ICSI – Intracytoplasmic Sperm Injection

In this micromanipulation method, a single sperm is injected directly into the egg. ICSI is performed utilising a special device – a micromanipulator. The success rate of fertilization is as high as 90 %.

This method is suitable for couples with poor quality sperm or couples where a low number of eggs have been retrieved from the woman. In some couples (severe spermatogenesis disorder) the use of this method is unavoidable. The usage of the ICSI method, i.e., the selection of both sperm and egg, significantly increases the likelihood of producing higher quality embryos compared to conventional in vitro fertilization.

MACS – Magnetic-Activated Cell Sorting

MACS is a method of sperm processing with the use of specific antibodies on magnetic microspheres and magnets. This method enables the removal of antibody-labelled defective sperm cells from the semen and retention of only live undamaged sperm cells, which are later used for assisted reproductive techniques. The method is suitable for patients with poor quality sperm, patients with a low rate of egg fertilization after IVF with ICSI, or after repeated failure of IVF treatment cycles without apparent cause.

MFSS – Microfluidic Sperm Sorting

The MFSS method is based on the principle of natural sperm selection by passage through micro-barriers imitating the natural environment of female reproductive system. In this method, sperm in the ejaculate are placed on a special chip and spontaneously pass through microchannels into the fertilization medium.

MFSS is mainly performed in couples with embryonic arrest in previous cycles, with repeated abortions or embryo transfers without embryo implantation and in older women.

TESE/MESA

If azoospermia (absence of any sperm in the ejaculate) is repeatedly confirmed, in some cases it is possible to obtain sperm by surgical methods – MESA (Micro Epididymal Sperm Aspiration), in which sperm are microsurgically extracted from the epididymis, or TESE (Testicular Sperm Extraction), in which a small piece of tissue is surgically removed from the testicle. The material is subsequently processed and, if sperm are retrieved, they can be used for the ICSI method of fertilization.

Within the framework of assisted reproduction methods, it is possible to perform genetic testing and selection of embryos before transfer to the uterus and implantation (preimplantation testing). The method of examination is based on the conclusions of the genetic consultation. Preimplantation testing can either be targeted at diseases already present in the family or at random genetic changes resulting from the external environment or the age of the parents. A cell or several cells are separated from the embryo and then sent to our affiliated genetic laboratory for testing.

There are two basic types of preimplantation testing:

PGT

PGT (preimplantation genetic testing) is a targeted testing of embryos to exclude hereditary familial diseases where one or both partners are carriers of disposition for specific disease. This may be a chromosomal defect (PGT-SR) or a monogenic hereditary disease (PGT-M) such as cystic fibrosis, spinal muscular atrophy or haemophilia.

In the case of sex-linked diseases (e. g. haemophilia), it is also possible to make a selection of embryos of the sex which does not have the risk of the disease. Otherwise, selection of embryos according to the sex is legally not possible. Regarding the tracked diseases, only healthy embryos are transferred into the uterus, thus minimising the risk of a having an unhealthy child or having to terminate the pregnancy when foetal impairment is detected.

PGT-A

PGT-A (preimplantation genetic testing for aneuploidy) is a method of testing embryos for chromosomal abnormalities before transfer to the uterus. Many IVF cycles can end in disappointment due to the failure of the embryo to implant (nest). One cause is an incorrect amount of genetic material (chromosomes) in the transferred embryo. The loss of a chromosome or an extra chromosome in the embryo is referred to as aneuploidy. While some aneuploid embryos may develop until the baby is born (e. g., Down syndrome with an extra chromosome 21), most aneuploid embryos do not implant in the uterus or their development results in spontaneous abortion.

EmbryoGlue is a medium that contains a high concentration of hyaluronan and recombinant human albumin. It mimics the conditions in a woman’s uterus and increases the adhesion of the embryo to the uterine lining.

Cryopreservation is a method of freezing and preserving cells and tissues for later use. We use a special method called vitrification for cryopreservation of eggs and embryos.

Vitrification is a rapid freezing method where we expose cells to a temperature drop to -196⁰C within seconds. This method of preserving cells is particularly suitable for embryos and eggs. The main benefit for the treated couple is the possibility of further (frozen) embryo transfer without the need for new hormonal stimulation of the ovaries.

When do we perform vitrification?

• Most often, we vitrify additional embryos that are produced during IVF treatment and can be transferred to the woman’s uterus later, if the woman does not become pregnant after a previous embryo transfer, or when the woman wants to become pregnant again.

• A woman’s eggs can be vitrified for medical reasons, e. g., in cancer patients.

• It is also possible to freeze a woman’s eggs for no medical reason, in the context of the so-called social freezing, when a woman wishes to increase her chances of becoming pregnant later in life.