IVF / ICSI / IMSI using own oocytes
The method of "in vitro fertilisation" or "extracorporeal fertilisation", in principle, means joining the egg and the sperm outside the mother’s body. For that purpose an egg is samples from the ovary and transferred to a test tube (= in vitro) where it is combined with the male sperm. The resulting embryo is introduced to the uterus after five days of cultivation (= embryo transfer). This procedure is a demoing challenge for the parents-to-be and that is why the approach should be absolutely individual and the therapy should be performed in confidence. The couple must be exhaustively informed about all aspects of the therapy. After study of existing findings, following a profound gynaecological examination and sperm inspection the therapeutic plan is prepared. In many cases psychological consultancy preceding in vitro fertilisation can have a positive effect. Accurate progress of individual examinations (ultrasonic checks, hormonal examinations, blood samples etc.) and a detailed list of medication will be received by each couple in the form of Therapeutic Plan following prior consultation. The therapy is individual and adapted to the current condition.
IVF / ICSI / IMSI using donor eggs
Therapy with donor eggs uses fresh eggs from an anonymous donor fertilised with sperm of the infertile woman’s spouse. The donor preparation and synchronisation of the menstrual cycle of the female donor and the female recipient takes about 2 months. The recipient only takes medication for uterine mucosa preparation for receipt of the embryo, without hormonal stimulation of the ovaries. Our IVF Centers Prof. Zech only accepts female donors at the age between 20 and 33 years, who must agree to and undergo all examinations and tests required by the applicable legislation. Donor selection considers phenotype criteria required by the female patient and her spouse. Our donor programme guarantees provision of at least two embryos in the blastocyst stage (in the case of the spouse’s normozoosperm), but we usually provide 5 embryos per pair. If we are unable to get the guaranteed number of two embryos from a single donor then we prepare new embryos for the couple at our cost.
ICSI - Intra-Cytoplasmatic Sperm Injection
By means of this method a single sperm is injected to the egg for the purpose of its fertilisation. Sperm selection is done under a special microscope with multiplied enlargement. ICSI method results in a similar pregnancy success as the classical method of in-vitro fertilisation. Despite that we consider the classical ICSI "obsolete” and replace it with IMSI method in our centre.
PICSI - Pre-selective intra-cytoplasmatic sperm injection
This technique imitates natural selection of mature sperm. Natural fertilisation only occurs by mature sperm able to bind to hyaluronan, the substance present on the egg surface. The principle of PICSI is to bind mature sperm to a special cup with applied hyaluronan gel. The selected sperm is then used for micro-manipulation fertilisation.
After egg fertilisation the embryos are cultivated for five days until the blastocyst stage, before the embryo transfer to the mother´s uterus is performed. The embryo may obviously be transferred in an earlier development stage as well but as the male factor only begins to significantly control the embryo development since the third day, it constitutes one of the many reasons why our centre uses the extended cultivation method for every cycle as a standard. Extended cultivation also offers increased chance for the embryo nesting in the uterus and an increased opportunity for selection of the morphologically most suitable embryo.
IMSI - Intra-Cytoplasmatic Morphologically-Selected Sperm Injection
In the case of the classical IVF (in vitro fertilisation) therapy the protective egg coat works as selective biological barrier against abnormal sperm so in most cases the egg can only be fertilised by "normal" sperm. In the case of the above mentioned ICSI method this "natural selection" mechanism is bypassed and sperm selection is decided on the basis of morphological assessment by a biologist. Quality of the subjective morphological find and selection can be improved by new microscopic techniques of IMSI.
Studies performed by our team have shown that the probability of isolation of one normal sperm without defect in the sperm head for the purpose of egg fertilisation is considerably increased in comparison to the ICSI method when the IMSI method is used. Sperm with head defect negatively affect embryo development and that is the reason why we prefer use of the IMSI method.
Blastocysts, primarily not transferred, are vitrified by a method we have significantly contributed to the development of, involving freezing (cryo-conservation) and thawed before use for another child or further needed therapy. We are pleased that our long-term collaborator is Dr. Pierre Vanderzwalmen, one of the pioneers in the field of cryo-conservation of embryos, sperm and eggs, as well as testicular and ovarian tissue.
In addition to cryo-conservation of embryos we also offer cryo-conservation of sperm or oocytes.
Preimplantation genetic testing in the context of fertility treatment is used for examination of non-fertilised/fertilised egg for potential genetic defects before its introduction to the mother´s uterus. All detailed information about the examination progress and possible risks, including medical indications or legislation, will be explained to you in the context of the related medical consultation.
Genetic examination as part of infertility therapy is mainly recommended in the following cases:
- Individual and/or family genetic burden
- Recurrent miscarriages
- Multiple failed treatment cycles of IVF therapy
Assisted hatching is a micro-manipulation method using laser to open the pellucid zone (the glycoprotein egg coat). This facilitates the hatching process, i.e. release of the inner part of the cellular part of the embryo via the pellucid zone. Assisted hatching is performed by our centre in the course of all therapies and for all embryos available for the patient, on day four of the cultivation when the embryos reach the compact stage.