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Advanced Fertility Techniques Medicover
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12-07-2024 Team Medicover Fertility

Advanced IVF Techniques at Medicover Fertility Clinic

Fertility treatment has come a long way over the last few decades. The number of fertility techniques and possibilities are huge.

  • One out of every six couples discovers that they are not able to conceive a child or are not able to hold the pregnancy, ending up with repeated miscarriages.
  • Infertility is a problem that concerns families, especially in countries like India, where having a child is almost mandatory.
  • The Indian population suffers from male and female infertility.

The two most common causes of infertility among the younger generation are

Many young couples have to deal with these infertility challenges. IVF treatment has enabled a large number of couples to have children. However, IVF is not a 100% successful treatment by itself and may require several attempts before a couple can get pregnant.

  • The success rate for IVF during the first attempt is around a measly 30%. With repeated tries, the success rate goes up to about 70% by the third cycle.
  • Many couples have been trying countless times, hoping that each cycle will be the one, but it doesn’t happen.
  • To improve the success rate of IVF researchers have come up with a number of advanced techniques.

These advanced fertility techniques have been devised to address the problems that have been diagnosed as possible causes that lead to the failure of the IVF cycle.

What Are Advanced Fertility Techniques?

  • The first successful IVF baby was born in 1978. For IVF conception, the sperm and the egg are fertilised in the lab after the egg is retrieved from the ovaries.
  • While the basic concept of IVF remains the same, there have been many changes to the way these procedures and techniques are conducted to ensure a higher implantation success rate.
  • Certain tests are conducted to ensure receptivity of the uterus as well as to check the quality and development of the embryo, as far as possible.
  • Fertilization techniques have improved, and now men can have biological children even with few sperm.
  • Azoospermia and oligospermia are no longer major hindrances to male fertility.

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How Are Advanced Fertility Techniques Used?

  • An advanced fertility technique is not an independent treatment by itself but is carried out in conjunction with the general IVF treatment.
  • Different fertility techniques are used at different stages of the treatment.
  • Advanced fertility techniques are not used for all the patients but only in cases where required.
  • Some of these techniques come at an additional cost.
  • Most fertility clinics discuss the options with the couple and allow them to make the final decision regarding how they would like to proceed with the treatment.
  • Some couples may opt for advanced procedures if they are very eager for a child.
  • Some couples decline the option and are willing to take the risk of doing without because they do not want to add to the cost of the treatment or they do not feel that this technique will help them.
  • Assisted fertility techniques are optional and most reputed fertility clinics offer them to patients to increase their odds of having a successful IVF pregnancy.
  • There is no compulsion to have any of the advanced fertility techniques along with the IVF treatment.

Types of IVF Techniques:

Various IVF (In Vitro Fetilization) methods are available, each designed to address specific fertility issues and individual patient requirements. Here are a few commonly used and latest IVF techniques:

ConventionalIVF:

This is the traditional method where eggs retrieved from the ovaries are combined with sperm in a laboratory dish for fertilization to occur naturally.

ICSI (Intracytoplasmic Sperm Injection):

In ICSI, a single sperm is directly injected into an egg to assist fertilization. This technique is often used in cases of male infertility or when previous IVF attempts have failed.

IVM (In Vitro Maturation):

In this technique, immature eggs are collected from the ovaries and matured in the laboratory before being fertilized. IVM is useful for women who have difficulties with ovarian stimulation or for those who prefer a less hormonally intensive treatment.

PGT (Preimplantation Genetic Testing):

PGT involves testing embryos for genetic disorders or chromosomal abnormalities before they are transferred into the uterus. This can help select embryos with a higher chance of implantation and reduce the risk of passing on genetic diseases.

Embryo Cryopreservation:

After fertilization, embryos can be frozen (cryopreserved) for future use. This allows patients to undergo multiple IVF cycles without needing to repeat ovarian stimulation and egg retrieval.

Embryo Transfer Techniques:

Different methods can be used to transfer embryos into the uterus, such as ultrasound-guided transfer, assisted hatching, or even embryo transfer with a catheter. The choice of technique may depend on factors like uterine anatomy or previous IVF outcomes.

Donor Egg or Sperm IVF:

When the intended parent(s) cannot use their eggs or sperm due to infertility or genetic reasons, donor eggs or sperm can be used in the IVF process.

Surrogacy:

In cases where a woman is unable to carry a pregnancy, a surrogate may be used. Embryos created through IVF are transferred to the surrogate's uterus for gestation and birth.

Assisted Hatching

  • Once the embryo is placed inside the uterus, it has to break out of its outer protective covering.
  • This is like a shell called the Zona pellucida. Scientists believe that in some cases the embryo’s outer covering may be a little too thick and this inhibits the embryo from being able to break out of its covering easily.
  • Patients with advanced maternal age are more likely to have a thicker zonapellucida making hatching difficult and hence preventing the embryo from implanting in the endometrial lining.
  • Failed implantation has quite often been linked to the inability of the embryo to hatch from its shell.
  • To eliminate this problem and make it easy for the embryo, doctors perform what is known as assisted hatching.
  • A small hole is made in the zona pellucida before it is placed inside the uterus.
  • This is a very delicate process and is conducted under high precision by a skilled embryologist.
  • Researchers believe that the hole will give the embryo some leeway as to where to start breaking out since the shell has already been weakened in one area.

