Intrauterine insemination (IUI)
Intrauterine insemination is the oldest and simplest method of infertility treatment. Conditions for use of this method are man’s healthy sperm cells, passable fallopian tubes, and proven ovulation in the woman.More about the IUI method
In vitro fertilization (IVF)
This method is about highly specialized lab micromanipulation techniques when sperm in a special solution is added to the retrieved eggs in a special media. Sperm have to penetrate the individual eggs by themselves. It is a matter of coincidence which sperm penetrates which oocytes.More about the IVF method
Sperm injection (ICSI)
ICSI has become one of the most reliable and modern methods. During egg injection, we choose the highest quality sperm cell and inject it directly into an egg cytoplasm.More about the ICSI method
|Special techniques of sperm selection||IUI||IVF||ICSI|
|Methods for a healthy embryo development monitoring|
|PGT-A / PGT-M|
|Methods for the most successful embryo transfer into mother’s body|
|Methods of sperm aspiration|
|Possible embryo cryopreservation for transfer in the future|
This technique leverages the fact egg surface contains hyaluronic acid and healthy sperm contain a developed receptor for this substance.
This selection technique is specially developed for future sperm injection in the future. We use the fact that the egg is covered in a substance that contains hyaluronic acid and that the heads of healthy sperm contain a developed receptor that is attracted to this substance, hence the phrase “a magnet for sperm.” This magnet lures the healthiest sperm that are the most suitable for conception. When utilizing ICSI we choose sperm based on morphology and motility. PICSI allows for the selection of sperm with optimal genetic characteristics in addition to these criteria. PICSI is suitable for patients who have marginal sperm analysis values or for patients who have not previously conceived. It is also suitable for couples that have had low fertilization rates or sub-optimal embryo quality.
Magnetic-activated cell sorting is one of the state-of-the-art non-invasive methods of sperm selection. MACS method enables functional selection of living sperm cells without signs of apoptosis.
MACS method utilizes the principle of magnetic labelling of defective sperm cells which are subsequently separated by means of a magnetic field. Magnetic nanoparticles detect, retain, and deplete the defective sperm cells from the sample.
The method is based on selective separation of apoptotic cells, meaning such cells which are damaged and useless, and that would be naturally eliminated by an organism via a programmed cell death (apoptosis) due to their non-functional system. Normally used techniques may unfortunately not separate such cells. The MACS method is sensitive to the extent that it detects also early apoptotic cells: the cells that look healthily form the outside as they have non-damaged cell membrane while their content is non-functional. MACS method is specialized to eliminate exactly these cells.
The remaining sperm cells have better values in comparison with the original sample in the following criteria: motility, morphology, and DNA fragmentation. The chance of conception when using these sperm cells is higher.
We recommend utilizing this method in men who have: increased DNA fragmentation in sperm, genetically conditioned development defects in spermatogenesis; also in men who are exposed to free radicals, smoking, increased testicular temperature, chemical substances (e.g. particular medications, smoking), stress; or in men of higher age and after repetitively unsuccessful treatment cycles.
Microfluidic sperm selection chips provide a gentler alternative to assisted reproduction procedures, which require centrifugation in the preparation process, which can lead to negative sperm loading and damage. The method is based on the principle of natural selection of sperm by leting it pass through microbarriers imitating the natural environment of a woman's reproductive system. Sperm sorted by microchip show better morphology and motility, lower DNA fragmentation, as well as lower levels of reactive oxygen species, which can also adversely affect sperm. Sperm prepared with a microchip can be used to fertilize human eggs by all methods, ie ICSI, PICSI, IVF or artificial insemination. Thus, when the sperm is processed in this way, it increases the chances for the fertilization of the egg, the chances for proper development of the embryo and the subsequent pregnancy and birth of a healthy child.
All of the above methods can be used together or freely combined with each other. Each of the methods works on a different principle of selection of "healthy" sperm and leads to increased success of fertilization, successful embryo development, pregnancy and the birth of a healthy child.
