8. Artificial Insemination (IUI): This procedure relies on the natural ability of sperm to fertilize an egg within the reproductive tract. The sperm from the male partner is collected and then washed in the lab to improve motility and concentrated sperm are then placed in the uterus using a thin catheter inserted through the cervix during the most fertile time in the menstrual cycle.
IUI Is Often Recommended for Women or Couples Who:
- Have ovulation problems and are undergoing ovulation induction
- Are unable to have normal intercourse
- Have mild male factor infertility
- Have unexplained infertility
Donor Sperm is used only when a male partner has an abnormal semen report. The procedure is simple and does not require anesthesia or hospitalization.
9. IVM (In Vitro Maturation) - New ART Procedure: In vitro egg maturation or IVM - Instead of removing fully mature eggs from the ovaries and then fertilizing them, IVF Specialists remove immature eggs, ripen them in a lab dish, and then add sperm. The rest of the procedure is the same as IVF, the time required for stimulation is reduced greatly. This may be particularly useful for women who suffer from polycystic ovarian syndrome, a hormonal disorder that disrupts ovulation.
10. IMSI Intracytoplasmic Morphologically selected Sperm Injection (IMSI): A specialized technique used in in vitro fertilization (IVF) to select the highest quality sperm for fertilization. IMSI is typically recommended for couples with male factor infertility, where conventional sperm selection methods may not be sufficient to identify the highest quality sperm for fertilization. By selecting sperm with the best morphological characteristics, IMSI aims to improve the chances of successful fertilization and embryo development, ultimately leading to better outcomes in IVF treatments.
11. Intra Cytoplasmic Sperm Injection (ICSI): Also known as micromanipulation. The Approach to male fertility management has changed over the last few years. Patients who had compromised semen samples had to undergo years of medication and surgical manoeuvers and only a few patients benefited. Now with the advancement of ART techniques, a conventional method of treating male infertility has been replaced by ICSI, a proven and wholly acclaimed scientific procedure. This revolutionary technique we performed has given fresh hope to many men whose chance to father their children was slim.
ICSI is indicated when few sperms are available or no sperms are available IVF is not possible or unexplained fertilization failure or low fertilization in previous IVF cycles. ICSI can benefit 90% of patients with azoospermia after confirming the presence of sperms in the testicular biopsy.
In this procedure, eggs are retrieved (as in IVF) from the female partner, and under an inverted microscope, each egg is injected with a single sperm isolated from the male partner's semen or by sperm collected from the testis (TESA/MESA). This is done as an adjunct to IVF.
12. Oocyte Donation: Oocyte Donation is for women whose ovaries are not functioning or have been surgically removed. In this procedure, another woman will be the egg donor. The donated eggs will be fertilized with the sperm of the husband of the recipient woman. The embryos are then transferred to the uterus of the recipient.
13. Laser Assisted Hatching: Assisted Laser Hatching may help couples who have had many attempts at assisted reproductive procedures without success. Embryo implantation is one of the greatest barriers to success in the “In Vitro Fertilization” (IVF) cycle. When Embryos are transferred into the woman’s uterus, they are covered by an outer coating called the Zona Pellucida, once the embryo can “hatch”, a necessary step for implantation. In certain situations, this step is less likely to naturally occur in women of higher age, women with elevated serum FSH levels, and women who have failed to achieve a pregnancy in a prior IVF cycle. A hole is created with the use of a laser beam in the Zona of the embryo before it is transferred to the uterus. It facilitates improved implantation and increases the chances of pregnancy.
14. Blastocyst Culture and Transfer: In conventional IVF the embryo transfer is done in the uterus after 48 hours at 4-8 cell stage. In natural conception, the embryo reaches the uterine cavity only on day FIVE. With the availability of a new extended culture medium, we can now culture the embryos in the laboratory till the blastocyst stage (i.e. days 5-6). Thereby increasing the chances of success dramatically to 50%.
Recent advances in blastocyst culture and transfer have resulted in improved IVF pregnancy rates and reduced multiple pregnancy rates. Traditionally, embryos are transferred to the uterus on day three (called Day 3 transfer) after fertilization and it is not uncommon to transfer three or four embryos. However, it is now possible to grow embryos in the laboratory to the blastocyst stage of development, which occurs on day five after fertilization when the embryo has 50-200 cells. Typically, the strongest, healthiest embryos make it to the blastocyst stage as they have survived key growth and division processes and have a better chance of implanting once transferred. The selection of potentially more viable embryos allows the embryologist to transfer fewer embryos, often one or two, lowering the risk of high-order multiples while maintaining high pregnancy rates.
Blastocyst transfer is not an option for all IVF patients. The technique is most successful with patients who are younger and have a large number of eggs available at retrieval. On average, patients with six or more high-quality embryos on day three are the best candidates for blastocyst culture because there is a better chance of more embryos growing successfully to day five.
15. Semen analysis by using Artificial Intelligence: Using artificial intelligence (AI) in semen analysis is an innovative approach that has the potential to improve accuracy, efficiency, and objectivity in assessing semen quality. Here's how AI can be applied in this context: