{"id":2095,"date":"2022-07-29T19:58:11","date_gmt":"2022-07-29T17:58:11","guid":{"rendered":"https:\/\/learningtoys.cz\/blog\/?p=2095"},"modified":"2022-07-29T20:00:00","modified_gmt":"2022-07-29T18:00:00","slug":"umele-oplodneni-aneb-deti-ze-zkumavky-postup-a-uspesnost","status":"publish","type":"post","link":"https:\/\/learningtoys.cz\/blog\/umele-oplodneni-aneb-deti-ze-zkumavky-postup-a-uspesnost\/","title":{"rendered":"Um\u011bl\u00e9 oplodn\u011bn\u00ed aneb d\u011bti ze zkumavky: postup a \u00fasp\u011b\u0161nost"},"content":{"rendered":"

Oplodn\u011bn\u00ed ve zkumavce\u00a0(odborn\u011b\u00a0in vitro\u00a0fertilizace,\u00a0IVF) je proces, p\u0159i kter\u00e9m se\u00a0vaj\u00ed\u010dko\u00a0oplod\u0148uje\u00a0spermi\u00ed\u00a0mimo t\u011blo:\u00a0in vitro. Je to jedna z metod\u00a0asistovan\u00e9 reprodukce, kter\u00e1 se pou\u017e\u00edv\u00e1 p\u0159i l\u00e9\u010den\u00ed\u00a0neplodnosti.<\/h1>\n

Postup zahrnuje hormon\u00e1ln\u00ed stimulaci\u00a0vaje\u010dn\u00edk\u016f za \u00fa\u010delem v\u00fdvinu a dozr\u00e1n\u00ed v\u00edce vaj\u00ed\u010dek, odb\u011br vaj\u00ed\u010dek z vaje\u010dn\u00edk\u016f a oplozen\u00ed vaj\u00ed\u010dek spermiemi. Oplodn\u011bn\u00e9 vaj\u00ed\u010dko (zygota) je pak p\u0159eneseno do\u00a0d\u011blohy. N\u00e1zev \u201eve\u00a0zkumavce\u201c je zav\u00e1d\u011bj\u00edc\u00ed, proto\u017ee oplodn\u011bn\u00ed\u00a0in vitro<\/i>\u00a0v\u011bt\u0161inou prob\u00edh\u00e1 v Petriho misce.\u00a0<\/strong>D\u011bti po\u010dat\u00e9 oplodn\u011bn\u00edm\u00a0in vitro<\/i>\u00a0se b\u011b\u017en\u011b naz\u00fdvaj\u00ed d\u011btmi ze zkumavky. Prvn\u00edm d\u00edt\u011btem ze zkumavky se v roce 1978 stala\u00a0Louise Brown.\u00a0Robert G. Edwards, kter\u00fd tuto metodu vynalezl, za objev z\u00edskal v roce 2010\u00a0Nobelovu cenu za fyziologii a medic\u00ednu. Ve stejn\u00e9 dob\u011b a nez\u00e1visle na Edwardsovi provedl indick\u00fd l\u00e9ka\u0159 Subhash Mukhopadhyay z\u00a0Kalkaty tak\u00e9 um\u011bl\u00e9 oplodn\u011bn\u00ed, kter\u00e9 vy\u00fastilo v druh\u00e9 d\u00edt\u011b ze zkumavky narozen\u00e9 v \u0159\u00edjnu 1978.<\/p>\n

\"\"Postup<\/h2>\n

<\/sup>Za \u00fa\u010delem zv\u00fd\u0161en\u00ed \u00fasp\u011b\u0161nosti IVF se p\u0159i procesu vyu\u017e\u00edvaj\u00ed dodate\u010dn\u00e9 technologie, jako nap\u0159. stimulace vaje\u010dn\u00edk\u016f za \u00fa\u010delem v\u00fdvinu a dozr\u00e1n\u00ed v\u00edce vaj\u00ed\u010dek, odb\u011br vaj\u00ed\u010dek z vaje\u010dn\u00edk\u016f, oplodn\u011bn\u00ed vaj\u00ed\u010dek spermiemi a kultivace embry\u00ed p\u0159ed p\u0159enosem do d\u011blohy.<\/sup><\/sup><\/p>\n

<\/span>Stimulace vaje\u010dn\u00edk\u016f a odb\u011br vaj\u00ed\u010dek<\/span><\/h3>\n

