HFEA reference

Assisted Hatching (AH)

The procedure involves incising the transparent sheath surrounding the embryo before it is transferred into the uterine cavity. The purpose of the procedure is to facilitate the process of embryo hatching and implantation. Opinions on AH vary; according to The National Institute for Clinical Excellence (NICE), the procedure is not recommended due to the lack of clear data on growth rates in pregnancies. In addition, there is a risk of damage to embryo cells. The AH procedure may be recommended in older women who are observed to have thicker clear casings. In this case, the procedure may significantly increase their chance of pregnancy (however, these observations are not scientifically confirmed).

EmbryoGlue 

EmbryoGlue is a medium used for embryo transfer that contains a high concentration of hyaluronan (the main component present in follicular fluid, fallopian tube fluid and uterine fluid). It acts as a "glue" to increase the chances of embryo implantation. There are no risks associated with using EmbryoGlue, and Cochran's research shows that using it increases birth rates by 10%.

Endometrial scratching, or "controlled endometrial injury"

Endometrial scratching aims to increase the success of embryo implantation; it is an intentional and controlled damage to the endometrium that causes an inflammatory response, theoretically increasing the endometrium's receptivity to implantation. Endometrial biopsy is performed prior to the IVF procedure. It is a minimally invasive procedure that does not require anaesthesia. It using a special catheter with which the doctor makes small "lesions" to the endometrium. There are currently three large clinical trials on endometrial scratching. Previous studies have concluded that the effectiveness of the procedure is lower than expected.

Preimplantation diagnosis (PGD)

PGD (currently PGT-A, PGT-M, PGT-SR) consists of genetic testing of embryos prior to their transfer into the uterine cavity in order to diagnose monogenic diseases, chromosomal aneuploidies, and chromosomal translocations, among others. The diagnosis is made on the fifth or sixth day of embryo development after it reaches the blastocyst stage. The test carries a risk of obtaining an incorrect/ambiguous result and the possibility of damaging the embryo during the procedure. Indications for testing may include but are not limited to implantation failure, recurrent miscarriage, female age over 37, the abnormal karyotype of either parent, and previous birth of a sick child/children in the family.

Reproductive immunology, or reproductive immunology, diagnosis and treatment

Reproductive immunology refers to the field of medicine that studies the interactions (or lack thereof) between the immune system and components related to the reproductive system, such as maternal immune tolerance to the fetus or blood-nucleus barrier immune interactions. This concept has been used to explain the causes of infertility, recurrent miscarriage, and pregnancy complications. However, there is no convincing evidence that such diagnosis and possible treatment has any practical significance. It does not increase the chance of pregnancy, and it also carries with it a number of serious drug-related consequences.

Time-lapse (EmbryoScope)

The time-lapse system, thanks to the use of time-lapse technology, allows for round-the-clock precise monitoring of embryo development at all stages from fertilization to transfer and freezing. It provides optimal, continuous breeding conditions without the need to take embryos out of the incubator. The time-lapse system allows to exclude abnormal fertilization and most importantly to select the most optimal and promising embryo for transfer. Thus, it may increase the chances of successful IVF/ICSI procedures and decrease the miscarriage rate.

IMSI, or injection of morphologically selected sperm

This is a method of in vitro fertilization based on injecting the most morphologically normal sperm into the cytoplasm of an egg cell, evaluated under high magnification (6000x). The IMSI method is non-invasive and does not carry any risks. It is especially recommended for couples in whom subsequent attempts at in vitro fertilization by the ICSI method have failed, and for couples with lowered/abnormal sperm parameters. Unfortunately, according to current research, there is no proven effectiveness of this method, and it does not increase the chance of pregnancy.

PICSI, a method for selecting mature and normal sperm for fertilization by ICSI

The PICSI in vitro fertilization procedure is a method in which sperm cells are selected based on their ability to bind to hyaluronic acid. A positive reaction indicates the maturity of the sperm. Gametes selected in this way increase the likelihood of fertilization of the egg and the subsequent proper development of the embryo. The PICSI method is non-invasive and risk-free. However, like IMSI, according to current research, PICSI does not statistically increase the chance of pregnancy compared to the standard ICSI procedure.