regulated by its own hormones. The process of gestation as a result - IVF - also needs hormonal regulation. Not always the mother's body is able to independently provide the necessary level of hormones.

Analyzes after IVF allow you to determine the growth rate of active substances, if necessary, correct them with drugs. But some hormones are an indicator of a normally developing pregnancy. For example, hCG after IVF in terms of growth rates can tell about the course of gestation, the likely threat of interruption, or, for this, it is enough to compare the results with the table.

• The role of hCG in IVF
• The first signs of pregnancy after IVF before hCG
• Allocations
• What is the dynamics of hCG after embryo transfer
• Interpretation of analysis results
• HCG table by day after IVF: normal
• What does low hCG mean?
• Causes of high hCG levels in the early and late stages
• Ultrasound control
• Prescribing hCG in injections after embryo transfer in IVF protocols

The role of hCG in IVF

For the first time, a woman who decides on artificial insemination encounters human chorionic gonadotropin when ovulation is stimulated. This procedure is performed for those who have regular unprotected sex, many women over 35 years of age and those who, according to the results of ultrasound, have abnormal development of the follicles or corpus luteum.

When stimulating ovulation, only an injection of hCG can be used. It is administered if, according to the results of ultrasound, the follicle matures, but its shell cannot rupture on its own and passes into or regresses.

Another stimulation scheme involves taking Clomiphene preparations, which stimulate the production of FSH and LH. These hormones ensure the maturation of the follicles. When, according to ultrasound, they reach a size of 17-18 mm, they give an injection of hCG. This hormone provokes the maturation of oocytes, the rupture of the membrane and the release of the egg. 24 hours after the injection, the woman is ready to produce and collect eggs. If the moment is missed, the follicle will rupture on its own and the oocytes cannot be collected.

Some protocols provide for the re-introduction of hCG if the size of the follicles has reached 20-25 mm, and the rupture has not occurred. Sometimes a hormone is needed to support the corpus luteum. But the dosage of such injections is very small - 300-1500 IU. An overdose of the drug, frequent use leads to early menopause.

Signs of pregnancy after embryo transfer before hCG analysis

An analysis for hCG is prescribed after 14 days. But many women, even before a blood test, feel the symptoms and the first signs of pregnancy after IVF:

• irritability, sudden mood swings;
• sleep disorders;
• headache, fatigue;
• that appear earlier than with natural fertilization;
• engorgement of the mammary glands;
• pain in the pelvis, in the ovarian region;
• lowering blood pressure;
• tides.

Allocations before hCG analysis: menstruation or implantation bleeding

Some may experience spotting. This is implantation bleeding, which occurs as a result of the dissolution of the endometrial vessels by the embryo. It should not be plentiful and long. But it is possible to accurately establish the fact only by the results of ultrasound and analysis for hCG.

Embryo implantation does not occur simultaneously with its replanting in the uterus. This usually takes up to 6 days. But sometimes a fetal egg cannot find a suitable place in the wall of the uterus for a long time, then it happens 10 days after planting. It does not affect this in any way, but hCG will also begin to rise later.

From the moment of conception to the birth of a child, two cells in the beginning give rise to a huge number of unique processes. Any future mother is interested in knowing what is going on inside her, how the fetus is formed. And the mother who resorted to eco and even more so. Therefore, women always want to carefully study the development of the embryo by day after the transfer in order to visualize the desired result as accurately as possible.

Embryo cultivation

After the union of the gametes of the spouses (egg and sperm), a new life begins to emerge. The unique process of creation thanks to scientists is available under a microscope. The development of the embryo on the days before the transfer takes place in a special environment - a Petri dish. The process takes from 3 to 5 days, depending on when the embryo transfer is scheduled. After replanting, the uterine stage of fetal formation already begins.

12-16 hours after the connection of male and female cells, the first assessment of the unborn child is carried out. The initial development of oocytes after IVF is very important. At this stage, the formation of the future karyotype begins - a connection of chromosomes is formed, which are responsible for all processes in the body, gender is established.

In medicine, all stages of fetal formation have names - zygote, morula, blastocyst, gastrula, embryo, fetus. The stages of development of embryos after transfer by day begin with a morula or blastocyst. It depends on which day the transfer was made.

Zygote. Sharing is a key element of any life. On the second day, the fertilized egg begins to divide into 2-4 cells, by the third day they become 6-8. The cells into which the embryo breaks down are called blastomeres.

Development analysis at this stage is determined by the following factors:

• total number of blastomeres;
• number without nuclei (anuclear blastomeres);
• evaluate their shape and size.

