ADVANCED INFERTILITY IVF TREATMENT
IUI (Intrauterine Insemination):-
IUI procedure is performed around the time of ovulation, typically about 24-36 hours after the surge in LH hormone (during ovulation)
The semen sample is collected and processed so as to increase the capacitation of the sperm. A catheter will then be used to insert the sperm directly into the cervix. This process maximizes the number of sperm cells into the cervix, and further travel to the fallopian tubes to mate with the egg(Oocyte) thus increasing the possibility of conception.
IVF (Intro – Vitro Fertilization)
During IVF process, the sperm and the eggs are mixed and stored together under specialized conditions in the laboratory to encourage fertilization. Once fertilization takes place, the resulting embryos are monitored for further cell growth and only the best quality embryo is inserted into the uterus with the help of a small catheter. This procedure is painless for most women, although some may experience mild –. If the procedure is successful, implantation typically occurs around six to ten days following embryo transfer.
ICSI (Intra – Cytoplasmic Sperm Injection)
The ICSI procedure can help achieve a successful pregnancy even with severe male infertility problems. During ICSI, the semen sample is collected or is surgically extracted from the testes or epididymis which is processed in the laboratory & the eggs (Oocytes) are surgically extracted from the ovaries. Using a hollow needle, one sperm is carefully injected into an egg & the fertilized egg is observed for growth and development. Only the best quality embryo will be implanted into the uterus where it has a chance to implant and grow further.
SURGICAL SPERM COLLECTION
Many azoospermic patients with non obstructive azoospermia (NOA) might be candidates for sperm aspiration as part of their in vitro fertilization procedure. Because sperm might be present in some but not all parts of the testes of such men, multiple samplings of the testicular tissue are usually performed to increase the probability of finding sperm in NOA patients.
PESA (Percutaneous Epididymal Sperm Aspiration):-
PESA is a simple method of sperm extraction used for men who have an obstruction of the vas deferens, either due to vasectomy or any other obstruction.
MESA (Micro Epididymal Sperm Aspiration):-
MESA, sperm retrieval technique involves aspiration of sperm from the epididymis with a fine needle which is a more advanced version of the PESA procedure.
TESE (Testicular Sperm Extraction):-
This method of sperm extraction is often used for non-obstructive type of azoospermia where sperm cannot be obtained from the epididymis. TESE procedure requires taking a small piece of tissue from the testis and isolating the sperm from this tissue.
LAH (Laser Assisted Hatching):-
LAH is based on the presumption of creating artificial openings (slits or holes) in the zona pellucida might assist the in vivo hatching process of embryos. This technique has been shown to increase implantation and pregnancy rates in women of advanced age, in women with recurrent implantation failure and following the transfer of frozen–thawed embryos.
In this technique a gap is made in the shell or “zona” of the embryo prior to the embryo transfer to increase implantation and pregnancy rates.
- In LAH, a circle of colored light is projected which shows where the laser will fire.
- The beam itself is invisible and when it is pulsed we can see the effect.
- The laser works by releasing energy in the embryo’s shell – thereby vaporizing or dissolving it.
- Because of the heat generated it must be used cautiously so that cells are not heated significantly.
- The exact technique can vary based on the spot size, power settings, technique, etc.
Gamete Donation :-
The major indication for use of donor oocytes is Premature Ovarian Failure, either primary or secondary.
Causes of Premature Ovarian Failure include:-
- Surgical oophorectomy
- Irreversible gonadal damage after certain regimens of chemotherapy or radiotherapy
- Turner syndrome
- Other chromosomal disorders causing gonadal dysgenesis.
- In addition, oocyte donation might be employed to avoid the risk of transmission of a genetic disorder in cases in which the carrier status of both partners is known.
- Women with markedly diminished ovarian reserve generally have a lower chance of conception using their own gametes thus should be offered the options of donor oocytes.
- Women with premature menopause should be offered the options of donor oocytes.