Sometimes nature needs a helping hand. Through the decades, thanks to assisted conception, millions of babies have been born to couples who could not conceive naturally. There are various approach involved in assisted conception. Your doctor would be able to recommend the most suitable approach to you after running some tests. Here are some of the latest advances in assisted conception.
In-vitro Fertilisation (IVF)
IVF is usually considered if the woman has damaged Fallopian tubes which are not amenable to surgical correction, or the husband has borderline low sperm count or quality, or when there are antibodies in the sperm. The woman undergoes a series of injections to stimulate the ovaries. When the eggs are matured, a small probe is placed into the vagina to guide the needle to the ovaries, and the eggs are sucked up. The eggs are then mixed with the sperms in a flat, glass petri dish and kept in culture in the incubator for at least two days. The fertilised embryos are then transferred back into the womb .
Intracytoplasmic Sperm Injection (ICSI)
ICSI is used if the male partner has extremely low sperm count or quality, or couples who have had IVF cycles where very little or no fertilisation occurred. Eggs are collected as for IVF. Mature eggs are chosen and each one is held on a tiny pipette while a single sperm is injected directly into the centre of the egg using microinjection equipment. Fertilisation occurs in about 70 % of the time and the fertilised eggs are subsequently transferred back into the womb.
In-vitro Maturation (IVM)
In-vitro maturation (IVM) involves retrieving immature eggs from an unstimulated or partly stimulated ovary, and maturing these eggs in the incubator. Subsequently, these matured eggs are fertilised using ICSI. This is an attractive alternative to conventional IVF as it minimises the discomfort and risks of ovarian stimulation. Also, there is a significant reduction in costs.
Laser Assisted Hatching (LAH)
For a pregnancy to result from IVF or ICSI, the embryo must successfully implant into the uterus following embryo transfer. Using a precision laser, an opening is made in the zona pellucida (the shell surrounding the fertilised egg) to weaken the wall of the embryo, thus helping the embryo hatch from the zona pelluida and implant correctly. This procedure is recommended for women undergoing Frozen Embryo Transfer (FET) and women with recurrent IVF failure.
Preimplantation Genetic Diagnosis (PGD)
Following IVF, one or two cells are removed from a fertilised egg (embryo) using very specialised techniques. These cells are then tested for specific genetic disorders such as thalassemia and/or the correct numbers of chromosomes in order to exclude conditions such as Down Syndrome. Only healthy embryos are then transferred back into the womb.
Time lapsed photography of developing embryos
The success of IVF greatly depends on selecting the healthiest embryos for transfer. Currently, the assessment of embryos is limited to minimal glimpses of the embryos to minimise disturbances to culture conditions. By continuously monitoring and observing the development of embryos using time lapsed photography, embryologists are able to identify the most viable embryos for transfer, thus improving the chance of a successful pregnancy.
Sperm or Egg Banking
It is now possible to freeze adequate amounts of sperm and eggs in the cryobank for future use. This method is particularly useful for people who may need to undergo surgery to remove their reproductive organs due to a cancerous condition, or undergo chemotherapy which may render them sterile. There are also women who want to freeze their eggs before they reach the end of their reproductive life as they have not found the right life partners yet.
The Journey to Conception Series is meant as a guide to help couples achieve their dream of starting a family. We hope to be your trusted companion in your journey by providing pertinent answers to your burning questions about conception and fertility. The series is meant as a guide only and cannot replace medical attention. Please see a fertility specialist to get yourself and your spouse evaluated for an accurate diagnose and treatment.
The content, opinions and views expressed in this scientific material are entirely those of the author and are in no way influenced by Merck Serono.
Dr Wong Pak Seng
Fertility Specialist, Consultant Obstetrician & Gynaecologist
This content, opinions and views expressed in this scientific materials are entirely those of the author and are in no way influenced by Merck Serono.