P\u0159i\u00a0ovulaci\u00a0se b\u011b\u017en\u011b uvol\u0148uje pouze jedno vaj\u00ed\u010dko, proto se p\u0159i IVF vyu\u017e\u00edv\u00e1 hormon\u00e1ln\u00ed stimulace vaje\u010dn\u00edk\u016f (odborn\u011b ovari\u00e1ln\u00ed hyperstimulace) za \u00fa\u010delem v\u00fdvinu v\u00edce vaj\u00ed\u010dek ve\u00a0folikulech. C\u00edlem je p\u0159itom z\u00e1rove\u0148 co nejmen\u0161\u00ed z\u00e1sah do hormon\u00e1ln\u00edho syst\u00e9mu \u017eeny. Existuj\u00ed t\u0159i hlavn\u00ed protokoly pro hormon\u00e1ln\u00ed stimulaci: kr\u00e1tk\u00fd protokol, dlouh\u00fd protokol a protokol s antagonisty. <\/sup>V t\u00e9to f\u00e1zi mohou nastat probl\u00e9my, a to kdy\u017e se u pacientky vyvine ovari\u00e1ln\u00ed hyperstimula\u010dn\u00ed syndrom (OHSS)<\/sup><\/p>\n

Odb\u011br vaj\u00ed\u010dek (anglicky\u00a0ovum pick up<\/i>, OPU) se prov\u00e1d\u00ed pot\u00e9, co pr\u016fm\u011br nejvy\u0161\u0161\u00edho folikulu dos\u00e1hne alespo\u0148 16 mm.\u00a0<\/sup>\u017den\u011b se aplikuje\u00a0lidsk\u00fd choriov\u00fd gonadotropin\u00a0(hCG) a asi 35 hodin pot\u00e9 se prov\u00e1d\u00ed ambulantn\u00ed z\u00e1krok v lehk\u00e9\u00a0anestezii, kter\u00fd trv\u00e1 zhruba 20 minut.<\/sup><\/p>\n

<\/span>Oplodn\u011bn\u00ed a kultivace embry\u00ed<\/span><\/h3>\n

Po kr\u00e1tk\u00e9m obdob\u00ed preinkubace (2\u20136 hodin) se vaj\u00ed\u010dka oplod\u0148uj\u00ed spermiemi, a to v pom\u011bru zhruba 75\u00a0000 spermi\u00ed na vaj\u00ed\u010dko. Spermi\u00edm, kter\u00e9 p\u0159edt\u00edm pro\u0161ly v\u00fdb\u011brem metodou proplachov\u00e1n\u00ed, by se m\u011blo poda\u0159it je oplodnit. Po zhruba 18 hodin\u00e1ch se kontroluje, zda k oplodn\u011bn\u00ed do\u0161lo, a pokud ne, zav\u00e1d\u011bj\u00ed se spermie do vaj\u00ed\u010dek p\u0159\u00edmo metodou intracytoplazmatick\u00e9 injekce spermie (ICSI).<\/p>\n

Embrya jsou kultivov\u00e1na dva a\u017e t\u0159i dny, ne\u017e se dostanou do stadia 2\u20134 bun\u011bk. Pokud je embry\u00ed dostatek (v\u00edce ne\u017e 5), prov\u00e1d\u00ed se prodlou\u017een\u00e1 kultivace, kter\u00e1 trv\u00e1 p\u011bt a\u017e \u0161est dn\u00ed. Tou se dosahuje lep\u0161\u00edho v\u00fdb\u011bru kvalitn\u011bj\u0161\u00edch embry\u00ed a zvy\u0161uje se tak \u00fasp\u011b\u0161nost oplodn\u011bn\u00ed.<\/sup><\/sup><\/p>\n

Kryokonzervace<\/span><\/h3>\n

B\u011b\u017en\u011b pou\u017e\u00edvanou metodou je hlubok\u00e9 zmrazen\u00ed embry\u00ed v po\u010d\u00e1te\u010dn\u00edch st\u00e1di\u00edch v\u00fdvoje a jejich dlouhodob\u00e9 uchov\u00e1v\u00e1n\u00ed v tekut\u00e9m dus\u00edku p\u0159i teplot\u011b – 184 \u00b0C. Tato metoda se pou\u017e\u00edv\u00e1 od roku 1993 i v \u010cesku.\u00a0<\/sup>Embrya si zachov\u00e1vaj\u00ed \u017eivotaschopnost po velmi dlouhou dobu, jak sv\u011bd\u010d\u00ed p\u0159\u00edpad zdrav\u00e9ho d\u00edt\u011bte, narozen\u00e9ho z embrya zmra\u017een\u00e9ho po 27 let.<\/sup><\/p>\n