When do we recommend these methods?
● in case of repeated unsuccessful IUI
● if the number of fertilized eggs in the previous cycle was low using the ICSI method
● in case of repeated abortions
● after repeated embryo transfers without subsequent implantation of the embryo,
● with poor embryo quality in previous IVF cycles
● in other cases, depending on the doctor's recommendation
This method helps us to recognize and identify healthy embryos.
The EmbryoScope monitors all embryos and captures the development and cultivation of the embryo with a microscopic camera which films continuously, 24 hours a day, for all five days of the cultivation. We assess the dynamics of the development phases. The probability of conception thus significantly rises in the first cycle.
At the same time, the EmbryoScope creates the best possible conditions and environment for embryo development. Embryos are continuously observed and their environment is not intruded. The chance of conception thus increases in the first cycle, even if only a single embryo is transferred to a uterus (single embryo transfer limits the risk of multiple pregnancy).
PGT-A – Preimplantation genetic screening means an aspiration of several trophectoderm cells from an embryo in the blastocyst stage; these cells are subsequently examined. The cell aspiration using the laser is performed very carefully. Thanks to the laser OCTAX NaviLaseTM it is possible to retrieve cells and perform genetic examination of embryos for all chromosomes; thus, increase success rate of the IVF cycle and decrease the risk of a possible miscarriage. The combination of the most modern laser type and embryo genetic examination of all chromosomes represents the most up-to-date and most effecting trend in IVF today.
The PGT-M of so-called monogenic diseases is often the only chance to give birth to a healthy child for patients with inborn defects or carriers of genetic inborn disorders. Thanks to the laser OCTAX NaviLaseTM it is possible to retrieve the cells from the embryos and perform genetic examination targeted on specific genetic disease.
Laser Assisted Zone Thinning (LAZT) represents thinning of the embryo shell that helps the embryo implantation in the uterus.
A human egg is covered in a shell which also covers a developing embryo. The embryo has to however “break free” from its covering before the implantation. This process is called the hatching. The assistance to break free will ease embryo´s contact with uterine cells in which the embryo is supposed to implant.
The assisted hatching using the laser cannot harm to the embryo. Utilization of the non-contact laser allows, in contrast to the classical hatching, many advantages and does not intervene into the protective zone layer and inner environment of an embryo. This method is suitable for all couples because it is considered a supporting method that facilitates acceptance and implantation of a fertilized egg; thus it increases probability of successful conception.
EmbryoGlue® is a special medium from Vitrolife designed to transfer embryos directly to the uterus.
The medium contains all the nutrients and energy sources needed for optimal embryo development.It also contains hyaluronan which is commonly found in follicular fluid in the uterus and in the uterus itself where it creates an environment of increased viscosity due to higher concentrations of hyaluronan which assists in the embryo attaching to the uterine wall.
Clinical results using EmbryoGlue culture medium containing hyaluronan (source: Vitrolife) show that 48% of patients became pregnant with a conventional transfer medium. When women received EmbryoGlue® pregnancy rates increased to 54.6%.
EmbryoGlue® culture medium is beneficial in embryo transfers of all developmental stages from two days to blastocysts and both fresh and frozen.
This method is suitable for men whose epididymis have no sperm present.
Similarly to MESA, TESE is performed under general anaesthesia by a urologist. This method of sperm extraction from the testis is performed in men in whose ejaculate and epididymis have no sperm present. When sperm are successfully extracted from the testis, they can also be used for the egg fertilization method ICSI (egg injection).
This method is suitable for men whose ejaculate contains no sperm.
Sperm is aspired by siphoning from the epididymis and is further administered into a suitable oocyte via egg injection (ICSI). A Urologist performs the MESA method while the patient is under general anaesthesia.
MESA is suitable for men with extremely low sperm count in ejaculate, sperm with abnormal morphology (shape), or with congenital sperm defects. It can help in cases where a man has had a vasectomy.