Types Of Assisted Hatching

  • Different types of assisted hatching are used for weakening the zona pellucida. The most common technique is chemical assisted hatching.
  • A minuscule amount of chemical solution is placed on the outer covering of the embryo which reacts with the shell and weakens it forming a small hole.
  • This is an intricate procedure, and the embryo is held in place using a hollow needle while a pipette is used to administer the chemical.

Mechanical-assisted hatching is a technique in which the doctor manually makes a hole in the zona pellucida using a micromanipulator machine. A glass needle is used to grind away a tiny section of the outer layer until a small hole is visible.

Another technique used by some doctors is laser-assisted hatching. This is known to be the safest technique and is performed with the help of a high precision laser. It is also a very quick method and requires very little manual intervention.

Assisted hatching is recommended for women over the age of 35 as the zona pellucida has a likelihood of being thicker and inhibiting implantation.

Risks Associated With Assisted Hatching

  • In a few occasional cases, assisted hatching has resulted in damage to the embryo.
  • However, this depends on the skill and experience of the embryologist.
  • The probability of monozygotic twins is higher with assisted hatching, especially with laser-assisted hatching.
  • This is the reason that laser-assisted hatching is the safest method, but it is not used very commonly due to the risks of twins.

Blastocyst Transfer

  • Typically, embryos are transferred to the uterus on the third day after fertilization. However, prolonging the embryo's time in the lab can increase the chance of successful implantation by allowing it to develop into a blastocyst structure.
  • By the fifth or sixth day, the embryo becomes a 200-cell blastocyst, which has a higher chance of successful implantation.
  • Studies have shown that the endometrium is more receptive to receiving the embryo by the fifth day, aligning with the natural cycle.
  • However, not all laboratories can successfully culture blastocysts, resulting in embryo death.
  • Nurturing embryos from 8-cell structures to blastocysts requires meticulous care and attention.
  • Some fertility clinics recommend a 3-day transfer due to uncertainty about their ability to culture embryos to the blastocyst stage.

Benefits Of Blastocyst Transfer:

  • Blastocyst transfer enables doctors to make more informed decisions when selecting the most suitable embryo for transfer to the uterus.
  • By limiting the number of embryos transferred to 2 during a blastocyst transfer, the risk of multiple pregnancies is significantly reduced.
  • The embryo starts to hatch before the transfer, allowing the embryologist to assess if any assistance is needed and provide it as necessary.
  • The transfer takes place at the optimal time for implantation, ensuring that the blastocyst begins to implant shortly after being transferred.

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When Should You Consider Blastocyst?

Anyone can have a blastocyst transfer as this increases the probability of implantation and IVF success. Women who are older than 35 should opt for blastocyst transfer.

Women who have undergone multiple failed IVF cycles have a better chance of getting pregnant with a blastocyst transfer.

Risks Associated With Blastocyst:

It has been found that there is a slightly high risk of multiple pregnancies with a blastocyst transfer.

The embryo tends to split in two resulting in monozygotic twins. However, the increased risk is about 2% as compared to the usual probability of multiple pregnancies in general.

Endometrial Receptivity Array:

  • Many IVF patients go through the whole process of IVF treatment. The different stages all lead up to the IVF procedure.
  • This is the moment when the embryo is transferred to the uterus. 2 weeks later, you find out that the embryo did not implant. The doctors determined this was because the uterus was not very receptive. The ERA test helps to determine when the embryo is the most receptive.
  • The receptivity of the uterine lining is very crucial for the successful implantation of the embryo. It has been found that among the women who face implantation failure, around 25% was due to an unreceptive uterus.

How Is ERA Done?

  • For conducting the ERA, a biopsy of the uterus lining is taken, and the genes in this tissue sample are analysed in the lab.
  • Through the changes in these genes, it can be determined whether the uterus is pre-receptive, receptive or post receptive.
  • Endometrial receptivity is studied by the menstrual cycle. This helps the doctors to calculate on which day of the menstrual cycle, the uterus will be most receptive for implantation.
  • The ERA test is conducted on a cycle before the IVF procedure so that the transfer can be made according to the ERA test results during a subsequent cycle.

Who Should You Consider ERA?

  • Women who have IVF failure due to lack of endometrial receptivity can have an ERA test a few days before their transfer to find out just how receptive the uterus is and get an idea of when it will be most receptive.
  • Even women who had repeated IVF failure due to other reasons could also have an ERA test to check the receptivity of their uterus, thereby increasing the likelihood of implantation.
  • IVF transfer with the Endometrial Receptivity Array test results is done preferably with a frozen embryo rather than culturing a fresh embryo in the lab till the uterus is ready.
  • This may result in having to culture the embryos for longer than 5 or 6 days in the lab while waiting for the uterus to be receptive, and it is not advisable.