<\/span>P\u0159enos embrya<\/span><\/h3>\n

P\u0159i p\u0159enosu embrya neboli embryotransferu se do d\u011blohy pacientky p\u0159en\u00e1\u0161\u00ed dv\u011b nebo t\u0159i embrya, jejich\u017e po\u010det z\u00e1vis\u00ed na v\u011bku pacientky a po\u010dtu p\u0159edchoz\u00edch pokus\u016f. Pro zv\u00fd\u0161en\u00ed pravd\u011bpodobnosti implantace se p\u0159ed p\u0159enosem embrya n\u011bkdy prov\u00e1d\u00ed asistovan\u00fd hatching, p\u0159i n\u011bm\u017e se naru\u0161uje ochrann\u00fd obal embrya, aby se pak mohlo l\u00e9pe uvolnit.<\/sup><\/sup><\/p>\n

<\/span>\u00dasp\u011b\u0161nost l\u00e9\u010dby<\/span><\/h3>\n

A\u010dkoliv je kv\u016fli komplexnosti l\u00e9\u010dby neplodnosti oplodn\u011bn\u00edm ve zkumavce slo\u017eit\u00e9 stanovit statisticky p\u0159esnou \u00fasp\u011b\u0161nost, lze jednozna\u010dn\u011b \u0159\u00edci, \u017ee s po\u010dtem opakovan\u00fdch cykl\u016f pravd\u011bpodobnost ot\u011bhotn\u011bn\u00ed stoup\u00e1. <\/sup>Z \u0161et\u0159en\u00ed \u00dastavu zdravotnick\u00fdch informac\u00ed a statistiky z roku 2016 <\/sup>vypl\u00fdv\u00e1, \u017ee z t\u00e9m\u011b\u0159 poloviny narozen\u00fdch d\u011bt\u00ed p\u0159i\u0161lo na sv\u011bt 11\u00a0% po prvn\u00edm cyklu a 48\u00a0% po cyklu opakovan\u00e9m (s p\u0159edchoz\u00edm zmrazen\u00edm embryi\u00ed). Ze statistik vypl\u00fdv\u00e1, \u017ee opakov\u00e1n\u00ed IVF cyklu m\u00e1 smysl, a to p\u0159edev\u0161\u00edm pro \u017eeny, kter\u00e9 cht\u011bj\u00ed ot\u011bhotn\u011bt po \u010dty\u0159ic\u00edtce.<\/p>\n

zdroj: cs.wikipedia.org<\/a><\/em><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Oplodn\u011bn\u00ed ve zkumavce\u00a0(odborn\u011b\u00a0in vitro\u00a0fertilizace,\u00a0IVF) je proces, p\u0159i kter\u00e9m se\u00a0vaj\u00ed\u010dko\u00a0oplod\u0148uje\u00a0spermi\u00ed\u00a0mimo t\u011blo:\u00a0in vitro. Je to jedna z metod\u00a0asistovan\u00e9 reprodukce, kter\u00e1 se pou\u017e\u00edv\u00e1 p\u0159i l\u00e9\u010den\u00ed\u00a0neplodnosti. Postup zahrnuje hormon\u00e1ln\u00ed stimulaci\u00a0vaje\u010dn\u00edk\u016f za \u00fa\u010delem v\u00fdvinu a dozr\u00e1n\u00ed v\u00edce vaj\u00ed\u010dek, odb\u011br vaj\u00ed\u010dek z vaje\u010dn\u00edk\u016f a oplozen\u00ed vaj\u00ed\u010dek spermiemi. Oplodn\u011bn\u00e9 vaj\u00ed\u010dko (zygota) je pak p\u0159eneseno do\u00a0d\u011blohy. N\u00e1zev \u201eve\u00a0zkumavce\u201c je zav\u00e1d\u011bj\u00edc\u00ed, proto\u017ee oplodn\u011bn\u00ed\u00a0in vitro\u00a0v\u011bt\u0161inou […]<\/p>\n","protected":false},"author":4,"featured_media":2098,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[],"yoast_head":"\nUm\u011bl\u00e9 oplodn\u011bn\u00ed aneb d\u011bti ze zkumavky: postup a \u00fasp\u011b\u0161nost<\/title>\n<meta name=\"description\" content=\"Oplodn\u011bn\u00ed ve zkumavce\u00a0(odborn\u011b\u00a0in vitro\u00a0fertilizace,\u00a0IVF) je proces, p\u0159i kter\u00e9m se\u00a0vaj\u00ed\u010dko\u00a0oplod\u0148uje\u00a0spermi\u00ed\u00a0mimo t\u011blo:\u00a0in vitro.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/learningtoys.cz\/blog\/umele-oplodneni-aneb-deti-ze-zkumavky-postup-a-uspesnost\/\" \/>\n<meta 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