The first labeling of the embryos is carried out. The letters (A-B-C-D) indicate the quality, and the numbers indicate the number of blastomeres. For example, 4A is an embryo of excellent quality, with 4 blastomeres, 6D is a six-cell embryo of unsatisfactory quality (more than 50% of anuclear blastomeres).

Development after the transfer

Morula. By the end of the third day, most embryos with genetic damage stop developing. This happens because up to this point the formation took place due to the nutrients of the egg itself, then the genetic apparatus starts up and the embryo behaves according to the program of natural selection. Surviving embryos continue to divide, the number of blastomeres reaches 10-16.

The process of compaction starts - intercellular bonds are strengthened, the surface of the cells is smoothed. The next stage of quality assessment is underway. If there are risks of stopping development at the morula stage, a decision is made about the possibility of transferring it to the uterus. It is generally accepted that in the body of a woman the chances of survival increase.

The development of 3-day-old embryos after replanting normally does not differ from that if they continued to be cultivated in the medium.

On the 4th day from the moment of fertilization, the process of compaction is completed, the blastomeres are divided into two groups - the cell mass and the trophoblast. The first of them will give development to all organs and tissues, the other will form extra-embryonic membranes - chorion, amnion, allantois, yolk sac, trophoblast will also play a decisive role at the time of implantation.

Blastocyst. Inside the morula, with the moment of separation of the blastomeres into groups, a cavity appears. When it reaches half its size, the embryo is already called a blastocyst. The chances of survival are higher for those blastocysts in which the cavity is larger and both groups of blastomeres are better formed.

Then the development of a 5-day-old embryo continues according to the scheme - the cavity increases, the transparent shell stretches and breaks (hatching). The blastocyst is now ready for implantation. A transplant is carried out in the uterus. Next, the development of the embryo begins by day after the transfer of 5 days.

Gastrula. On the 6-7th day after the fertilization of the egg, or on 3-4 DPP of 3 days, or on 1-2 DPP of 5 days, the process of implantation begins. The blastocyst adheres to the mucous membrane, the trophoblast begins to form villi that help to penetrate deeper into the endometrium.

Closer to the 9th day of PO, the process of implantation is completely completed, the embryo is completely immersed in the uterus. Further, a complex mechanism for the formation of the placenta, the formation of future organs of the embryo, extra-embryonic membranes is launched, the production of the hCG hormone begins. Every day its level grows and on the 14th day after fertilization, pregnancy can sometimes be diagnosed. Now the embryo is fully called an embryo.

Important information on the development of embryos

What happens to the embryo after transfer to the uterus by day? In the absence of negative factors, every day the embryo develops safely. If at any stage deviations in the genome occur, the impact of the artificial environment for cultivation affects, or there are processes in the woman’s body that prevent its growth, then the chances of survival are small, “natural selection” occurs in the uterus.

How does the embryo develop after transfer to the uterus by day? If a 3-day-old embryo was implanted, then it is logical that, first of all, it reaches the blastocyst stage. After that, the development of the embryo after transfer to the uterus by day has the same pattern for everyone.

Why don't embryos develop after transfer? Among the reasons that stop the growth of embryos in the uterus may be the unwillingness of the endometrium to accept a foreign body, various endocrine, immune and other problems of the patient. Unfavorable factors are also stressful situations that lead to tachycardia.

Such palpitations after embryo transfer may also be due to complications with the ovaries, which will also negatively affect implantation. But, the most likely problem is the quality of the embryos themselves, on average it is 80% percent of all failures.

To eliminate the risks of obtaining a low-quality embryo, even at the stage of pregnancy planning, modern trends in genetics in in vitro fertilization are used. Genetic testing of parents at different levels (the entire genome or several genes) will determine the risk of getting pathologies in the unborn child, not only after birth, but also those that may appear with age. And the method of PGD - preimplantation genetic diagnosis, will determine deviations in the set of chromosomes before embryo transfer.

No matter how scary it may seem, in vitro fertilization works. After a positive analysis of hCG, many women became happier. And they are looking forward to the time of the ultrasound to confirm the onset of pregnancy and in order to hear their baby for the first time.

Which one can hear the heartbeat? The first ultrasound after hCG analysis is scheduled for 21-24 DPP. As a rule, it determines only the presence of a fetal egg, the place of its attachment. And only at the next ultrasound examination, after a week and a half, a heartbeat is visible at an average of 35 dpo.

Further development of the fetus can also end in different ways. Basically, after the positive results of the first ultrasound, a woman diagnosed with pregnancy after IVF is observed, like any other. At this stage, the options for the course of pregnancy are the same.

However, this is the most generalized graph. Sometimes the gynecologist can change it somewhat and prescribe a second ultrasound within two weeks after the first. In the future, it may be necessary to conduct ultrasound examinations at the specified frequency or even more often.

