Laboratory techniques
ICSI- intracytoplasmatic sperm injection
Only one selected sperm is placed under the microscope in the mature egg. This method is used for serious sperm failure, or if fertilization has not occurred in the classical method of artificial fertilization. We also recommend it in elderly patients or with a small number of oocytes.
PICSI- preselected intracytoplasmatic sperm injection
In this method, pre-ICSI mature sperm are selected from the ejaculate sample which is dropped onto a special gel containing hyaluronan. For fertilization, only the sperm that are attached to this gel are used. Only mature and quality sperm is capable of such a bond.
MACS® sperm separation- magnetic-activated cell sorting on sperm
Method of magnetic sperm selection – it serves to separate poor quality sperms (with damaged DNA) from the ejaculate sample.
The use of these methods is recommended in cases of inexplicable infertility, repeated embryo implant failure, stopping embryo development before embryo transfer and worse spermiogram parameters.
MESA, TESE- Micro Epididymal Sperm Aspiration/Testicular Sperm Extraction
Methods for obtaining sperm with testicals and algae. It is a surgical method in which a tissue sample is taken in which sperm are usable for freezing under the microscope or can be used immediately for fertilization. This method is indicated in patients who have not found sperm in the ejaculate (azoospermia).
Prolonged cultivation
It means embryo cultivation in the media up to blastocyst stage, 5 days after fertilization. It will enable natural selection of more active embryos with greater potential to fend off. It is recommended for more embryos.
In vitro maturation of oocytes
Taking the immature eggs that mature for another 36-48 hours in a special solution in the incubator. After maturation, fertilization, embryo cultivation, and transmission to the uterus followed in the classic IVF cycle.
Embryo freezing
With more embryos, up to 2 embryos are transmitted to the cervix. All other top quality is recommended to freeze. Their thawing transmission does not require hormonal stimulation.
AZH- Assisted Zonal Hatching
Open the embryo package. The embryo is fed into the uterine mucosa only after leaving the container that protects the embryo during dividing. Sometimes this packaging can be a hard embryo that can not “get out”. In this case, the embryologist can use the laser beam to make an opening where the embryo gets easier out.
SPF (Seminal Plasma Flushing)
The partner’s laboratory-treated ejaculate is injected into the uterine cervix before transfer. Its administration stimulates the uterine mucosa and increases the chance of embryo stinging.
EmbryoGlue
“Embryo glue” is a medium in which embryos are cultured shortly before transfer. This procedure increases the chance of embryo implantation in the uterus. It is used before transfer of embryos at any stage of development even in the transfer of thawed embryos.
Predimplantačné genetické vyšetrenie
Genetic examination of embryos before transfer to cervical cavity.
PGS – Investigation of a possible genetic disorder in an embryo. An older method (FISH) allowed the analysis of a limited number of chromosomes (5-8). Most frequent disturbances leading to repeated abrasion and congenital developmental errors are investigated. The newer method (aCGH) allows the whole DNA to be examined in large sections.
Indications: age over 37 years, repeatedly failed IVF cycles, repeated abortion, severe spermiogram disorder, previous oncological treatment
PGD - In this investigation, we aim for a specific genetic disorder. It is used for the examination of a pair of embryos in which one partner carries the chromosome rearrangement that causes infertility.
PGD Monogenic Diseases – Targeted embryo examination on a known genetic condition in one of the partners or one of the family members.
The use of over-standard laboratory methods always consults a couple with an embryologist and a physician at the center.