Damia Medical Center for Reproductive Health began with a sincere desire to help expectant parents achieve the most desirable thing – the appearance of a baby in their family. Over the years, it has grown into a center with the latest technology, where the use of evidence-based medicine and patient comfort are equal in importance.
Our doctors in the process of treatment always move from the simplest methods to the most complex. In any situation, we do everything possible to give the couple a chance to conceive as close as possible to natural.
However, for many couples, the only way to realize the dream of fatherhood is to be fertilized with ART. We have many years of experience in the treatment of complex infertility cases, successfully using all currently available ART technologies. This significantly increases the chances of conceiving and giving birth to a child with infertility of any degree of complexity.
Our clinic uses the following assisted reproductive technologies:
- artificial insemination with sperm (partner or donor);
- IVF (in vitro fertilization);
- ICSI (Intracytoplasmic Sperm Injection);
- obtaining sperm for ICSI procedure (TESA, micro TESE, PESA);
- donation of reproductive cells and embryos;
Intrauterine insemination (IUD) is the simplest method of assisted reproductive technologies. At the same time, it is the method with the lowest efficiency (up to 10-15%) according to world statistics.
Insemination as a method of infertility treatment is suggested in the following cases:
- in women confirmed patency of the fallopian tubes;
- ovulation confirmed during folliculometry;
- a man has satisfactory sperm quality.
Before the manipulation, the sperm is prepared in the laboratory for the selection of sperm with normal motility. Such fertile sperm is injected into the uterine cavity at the time of ovulation.
Male semen or donor semen is used for VMI.
Insemination is performed:
In vitro fertilization (IVF) or in vitro fertilization (IVF)
In vitro fertilization or in vitro fertilization (IVF) – a method of assisted reproductive technologies, in which some or all stages of conception and early development of embryos are carried out outside the body of a woman. </ span>
- male infertility;
- tubal-peritoneal infertility (uterine tube obstruction);
- polycystic ovary syndrome (PCOS) and other hormonal forms of infertility in which ovulation (ovulation) cannot be achieved with medication;
- immunological infertility;
- unexplained infertility.
The main stages of the in-vitro fertilization cycle:
The in vitro fertilization cycle can be stopped at one stage for the following reasons:
- lack of ovarian response (follicle growth) to drugs;
- premature ovulation (up to 0.5% when using a long protocol and up to 30% in the natural cycle);
Risks and complications associated with follicle puncture and ovulation aspiration
Follicle puncture is performed transvaginally under ultrasound control with a special needle, 30-35 cm long and 1.2-1.5 mm outer diameter. The ovaries are surrounded by large vessels, intestines, bladder and therefore, in theory, possible injuries to these organs. The risk of abdominal bleeding is about 1 per 1000-1200 punctures, infectious complications – 1 per 350-500 punctures (Serour et al., 1998).
Risks of pregnancy resulting from ART treatment
Multiplicity occurs in 25-30% of pregnancies resulting from ART treatment, in particular, twin pregnancies – 20-25%, triplets – up to 5% (our data Center for 2006-2009).
Ectopic pregnancy (pregnancy pathology in which the fertilized egg develops outside the uterus: in the fallopian tubes, ovaries, cervix, abdomen) occurs in 1.5-2% of all pregnancies (according to our data for 2006-2014 – 1.3%). Treatment is usually surgical.
“Heterotopic pregnancy (pathology of pregnancy in which fetal eggs develop simultaneously in the uterine cavity and outside the uterus: in the fallopian tubes, ovaries, cervix, abdomen) occurs in 0.1-1% of all pregnancies. Treatment is surgical only. The prognosis for uterine pregnancy is favorable.
Abortion (14-20%) and the development of other complications do not exceed the number that occur during a natural pregnancy (Serour et al., 1998).
Risk of developmental abnormalities in children conceived using ART techniques
Most children are born healthy after using ART techniques, but compared to children born as a result of spontaneous pregnancy, the following complications are more common: mismatch of the baby’s weight during pregnancy, premature birth (Reddy et al., 2007). These complications are typical of singleton pregnancies.
Intracytoplasmic Sperm Injection (ICSI)
ICSI method (ICSI) is one of the main methods of ART (assisted reproductive technologies). It involves inserting a single sperm directly into the nucleus or cytoplasm of an oocyte using a thin glass needle. The embryo is then placed in the uterus according to the same procedure as for conventional IVF.
This method is used in severe cases of male infertility: </ p>
- azoospermia – lack of sperm in the ejaculate;
oligozoospermia – decreased sperm concentration (less than 2 million / ml);
- asthenozoospermia – less than 1 million active motile sperm in 1 ml of ejaculate;
- teratozoospermia – less than 5% of sperm of normal structure; combined sperm pathology;
- the presence of antisperm antibodies in the ejaculate (MAR-test more than 50%), which interfere with natural fertilization, even in cases of normal sperm concentration; </ li >
- when obtaining sperm surgically;
- if there was no fertilization in previous ART cycles;
- after egg freezing;
- cycles in which genetic testing of embryos (PGD) is carried out;
- age of woman over 38.
The PICSI method is a variant of ICSI and involves the selection of mature sperm for fertilization.
In severe cases of male infertility in our center are minimally invasive operations, namely methods of testicular biopsy PESA, TESA, TESE, MESE (puncture or open biopsy to collect sperm directly from the testicle). These methods are used in the absence of sperm in the semen.
Most recently, the very idea of conceiving a child in vitro (“in vitro”) was considered fantastic. On July 25, 1978, the first child born by IVF was born to Britain’s Louise Brown. But modern reproductive medicine is ready to offer couples who have difficulty conceiving new opportunities that significantly increase the chances of having a child.
What is cryocycle and cryopreservation?
Cryocycle is an ART procedure in which thawed embryos are transferred. In foreign literature, it is called transfer “with thawed embryos”.
Cryopreservation is a procedure to stop all biological processes in a cell by freezing and then preserving them at low temperatures.
Oocyte donation is sometimes the only chance for many couples and single women to have children.
Donor oocytes (eggs) are used in cases where it is impossible to obtain their own eggs or they are unfit for conception.
Indications for in vitro fertilization using donor eggs:
- lack of oocytes due to natural menopause;
- syndrome of premature ovarian failure;
- condition after ovariectomy, radiotherapy or chemotherapy;
- genital developmental abnormalities (gonadal dysgenesis, Shereshevsky-Turner syndrome);
- risk of sexually transmitted diseases (haemophilia, Duchenne myodystrophy, ichthyosis, Charcot-Marie-Trussot myotrophy);
- unsuccessful repeated attempts of IVF (4 and more) with insufficient response of the ovaries to the induction of superovulation, repeated production of low quality embryos.
Egg donors can be: