IVF treatment

Intra Cytoplasmic Sperm Injection (ICSI)

ICSI is based on the insertion of a selected sperm into the oocyte, overcoming the limitations that conventional IVF faces with poor semen samples and deficiencies in the interaction between the gametes. Because of this, ICSI has become the most commonly used IVF technique. With the help of an advanced micromanipulation station (including microscope, microinjectors and micropipettes) the sperm has to be individually selected and immobilised. During the microinjection the oocyte must be held while the sperm is inserted and released inside the inner part of the oocyte. The day after the microinjection, signs of proper fertilisation will be checked in each oocyte.

PHYSIOLOGICAL INTRACYTOPLASMIC SPERM INJECTION (PICSI)

If you are undergoing IVF treatment, your specialist doctor will tell you about Physiological Intracytoplasmic Sperm Injection (PICSI).

PICSI is a method of selecting the best possible sperm for fertilisation before injection into the egg in the IVF protocol. Sperm are placed in the PICSI dish containing samples of hyaluronan (a naturally occurring biopolymer found in all human cells) hydrogel.

What PICSI does is select sperm according to how well they bind to the hyaluronan around an egg cell. Mature, biochemically competent sperm bind are then isolated by the embryologist and used for ICSI.

The selected sperm is essentially the same as one that would be successful in the natural reproductive process. The more mature a sperm cell, the more able it is to bind to hyaluronic acid, meaning that it is better suited to fertilising the egg.

LASER ASSISTED HATCHING

A small opening or a crack is made on the outer shell of the embryo to make the hatching process easier right before it is placed into the woman’s body. This is done with the hope that the embryo will expand and implant into the uterine wall. In Laser-assisted hatching, a laser device is used to make an extremely precise opening in the Zona Pellucida. This technique makes it possible to have exact control over the size of the breach in the shell. The embryologist sends a brief and strong light beam under a microscope to create a crack on the shell. The embryo is then transferred back into the uterus to implant itself to the lining and continue growing.

PRE-IMPLANTATION GENETIC SCREENING AND DIAGNOSIS (PGD PS)

Preimplantation Genetic Testing or PGT is a laboratory process performed during an IVF cycle in which embryos can be tested for abnormal chromosomes before they are transferred to the uterus. One or more cells from each embryo can be sent for genetic testing. After this test, genetically healthy embryos are transferred to the uterus, where they may attach to its lining and produce a healthy pregnancy.

Generally, PGD is recommended for someone who has or is a carrier of a known genetic disorder. In some cases, it may be recommended for someone with recurrent miscarriage, someone who is older or whose ovaries do not work as well as expected, or someone with multiple failed fertility treatments. Some couples also choose to do PGS for personal reasons.

It includes

PGT-A; PGT-M
PGT- SR
SCREENING FOR SPECIFIC GENETIC DISORDERS

NACE SCREENING

NACE is a non-invasive prenatal test. This means that it is completely safe for you and your baby: a small blood sample, just like in any other routine blood analysis, is sufficient to perform the test. NACE uses the latest sequencing technology to analyse foetal DNA to detect the most common anomalies with high precision and reliability.

NACE detects abnormalities in chromosomes 21, 18, 13 and the most common anomalies in the sex chromosomes (X and Y).

NACE 24 Extended analyses all 24 chromosomes and identifies microdeletions associated with 6 major genetic syndromes.

SPERM RETRIEVAL TECHNIQUES (TESA/TESE)

There are various methods to retrieve sperms from male for IVF purpose. They are:

A. Testicular sperm aspiration (TESA) A needle is inserted in the testicle and tissue/sperm are aspirated. TESA is performed for men with obstructive azoospermia.

B. Percutaneous Epididymal Sperm Aspiration (PESA) PESA is a procedure performed for men who are having sperm retrieved for IVF/ICSI who have obstructive azoospermia from either a prior vasectomy or infection.

C. Testicular sperm extraction (TESE) TESE involves making a small incision in the testis and examining the tubules for the presence of sperm.

ENDOMETRIAL RECEPTIVITY ASSAY (ERA)

Endometrial receptivity array (ERA) is a diagnostic procedure that may help determine whether the endometrial cavity is ready for embryo implantation.

ERA endometrial biopsy is a relatively new procedure, which involves biopsy of a small sample of the endometrium, or lining of the uterus, for molecular analysis.

Problems with the endometrial lining are one of the causes for infertility in women with recurrent pregnancy loss or multiple failed IVF transfers.

ERA biopsy may be considered for women who have undergone IVF cycles in which implantation failed or for women who have experienced multiple miscarriages or recurrent pregnancy loss.

PRP UTERUS (UTERINE REJUVENATION)

Intrauterine infusion of platelet-rich plasma (PRP) is a novel approach that has been suggested for the treatment of thin endometrium.

PRP is autologous blood plasma that has been enriched with platelets at about 4-5 times more than the circulating blood.

It helps in cases of recurrent abortions, cases which the endometrium lining does not became thicker using oestrogen, in cases of oocyte donation or after Asherman Syndrome.

PRP OVARIES (OVARIAN REJUVENATION THERAPY)

The treatment uses PRP (Platelet-Rich-Plasma), which with or without stem cell therapy is the novel therapeutic approach for restoring the quality of the ovarian reserve.

In Ovarian Rejuvenation PRP is directly injected into a patient’s ovaries with her own platelet-rich plasma (PRP), infusing the ovaries with proteins rich in growth factors and stem-cell chemoattractant.

The best outcome of PRP is a chance to become pregnant using your own eggs.