Dr. Beena Muktesh is a renowned infertility specialist and a consultant reproductive endocrinologist having a total experience of about 39 years and 16 years of experience in the field of IVF and infertility. Currently, she is the Director at Silver Leaf fertility centre and clinic director fertility at Cloudnine hospital, Gurgaon. She also has served as head of the department at Miracles Fertility, Gurgaon and at Sunder Lal Jain Hospital, Delhi.
The I.V.F (or a “test-tube baby” treatment ) is the most advanced treatment in reproduction. The fertilization of eggs occurs outside of the female body, in a Petri dish. Multiple eggs are removed from the woman’s ovary using a needle guided by ultrasound under anesthesia and then mixed with her partner’s sperm. Resulting embryos are kept in the incubator for several days and allowed to divide and multiply their cells. The well developing embryos are then placed into the uterus by introducing a thin plastic catheter through the cervix.. If the woman fails to develop good quality eggs in her ovaries, the couple may decide to use eggs obtained from a healthy and fertile donor. The resulting embryos are then placed into the woman’s uterus.
Intrauterine insemination (IUI) is an infertility treatment that is often called artificial insemination. In this procedure, the woman is injected with specially prepared sperms. Sometimes the woman is also treated with medicines that stimulate ovulation before IUI.
Cryopreservation of embryos is the process of preserving an embryo at sub-zero temperatures, generally at an embryogenesis stage corresponding to pre-implantation, that is, from fertilisation to the blastocyst stage
Embryo cryopreservation is useful for leftover embryos after a cycle of in vitro fertilisation, as patients who fail to conceive may become pregnant using such embryos without having to go through a full IVF cycle. Or, if pregnancy occurred, they could return later for another pregnancy. Spare oocytes or embryos resulting from fertility treatments may be used for oocyte donation or embryo donation to another woman or couple, and embryos may be created, frozen and stored specifically for transfer and donation by using donor eggs and sperm.
Embryo crypreservation is generally performed as a component of in vitro fertilization (which generally also includes ovarian hyperstimulation, egg retrieval and embryo transfer).
The main techniques used for embryo cryopreservation are vitrification versus slow programmable freezing (SPF). Studies indicate that vitrification is superior or equal to SPF in terms of survival and implantation rates.
In current state of the art, early embryos having undergone cryopreservation implant at the same rate as equivalent fresh counterparts. The outcome from using cryopreserved embryos has uniformly been positive with no increase in birth defects or development abnormalities, also between fresh versus frozen eggs used for intracytoplasmic sperm injection (ICSI)
Semen cryopreservation is a procedure to preserve sperm cells. Semen can be used successfully indefinitely after cryopreservation. For human sperm, the longest reported successful storage is 21 years. It can be used for sperm donation where the recipient wants the treatment in a different time or place, or for men undergoing a vasectomy to still have the option to have children.
Semen is frozen using a newer flash-freezing process known as vitrification. Vitrification gives superior post-thaw motility and cryosurvival.
Thawing at 40°C seems to result in optimal sperm motility. On the other hand, the exact thawing temperature seems to have only minor effect on sperm viability, acrosomal status, ATP content, and DNA.
Egg donation is the process by which a woman provides one or several (usually 10-15) eggs (ova, oocytes) for purposes of assisted reproduction or biomedical research. For assisted reproduction purposes, egg donation involves the process of in vitro fertilization as the eggs are fertilized in the laboratory. Egg donation is part of the process of third party reproduction as part of ART.
Egg donors are first recruited, screened, and give consent prior to participation in the IVF process. Once the egg donor is recruited, she undergoes IVF stimulation therapy, followed by the egg retrieval procedure. After retrieval, the ova are fertilized by the sperm of the male partner (or sperm donor) in the laboratory, and, after several days, the best resulting embryo(s) is/are placed in the uterus of the recipient, whose uterine lining has been appropriately prepared for embryo transfer beforehand. The recipient is usually, but not always, the person who requested the s ervice and then will carry and deliver the baby and keep it.
Nationwide, egg donor cycles have a success rate of upwards of 60%. When a “fresh cycle” is followed by a “frozen cycle”, the success rate with donor eggs goes up to approximately 80%. With egg donation, women who are past their reproductive years or menopause can become pregnant.
Common reasons to donate are to help childless couples, and, for some, the monetary compensation. Reluctance to donate may be caused by a sense of ownership and responsibility for the well-being of the offspring
Men who have no sperm in the ejaculate may undergo a direct sperm aspiration from the epididymis or testis These are different procedures to retrieve sperms from the male testes and epididymus ,if no sperms are found in semen sample. These retrived sperms are used for IVF /ICSI. Both these procedures should to be coordinated with their female.
P.E.S.A is a procedure performed for men who have obstructive azoospermia from either a prior vasectomy or infection. In this procedure, a needle is inserted into the epididymis and sperm is withdrawn. It is done under local anesthesia in the OT .
If sperm cannot be found in the epididymis( PESA), TESA is used to extract sperm from testicular tissue, and the needle is inserted directly into the testis. This procedure is performed on the male under local anesthesia in the OT. In this procedure a needle is inserted directly into the testicles and the tissue or sperms are aspirated from there. TESA is performed for men with obstructive azoospermia. TESA at times may not provide enough tissue or sperms and an open testis biopsy may be required.