A lot of couples and singles who are diagnosed infertile are still unable to get pregnant after such therapies as ovulation induction, intrauterine insemination, or reproductive surgery. In this case it is time to address assisted reproductive technologies (ART) among which are in vitro fertilization (IVF), egg donation, surrogacy and other laboratory practices aimed at resolving the situtiation and achieve best possible results. Due to the delicate nature of all of these procedures, they require careful and thorough preparation, significant efforts and can be expensive. So it is natural that in order to minimize your stress one prefers to learn as much as possible about ART methods.
Achieving fertilization can be also helped with ICSI being equal to traditional IVF when a couple has low sperm count or poor quality sperm. ICSI is also a solution for those couples who did not manage to get pregnant with previously carried IVF attempts or have egg abnormalities or low egg number.
The ICSI technique is used to fertilize mature eggs directly. Under the microscope, an embryologist picks up the best single spermium and injects it directly into the cytoplasm of the egg using a small glass needle. The ultimate medical recommendations are to grow embryos for five or six days until they reach blastocyst stage.
In many situations, especially when a female patient is in her late 30’s and early 40’s, infertility may result from a decrease in ovarian function and a consequent fall in egg quality. In the event of a severe compromise in ovarian function, successful pregnancy is very unlikely. A treatment that often offers an excellent chance of success is to use eggs from a young donor who produces good quality eggs.
Surrogacy is a method of reproduction whereby a woman agrees to become pregnant and deliver a child for a contracted party. She may be the child’s genetic mother (the more traditional form of surrogacy), or she may, as a gestational carrier, carry the pregnancy to delivery after having been implanted with an embryo.
(AH) is a procedure performed prior to transfer in selected cases. An embryo needs to escape or “hatch” from it’s protein shell, called the Zona Pellucida, before it can implant in the uterus. In AH, a chemical or a laser can be used to dissolve part of the zone, to facilitate the hatching process later. This technique is often used with prior failed IVF cycles, female age over 38, and with abnormally thick zone.
Percutaneous Epidydimal Sperm Aspiration and Testicular Sperm Extraction (PESA and TESE)
Some men have no sperm in the ejaculate but still produce them in the testicles. This may occur due to a vasectomy, to a congenital obstruction of the sperm ducts leaving the testicles, or to inadequate development of the sperm such that they cannot leave the testicles. In these situations, a urologist can remove sperm by placing a needle into the testis or the tubes that drain it. These procedures are done under anesthesia and can be very effective when combined with ICSI.
Embryos that are not transferred but continue to thrive in the laboratory can be cryopreserved (frozen). We’d recommend freezing for any high quality embryos that survive to the blastocyst stage. These embryos are stored in liquid nitrogen and can be thawed at a later date. While the pregnancy rates with frozen embryos are not as high, the procedures involved in preparing for a frozen embryo transfer are much simpler and less expensive. Freezing only embryos that survive to the blastocyst stage maximizes the chance for success in a thaw cycle.