Time Lapse Imaging

  • Blastocyst transfer enables doctors to make more informed decisions when selecting the most suitable embryo for transfer to the uterus.
  • By limiting the number of embryos transferred to 2 during a blastocyst transfer, the risk of multiple pregnancies is significantly reduced.
  • The embryo starts to hatch before the transfer, allowing the embryologist to assess if any assistance is needed and provide it as necessary.
  • The transfer takes place at the optimal time for implantation, ensuring that the blastocyst begins to implant shortly after being transferred.

The Benefits Of Time Lapse Imaging

  • Reduced miscarriage
  • Better implantation rate
  • Quicker pregnancy

Pre Implantation Genetic Screening (PGS)

  • A weakness in the embryo causes implantation failure or a miscarriage. Embryo weakness, to a large extent, is caused by chromosomal abnormalities.
  • Aneuploidy is a condition when the number of chromosomes in the embryo is not correct. It is usually one or two in excess or a few less. Embryos with a chromosomal abnormality will result in a failed IVF.
  • To overcome this, hurdle doctors perform a PGS test. For this test, one or two cells of the embryo are removed and checked for their chromosome count.
  • The PGS test checks the cell for the normalcy of the chromosomes.

When Is PGS Recommended?

PGS is recommended when a couple are over the age of 37. Researchers believe that the percentage of chromosomal abnormalities in the eggs and sperm increases after this age. Couples who have had multiple failed IVF treatments which have been attributed to weak embryos are also recommended PGS.

Risks Of PGS

  • PGS is basically a safe procedure, and there are no major risks associated with it as such.
  • In a few cases, there has been damage to the embryo while removing the cells.
  • This is a high precision procedure, and occasionally things can go wrong, but in general, the procedure is risk-free.

Benefits Of PGS

  • Better chance of a healthy pregnancy for any age group
  • Reduced miscarriage
  • Single embryo transfer, eliminating the risk of multiple pregnancies
  • Chromosomal abnormalities are the leading factor for IVF failure. The genetic screening process increases the probability of implantation multi-fold.

Embryo Glue

  • The thought of having the embryo glued to your uterus may be discomforting. However, it is not exactly what it sounds like.
  • This is not the conventional glue that we are used to using for sticking stuff. Anything that goes inside the body should be acceptable to the body and as far as possible made from substances found in the body.
  • Researchers always work on imitating the body’s functioning whenever they come up with some new technology.

What Is Embryo Glue Made Of?

  • The main components of the embryo glue are hyaluronan and recombinant human albumin.
  • It comprises the blastocyst culture base, which is packed with the required nutrients for the embryo.
  • Hyaluronan is a substance that is naturally secreted by the uterus, ovaries and fallopian tubes. This helps the embryo to stick onto the wall of the uterus, which then results in implantation.

What Is The Use Of Embryo Glue?

  • The embryo glue prompts the embryo to stick itself onto the uterus wall when it is transferred to the uterus.
  • Once the embryo is attached to the uterus wall, the embryo fuses with the endometrial lining and implantation takes place. Implantation is a crucial stage and defines the success of IVF treatment.
  • Embryo glue is especially recommended for those patients who have experienced multiple failed IVFs due to implantation failure.

Risks Of Using Embryo Glue

Some doctors feel that embryo glue is all hype and does not help the implantation. There are no health risks associated with using embryo glue as it is made of natural substances. The only drawback is that some clinics may charge extra for the embryo glue.

Advanced Fertility Treatment At Medicover Fertility

Medicover is always looking to break new ground to provide their patients with the best and the latest treatments. Medicine remains at the forefront of keeping up to date with the most recent happenings and scientific advances. Implantation failure is the borderline and Medicover fertility makes every resolve to head in the opposite direction with astounding success rates.

Medicover aims to provide patients with tailor-made treatments specific to their cases. This leads to a high success rate as each case is dealt with distinctly rather than generally.

Frequently Asked Questions

Medicover Fertility Clinic offers a range of advanced fertility techniques, including In Vitro Fertilization (IVF), Intracytoplasmic Sperm Injection (ICSI), Preimplantation Genetic Testing (PGT), Egg Freezing, Sperm Freezing, Donor Egg/Sperm Programs, and Assisted Hatching.

A technique used to facilitate an embryo's easier uterine implantation is called assisted hatching. To aid in hatching and implantation, a tiny aperture known as the zona pellucida must be made in the embryo's outer layer.

Ideal candidates include individuals or couples struggling with infertility due to factors including low sperm count, obstructed fallopian tubes, advanced maternal age, genetic disorders, or unexplained infertility.

Success rates vary depending on the technique, patient age, and underlying health conditions. Clinics provide personalized success rate estimates based on individual assessments.

Potential risks include multiple pregnancies, ovarian hyperstimulation syndrome (OHSS), and procedural complications. Patients are thoroughly informed about these risks before treatment.

Yes, many fertility clinics offer treatments tailored to the needs of same-sex couples and single individuals, providing inclusive and personalized care.

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