DIVF Therapy Techniques
How are oocytes sampled?
Oocytes are obtained from the donor by suction of follicles with a thin needle through the vagina wall under ultrasonic control. Like hormonal stimulation, oocyte puncture is undergone at our clinic by hundreds of donors every year.
Fertilization (ICSI, PICSI)
Intracytoplasmic sperm injection - ICSI
Using this micromanipulation technique, an individual sperm cell is implanted directly into the egg. ICSI is carried out on a special instrument, a micromanipulator. The success of fertilization is up to 90%.
Physiological intracytoplasmic sperm injection - PICSI
PICSI is a modification of ICSI, where only mature sperm cells specifically selected by binding to hyaluronan gel are used for fertilization. Hyaluronan is a substance surrounding the egg and helping create the egg-sperm bond. Only mature sperm cells with proven significantly lower incidence of chromosome anomalies are able to establish this bond.
Embryo quality assessment
The success of fertilization is checked by the embryologist under the microscope 16 - 18 hours after fertilization. The embryos formed are called pronuclei. Their number depends on the quality of sperm, eggs and fertilization method. It is very difficult to assess the quality of embryos at the pronucleus stage. Prolonged cultivation is used to assess the quality of embryos. The embryos grow to higher stages in special media. Prolonged cultivation enables embryos that develop normally to be distinguished from those whose development is slowing down or ceased, and quality embryos for transfer to be selected. The decision about which day of cultivation is most suitable for embryo transfer depends on the quantity and development stages of each embryo, and is fully in the hands of the embryologist.
What is assisted hatching?
The developing human embryo is covered by a thin sheet. Before nesting in the uterine mucosa, the embryo has to leave this sheet. This sheet is stronger in a number of patients, mostly of higher age. Facilitation of the embryo’s journey is called assisted hatching and is performed with a laser in a laboratory. Some research publications have confirmed a higher chance of pregnancy using this method.
ET - Embryo Transfer
When does embryo transfer take place?
The transfer of embryos into the uterus takes place usually on the 2nd, 3rd or 5th day following egg retrieval. The decision about which day of cultivation is most suitable for embryo transfer depends on the quantity and development stages of each embryo.
How is embryo transfer performed?
The transfer is painless, and it is performed without general anaesthesia. It is similar to a standard gynaecological examination. The physician inserts embryos into the uterus under direct ultrasound control. The patient and her partner can see their embryos on the monitor, and watch their transfer into the uterus.
Return to normal everyday life after the transfer
After the transfer, the woman remains resting in a lying position at the theatre for 10 to 15 minutes. The nurse then prepares all prescriptions required and shows the patient to the cash department to close the treatment.
Resting is recommended on the day of transfer and the following two days. It is possible to return to your normal everyday life from the third day following the transfer.
Pre-implantation Genetic Diagnosis (PGD)
What is PGD
The basis of pre-implantation diagnosis is a genetic examination of the embryo before its transfer into the uterine cavity. The genetic examination takes place on a single cell taken from the developing embryo. Sampling usually takes place on the 5th day of the embryo’s development.
This procedure does not harm the embryo as it is able to easily compensate for the loss of cells at the early stage of development.
Cryopreservation and Vitrification
Cryopreservation is a reproductive cell freezing technique, employing special media for preservation in liquid nitrogen at -196 °C. This method allows preserving reproductive cells for many years, even decades.
Classical cryopreservation allows preserving embryos and sperm samples. Advanced ultra-fast freezing technique (vitrification) also allows preserving eggs.
We do believe that you will be satisfied with our care and attitude.
MUDr. Štěpán Machač, PhD.