Reproductive health: Centre for in-vitro fertilization and pre-implantation genetic diagnosis
"We bring new hope to patients around the world"
"Our Center for In-Vitro Fertilization and Preimplantation Genetic Diagnosis strives to increase fertility options and rates and successful births. Transferred embryos are kept under constant monitoring and control by our trained specialist doctors. Our Centre has state-of-the-art laboratory systems, embryoscopy equipment, high-tech incubators, and other technologies - significantly increasing conception success rates, even in cases that have not previously registered for treatment.
The root cause of the vast majority of infertility cases is genetic; our modern genetics laboratory aims to identify and resolve these issues by determining gamete and embryo abnormalities, and thereby lead to the development of effective and successful treatment strategies for the benefit of our foreign patients."
Preimplantation genetic diagnosis
Our laboratory with state-of-the-art genetic equipment, experienced specialists and highly skilled technicians ensure that the embryo will have no genetic or chromosomal abnormalities prior to embryo transfer. The Centre’s in-vitro fertilization and pre-implantation genetic diagnosis department offers a comprehensive and detailed male infertility screening and analysis, and has the capacity for high-quality sperm selection. The root cause of a large proportion of infertility cases is genetic; our state-of-the-art genetics laboratory aims to identify and resolve these issues by determining gamete and embryonic abnormalities, leading to the development of effective and successful treatment strategies.
Freezing / Vitrification
Our Centre's specialists have extensive experience in freezing eggs, semen or embryos to preserve fertility using the world's leading freezing technologies and protocols - with 97% of eggs and embryos surviving.
Technology
Liv Hospital works with technologies that are already international industry standards.
In-vitro fertilization
Embryo cryopreservation, oocyte cryopreservation, assisted hatching, blastocyst culture.
Comprehensive Andrology Laboratory Service
Intrauterine insemination (IUI), seminal fluid “washing”, sperm analysis, comprehensive diagnostics, intracytoplasmic sperm injection (ICSI), non-surgical sperm aspiration (NSA), sperm freezing
Intrauterine insemination
Seminal fluid is extracted by masturbation, then it is processed in a laboratory, and the best samples are extracted and concentrated. The mother-to-be, whose eggs have been matured by hormone medication, undergoes a 15-minute painless procedure in which highly motile sperm are inserted into her uterus for the purpose of natural fertilization. Vaccination can also be performed up to 4 times, as long as there are no severe seminal fluid disorders; the woman's fallopian tubes are open and there are no concerns regarding eggs or age. On average, each procedure has a 20% chance of success.
Test tube baby
Technically called in-vitro fertilization, the "test tube baby" method is a procedure in which eggs are taken from the expectant mother's ovaries and united with sperm from the expectant father in a laboratory, and the resulting embryos are re-implanted into the mother's uterus. In the first phase of treatment, the eggs are formed and then retrieved at the appropriate time. Fertilization occurs when they are combined with the sperm in the laboratory and the embryos that develop are re-implanted into the mother's womb. Traditional in-vitro fertilization methods were first performed in 1978 and soon after began to spread around the world. Our center has been performing successful in-vitro procedures since 1998, using the microinjection technique invented in 1992 (ICSI - intracytoplasmic sperm injection).
Traditional in-vitro fertilization (in-vitro fertilization – test tube baby)
About 500,000 sperm are put together with 7-8 eggs and natural fertilization is expected. In-vitro fertilization is usually the preferred method for women who find it impossible to conceive due to blocked or limited fallopian tubes, due to infertility because of a male factor and for women who do not have egg related problems.
Intracytoplasmic sperm injection - ICSI (microinjection method)
Under a microscope, a single sperm is selected, which is injected inside an egg with a thin needle. The subsequent phases of this procedure follow the same sequence as the traditional test-tube baby method. This method reduces the risk of infertility. First introduced in 1992, intracytoplasmic sperm injection represents a revolutionary development for couples who cannot have a child, especially when the reasons lie with the man. Microinjection is the preferred method because of the minimal chance of unsuccessful fertilization, and not only in cases of infertility due to reasons in the man, but also in cases of thickening and hardening of the outer membrane of the egg, which prevents the sperm from breaking through, in couples who have previously tried in-vitro fertilization but without success, and specifically in older couples and women who produce fewer eggs.
In vitro fertilization - step by step
Various drugs are used to stimulate the development of eggs in the ovaries. Under normal conditions, one egg grows every month, but in in-vitro fertilization we know that the possibility of success increases when between 10 and 20 eggs develop. For this reason, the ovaries are stimulated with controlled insertion of medication. The eggs develop into small clusters of cells called follicles. The eggs that are inside the follicles are not visible and follicle growth can only be tracked with ultrasonography. With ultrasonography, the eggs are collected at the 36th hour after the injection of hCG (a hormone used to induce ovulation). The eggs are collected in the operating room setting, through the vagina, under general anesthesia and with the help of ultrasonography. Sperm is collected from the man, in a specially prepared room by masturbation, and the highest quality sperm are selected in a laboratory. Subsequent procedures depend on whether the couple will undergo treatment with a test-tube baby or microinjection.
Assisted hatching
The outer membrane of the egg (pellucid zone) is opened microscopically by laser or mechanically, facilitating the appearance of the embryo before it is implanted in the uterine wall.
Defragmentation (removal of cell debris)
Occasionally, embryos shed debris as they divide; these structures lower the quality of the embryo and can impede the progress of division. These debris are removed by inserting a thin pipette.
Embryonal biopsy
If genetic diagnosis is to be performed before implantation, one or both of the cells that make up the embryo are removed for genetic examination. This is done in order to select the healthiest embryos.
Preimplantation genetic diagnosis
In in-vitro fertilization procedures, embryos are selected between the second and sixth day and transferred to the future mother. Although the embryos that look the best are selected, the success rate of implantation into the uterine wall and achieving a clinical pregnancy is not 100%. Miscarriages caused by genetic disorders can occur during the first 3 months of pregnancy. Preimplantation genetic diagnosis techniques developed in recent years allow the detection of this group of embryonic genetic diseases. The introduction of preimplantation genetic diagnosis in the application of in-vitro fertilization has revealed some of the causes of low pregnancy chances. This method has shown that, depending on age, an average of 30% of even the best-looking embryos (and 90% of those considered low-quality) are genetically defective. Because of this, the chance of a pregnancy resulting from embryos that look healthy but have abnormalities is very low, and even if a pregnancy does occur, there is a high chance of miscarriage.
Freezing an embryo
If at least 2 more healthy embryos are formed in addition to those transferred after treatment, they can be frozen and stored for up to 5 years. These embryos are stored in liquid nitrogen under very specific conditions at a temperature of -196°C and can be implanted in the patient's uterus whenever she wishes. This process has been developed to achieve pregnancy using frozen embryos without having to repeat the egg development, collection and laboratory work that has already been done.
Implantation of embryos into the uterus (embryo transfer)
2 to 6 days after egg collection and fertilization, one or two embryos that have formed are implanted in the mother's uterus through a special catheter in a highly sterile and careful manner. The procedure is painless and considerably easier than a normal gynaecological examination. It takes about 15 minutes. Afterwards, the patient is given detailed information about the number and quality of the implanted embryos, the risks of multiple pregnancy and the precautions she should observe. The patient can then go home after resting for about half an hour. She can return to work the next day as long as it does not involve intense stress or physical activity. Sexual intercourse is not recommended during this period.