/ Gyn & Fertility Centre
Assisted Reproductive Technologies (ART)
Intra-uterine Insemination (IUI)
Intrauterine insemination (IUI) is the placement of washed sperm into the uterus, at the time of ovulation. The sperm is washed in order to increase sperm motility, to filter out abnormal sperm, and to remove bacteria and other substances which would otherwise irritate the uterine lining. Washed sperm is more motile and more likely to achieve fertilization than unwashed sperm, especially in men with sperm problems, or in older women.
In Vitro Fertilisation (IVF)
The first IVF baby was performed in 1978; The IVF Treatment means fertilization outside the woman body in a test- tube. IVF has resulted in over 1,000,000 babies worldwide. The indications for IVF are damaged or blocked tubes, endometriosis, male factor infertility, repeated IUI failure, PCOD, immunological factor, unexplained infertility, any unsuccessful fertility treatment after two trials.
The IVF treatment involves the administration of fertility drugs, monitoring of the cycle, collection of the eggs, mixing eggs and sperm together outside the woman’s body in a culture dish or test-tube. Any resulting embryos are left to grow and the best two or occasionally three embryos are then transferred into the woman’s womb.
Intra-cytoplasmic Sperm Injection (ICSI)
ICSI is the most practical form of in vitro fertilization whereby a single sperm is injected into the egg using a fine glass needle. This technique assists couples with very low sperm counts. Even partners who have no sperm in the ejaculate but can have sperm retrieved from the testes by testicular biopsy will benefit from ICSI. With ICSI, the eggs are retrieved the same as if you were doing conventional IVF. However, the eggs and the sperm are then fertilized in the laboratory, by direct injection of a single sperm into each egg. Three days later the resulting embryos are simply placed into the uterus with no surgery, just as with IVF. This technique is very cost-effective, and will result to the same high chance for getting pregnant as any couple with normal sperm.
Ovulation induction is a safe and effective means of helping infertile women who do not ovulate or who ovulate irregularly.Ovulation induction involves stimulating the ovary to produce one or more eggs. It may be accomplished using a number of different medications and may be helpful in a variety of treatments. Additionally, it may be used to induce the development and release of multiple eggs in ovulatory women undergoing other infertility treatments.
The sperm freezing is very useful in many cases,we may be able to use them for treatment in the future including:
• Men who are about to undergo a medical treatment that may affect their fertility and their ability to produce sperm, for example, some forms of cancer treatment (chemotherapy).
• Men who have a low sperm count or they are producing sperm that are deteriorating in quality over time
• Men who have difficulty producing a sample on the day of fertility treatment.
• When the husband might be a way during his wife’s treatment.
This is a newly introduced service by verification; we have a better survival rate of eggs than with older techniques. This technique is relevant in women who have to undergo chemotherapy or want to preserve their eggs to utilize later on, when their own timing permit them to plan for a pregnancy.
Pre-implantation Genetic Diagnosis (PGD)
Pre-implantation Genetic Diagnosis (PGD) is a highly sophisticated scientific technique to test embryos for specific genetic or chromosomal abnormalities. It enables the selection of unaffected embryos prior to implantation and pregnancy.
You may wish to consider Pre-implantation Genetic Diagnosis if you are concerned about any of the following issues:
• risk of having a child with an inherited genetic condition
• either partner has a known family history of chromosome rearrangement
• previous chromosomal abnormality in a pregnancy
• advanced maternal age (usually to test for Down syndrome where the mother is over 38 years old)
• recurrent miscarriage
• repeatedembryo transfers without pregnancy
• if you would find it difficult to consider termination of an affected pregnancy
In PGD testing, one cellis removed from a day-3 embryo and tested for a specified condition, such as cystic fibrosis or Down’s syndrome. Only those embryos diagnosed as being unaffected or free of a specific disorder will be transferred in the IVF cycle, maximising the chance of a healthy baby.
We are able to test for a very large number of single gene disorders, including:
• Huntington’s disease
• Cystic fibrosis
• Duchenne muscular dystrophy
In order for the embryo to implant into the womb and form a pregnancy, it has to 'hatch' from its outer shell. This may not happen in some women who have thicker than usual outer shell in their eggs. To overcome that, we perform the chemical or mechanical technique to increase the chances of success.
The assisted hatching may be advised to women over 39 years and using their own eggs, women who had recurrent failure of embryo implantation (three or more embryo transfers without a pregnancy), women whose embryos exhibit thick zonapellucida and women with elevated FSH levels.
Treatment of Azoospermia
Azoospermia is the term used when there is a complete absence of sperm in the ejaculate. This represents the most severe form of male infertility. About 8% of men who present to our centre suffer from azoospermia, These men require careful and expert assessment. A few of them have reduced hormones and will respond well to hormonal treatment. Most, however, will require a minor surgical procedure to obtain sperm from the testis (TESA) or by needle aspiration through the epididymis (PESA) or a small piece of tissue can be taken by miniature cut (Biopsy) especially if there is only immature form of sperm present (spermatide) and then use them for ICSI.