Signs of pregnancy after in vitro fertilization

After embryo transfer, it usually takes three days for successful cell implantation. In some cases, it takes up to ten days for this. Late implantation is also considered the norm.

Due to the successful implantation of the embryo, the patient has the following first signs of pregnancy:

• toxicosis of pregnant women;
• redness of the skin;
• hot flashes;
• an increase in temperature, indicating that the woman's body is preparing to bear a child;
• sudden mood swings;
• swelling of the mammary glands;
• change in the color of the nipples.

Important!
Sometimes artificial insemination may not cause these first signs of pregnancy. In this case, the completed embryo transfer is indicated by an increased concentration of human chorionic gonadotropin in the blood.

First ultrasound after embryo transfer

A woman does not have to worry about what. Such studies are absolutely safe for mother and child. So you can not be afraid to conduct such studies as directed by a doctor.

The technique of conducting an ultrasound examination during IVF is no different from what is carried out during conventional fertilization. A doctor can use one of two types of ultrasound diagnostics.

one. . It is passed through the anterior abdominal wall. This uses an ultrasonic sensor that emits and receives high frequency sound waves. Ultrasound and the sensor do not cause any discomfort to the expectant mother. This option is most successful for the second or third trimester, when the fetus is already large enough.

2. . In this case, the ultrasound probe is inserted directly into the vagina. It is recommended to carry out such a procedure. After all, the embryo in this period has a very small size, and it is very difficult to see it using the usual method.

In addition, with this method of research, you can examine in detail the cervix.

For the patient, this procedure is very simple and does not cause inconvenience. There is no need to follow a special diet. Before the examination, it is necessary to empty the bladder and intestines. It is also necessary to limit the consumption of foods that contribute to the formation of gases in the intestines.

For the first ultrasound, only transvaginal examination is used. This is due to the fact that the doctor must examine the embryo in detail, as well as its location. This method of research is extremely important for improving the accuracy of diagnosis. Subsequently, the doctor may repeat the transvaginal examination, and in the future - only transabdominal.

What does this study show and why is it being done?

Take note!
In vitro fertilization does not give a full guarantee. It takes several attempts to get pregnant. However, sometimes just one transfer is enough for a successful pregnancy.

Statistics show that embryo transfer ends successfully in 40 to 60 percent of cases. In a quarter of all cases, the development of multiple pregnancies is possible. And finally, in rare cases, development is possible. That is why it is so important to do the first ultrasound after this type of fertilization.

In addition, the first ultrasound is done in order to make sure that the embryo obtained as a result of IVF is viable.

The first ultrasound shows:

• the success of the transfer of the embryo (that is, the doctor can make sure that the pregnancy has occurred);
• the location of the fetal egg (in the uterus, ovaries or egg tubes);
• the number of embryos obtained as a result of in vitro fertilization;
• viability of the embryo(s) after transfer;
• functionality of the ovaries (to clarify the need for hormonal correction).

The role and significance of the first ultrasound after in vitro fertilization are enormous. After all, this procedure is not just a confirmation of implantation and successful transfer. Ultrasound is able to detect very dangerous pathologies at the earliest stages - for example, or an ectopic pregnancy.
The detection of multiple pregnancy as a result of IVF is also very important. Indeed, in this case, the doctor will prescribe a special regimen for the patient.

Further actions

A successful result of an ultrasound examination after an embryo transfer is not a reason not to go to a doctor for further diagnostics. On the contrary, a woman should be extremely attentive to her body and respond in a timely manner to any suspicious symptoms. That is why she needs to undergo repeated diagnostic studies. Most often, they are done just with the help of ultrasound - the safest way to see the vital activity of the body.

As a rule, on the 31st day after the replanting of the embryo, a second ultrasound is done. This must be done to determine the state of the embryo and. If the fixation of the heartbeat gave a positive result, the woman is registered with the obstetrician. He observes the patient during the entire period of pregnancy and, if necessary, conducts repeated studies.

If the results of the extracorporeal study are unsatisfactory, the procedure is repeated. However, this can be done no earlier than three months later. If embryos were cryopreserved after the first attempt, then there is no need to re-stimulate in the future. In this case, IVF can be done more often.

conclusions

Ultrasound after in vitro fertilization is the most important diagnostic procedure. It allows you to determine the effectiveness of the procedure and decide on further actions. A woman may not be afraid that ultrasound will harm the unborn baby: it is absolutely harmless to him.
A woman should also adhere to the established scheme for conducting ultrasound procedures. So it will be possible to determine the pathology of pregnancy in a timely manner and prescribe timely treatment.