Innovations

The Motile Sperm Organelle Morphology Examination (MSOME) technique allows the structure of a living sperm to be observed at 6000x or even 8000x magnification. This makes it possible to determine if the structure of the sperm is correct and which sperm is best. Sperm with the correct structure determines not only successful fertilization, but also, to a large extent, the correct development of the early embryo. The possibility of selecting the healthiest and most promising sperm and the subsequent use for in vitro fertilization significantly increases the chances of having offspring. This is also true for those couples in which the man has very poor semen. The results of semen testing using the MSOME technique influence the choice of a treatment procedure, e.g. insemination, in vitro, intra-cytoplasmic sperm injection, ICSI-IMSI.

During routine embryo culture (no time-lapse technique), after fertilization, the embryo is placed in a special incubator that maintains constant gas-thermal and pH conditions. On subsequent days, the course of fertilization and embryo development is evaluated once a day under a microscope. On this basis, properly developing embryos are transferred or frozen. Thanks to the EmbryoScope microscope-camera system, it is possible to observe the development of embryos without taking them out of the incubator, which reduces the negative impact of external factors during the evaluation of zygotes and embryos. The images collected during culture allow detailed analysis of cell divisions as well as a video recording showing all stages of development. Using the EmbryoScope system has a number of positive implications, including:

• Ensuring consistent breeding conditions

• Exclusion of certain abnormalities in embryonic development

• Selection of the most promising embryo for embryo transfer

• Increase the chance of a successful IVF/ICSI procedure

• Reduction in miscarriage rate

• Provide patients with a video showing the entire process of embryo development from the time the gametes are fused to the day of embryo transfer or freezing

The term ICSI/IMSI refers to the method of fertilization of egg cells. Intracytoplasmic morphologically selected sperm injection (IMSI) is based on the evaluation of the sperm head under very high magnification just before injection into the egg. The procedure allows for optimization of fertilization while increasing the chances of successful treatment for the infertile couple.

Indications for IMSI:

1. Recurrent miscarriage: Traditional IVF methods have a fairly high rate of abnormal implantations and miscarriages. There are many causes responsible for these phenomena. One of them is a "weakness" in the genetic material of the sperm that fertilizes the egg. In the traditional procedure of intracytoplasmic sperm injection (ICSI), due to insufficient magnification, the sperm nucleus cannot be visualized. The IMSI method increases the chance of fertilizing an egg with a sperm with a normal nucleus and thus with correct genetic material.

2. Poor ovarian response to hormonal stimulation: The use of IMSI also increases the chances of a successful pregnancy when the ovarian response to stimulation has been unsatisfactory. The low number of oocytes obtained during such a procedure poses the risk that some of them may be fertilized with abnormal sperm. The IMSI method, through the possibility of selecting the best sperm, improves the chance of obtaining correct embryos and thus the chance of pregnancy.

In our clinic, it is possible to freeze gametes - both sperm and ova - for future use. We use the latest generation freezing methods (including vitrification), thanks to which we protect the quality of the material and increase the effectiveness of fertilization using it. The procedure of fertility preservation may help those women who, due to their life situation (lack of a partner) do not actively try to have a child, but at the same time are aware of the role of age in the reproductive process and would like to have a family in the future. Similarly, oncological treatment is associated with the risk of loss of fertility, especially in women of childbearing age. In this case, it is recommended - before the start of therapy - to take measures that will protect fertility and fulfilling the dream of a family after treatment.

At TFP Fertility Vitrolive, it is possible to freeze the surplus oocytes in order to use them for the next in vitro fertilization procedure (after thawing, the oocytes undergo fertilization in the procedure of intracytoplasmic sperm injection). Freezing causes inhibition of metabolism and stops the ageing process of the cell. Thus, the "age" of the egg after thawing is the same as the age of the patient on the day of their collection, which may be important in the success of the in vitro fertilization procedure. It has been shown that the age of the patient is one of the most important prognostic factors when trying to get pregnant. The use of frozen oocytes also makes it possible to bypass ovulation stimulation, which is harmful to the body.

This evaluation uses the phenomenon of polarization. The system is based on visualization of the position of the karyokinetic spindle. Its use avoids damage to the oocyte during microinjection and reduces the risk of abnormal development of the embryo after fertilization by intracytoplasmic sperm injection (ICSI). It also allows for a highly sensitive assessment of the oocyte quality, allowing us to determine the appropriate moment for its puncture or freezing, which significantly increases the efficiency of the procedures performed.

Laser thickness reduction or complete mechanical rupture (incision) of the zona pellucida surrounding the embryo (Assisted Hatching - AH), aims to support the process of its hatching, the process preceding implantation, or is used to create an opening in the zona pellucida in order to collect material for pre-implantation diagnosis (PGT) (biopsy of blastomeres, corpus callosum). In selected cases, AH is associated with increased chances for implantation, improving the effectiveness of in vitro procedures.

PICSI is an in vitro fertilization procedure involving the intra-cytoplasmic injection of sperm into the ovum, using sperm that shows the ability to bind to hyaluronic acid. Indications for PICSI include a below-normal HBA test result.