Stages of artificial insemination

• Egg stimulation
  In the normal menstrual cycle, woman produces only one egg, which matures under the control of two pituitary hormones (gonadotropins) FSH and LH. The goal of egg cell stimulation is to enhance this natural process by administering higher doses of gonadotropins in the form of injections with the aim to developing a number of eggs. Having several eggs, you can get several embryos, which increases the chances for success. When eggs reach maturity, an injection of hCG, another gonadotropin necessary for fertilization, is prescribed.
• Egg collection
  This procedure, as well as the subsequent ones, is carried out in the clinic. 35 hours after hCG injection, eggs are selected by transvaginal puncture of the ovarian follicles under ultrasound control. This procedure takes place in the surgery room under general or local anaesthesia (depending on how many eggs are required to be taken) and does not last long. Within a few hours after the operation, woman can return home.
• Fertilization
  Shortly after collection, eggs are inseminated by the sperm, usually collected from spouse on the same day – that is conventional in vitro fertilization (IVF). If there is a risk of unsuccessful use of IVF, another method of fertilization is used – the introduction of sperm into the cytoplasm of the egg (ICSI). ICSI is used mainly in cases when sperm quality is very poor or cells are taken taken by testicular biopsy. Signs of fertilization are observed 18-20 hours later. Fertilized eggs (zygotes) contain 2 nuclei – one maternal, the other paternal. For the purpose of further development, 2 or 3 zygotes are retained. In the presence of additional zygotes, they are immediately subjected to cryopreservation for future attempts.
• Embryo transfer
  Zygotes are kept in an incubator under conditions very close to those in mother’s body. Here they begin to divide until they reach stage of embryos. These embryos are transferred to the mother’s uterus on the 2nd or 3rd day after fertilization. In some cases, determined by individual clinical criteria, they are transferred later, on the 5th or 6th day. Embryo transfer is painless. Embryos are placed in a thin catheter, which is carefully inserted into the uterus. For proper insertion and placement of the catheter, sonographic monitoring can be used. A blood test for pregnancy test (hCG) is performed 12 days after the transfer.

Technology

Anaerobic development Embryos develop in the tubes and in the uterus with oxygen levels reduced to 5%. In laboratories, oxygen makes up 20% of air. In the modern laboratories, incubators provide reduced oxygen levels for embryo development. This method of culturing embryos is closer to natural conditions and provides embryos with optimal development potential and stress-free growth that increases the chances of successful pregnancy.
Indications:
• All indications for artificial insemination

Classic In Vitro Fertilization (IVF)
The oldest and most natural way. Sperm cells are placed in the culture medium along with the eggs selected by ovarian puncture. Eighteen hours later, fertilization is confirmed by the presence of two nuclei in the egg.
Indications:
• fallopian tubes changed or missing
• Ovulation disorders
• Endometriosis
• Failure after three insemination cycles

ICSI (Intracytoplasmic sperm injection)

In cases when quantity and/or quality of sperm exclude the natural fertilization of the eggs, this method injects selected sperm cells of best morphology and motility directly into each egg. This method has been used for 20 years and allows fertilization in cases where classical IVF is ineffective.

Indications:
• Male factor
• Unsuccessful classic in vitro fertilization (IVF)

Extended cultivation (blastocyst transfer) Some embryos, not only in the laboratory, but also in nature, stop being developed after a few days of life. This is normal, and this explains why couples with normal ability to fertilise cannot achieve pregnancy. Cultivating embryos up to the 5th day of their development ensures the transfer of embryos that are potentially more capable of leading to pregnancy.
Indications:
• Failure of implantation after early embryo transfer
• Optimisation of chances of pregnancy during the transfer of thawed
embryos

Zygote freezing
Modern laboratories have gained extensive experience in freezing zygotes using slow freezing and vitrification methods. In our partnering laboratories, more than 85% of zygotes survive thawing and allow one or even two pregnancies to be obtained without the financial costs, time and stress that new cycle of egg stimulation would require.

Sperm freezing
Sperm freezing can be done based on medical reasons (prior to cancer treatment or treatment that could lead to infertility) or social reasons (absence of a spouse, for example, due to professional circumstances). In certain cases, sperm can only be obtained by surgical removal from the testicles. Sperm freezing allows several attempts of artificial insemination with a single surgical intervention. Our reproductologists will help you realize your plans for having a baby even in difficult cases.

Freezing eggs and ovarian tissue
Freezing mature eggs or ovarian tissue before cancer treatment or treatment that can lead to infertility makes it possible to carry out a birth plan with your own gametes after recovery. Egg freezing is also advisable for delayed motherhood, that is, when you want a baby, but are not yet able to contain it and are afraid that such an opportunity will appear at too late an age. There are several ways to keep a woman fertile. You will choose the method
that best suits your situation, after detailed consultations with one of our specialist. Vitrification is the preferred method for freezing eggs: survival rate during thawing is higher than with the traditional freezing technique. This technology is considered today the most promising for maintaining female fertility.