Thanks to the advances and studies in the world of assisted reproduction, nowadays fertility clinics work with a wide range of treatments and specialised techniques. Depending on the type of fertility treatment (AI, IVF, egg donation, embryo adoption…), complementary techniques will be the key to achieving excellent results.
COMPLEMENTARY TECHNIQUES TO ICSI-IVF
In Vitro Fecundation, better known as IVF, is a high complexity treatment ideal for patients with previous failures of AI treatments, women with poor oocyte quality, women with endometriosis or men with poor sperm quality.
The union between egg and sperm cell takes place in a laboratory and this is one of the most precise techniques available. ICSI (Intracytoplasmic Sperm Injection) is a technique that forms part of the IVF process. To carry it out, a special microscope is used to see the spermatozoa in a semen sample and select the most suitable for the fertilisation with the egg. Moreover, there are other techniques that help to achieve better results:
TESA (Testicular Sperm Aspiration)
TESA (Testicular Sperm Aspiration) is a microsurgical technique used to directly remove sperm cells from the testicular tissue. It is ideal where no sperm cells are present in the ejaculation or when a semen sample cannot be obtained.
This is a new technique that helps eliminate sperm cells with DNA double-chain fragmentation from a semen sample. Thanks to this method, the fertilisation rate improves when sperm cells without fragmentation are obtained.
TRIPLE SPERM SELECTION (MACS, PICSI, AND DENSITY GRADIENTS)
Better known as “annexin columns”. This is a procedure that allows sperm selection with the lowest sperm DNA fragmentation rate. The use of these annexin columns makes it possible to carry out a magnetic separation of sperm cells with altered DNA and, therefore, to select the best sperm.
This is an ICSI-friendly technique in which selection is carried out on the basis of sperm maturation. A higher degree of sperm maturation is linked to a lower rate of aneuploidy and less DNA fragmentation. Therefore, the use of mature sperm in ICSI improves fertilisation rates and embryonic evolution. The sperm cells chosen will be those capable of joining with hyaluronic acid.
Motility: density gradients
Density gradients allow the sperm sample to be separated according to the sperm’s ability to pass through different media with different densities. For this reason, a special tube with different gradients is used to see how many sperm reach 80% density.
This technique is used to identify a specific gene in a chromosome. Applied to sperm cells, it allows us to analyse part of their genetic code. FISH is indicated in sperm cells when there is a clinical history of repeated miscarriages or implantation failure in the couple and a possible embryonic alteration is suspected.
COMPLEMENTARY TECHNIQUES TO IMPROVE THE EMBRYO IMPLANTATION RATE
Implantation is the last decisive step in assisted reproduction treatment. It consists of the adhesion of the blastocyst-stage embryo in the inner wall of the uterus, called the endometrium. Some patients face what we call implantation failure, when after three or more good embryo transfers, implantation does not take place. The following additional tests can be performed to determine the cause:
Endometrial microbiome study
More and more importance are being attached to the endometrial microbiome. These are microorganisms that are present in the uterus, which can affect the chances of implantation. Through a study, on the one hand the endometrial microbiome can be analysed and on the other hand the presence of bacteria that are causing endometritis.
The ERA test or endometrial receptivity test is a diagnostic test that allows the endometrium to be studied to assess whether it is in the best condition for implantation in the mother’s uterus. If the result of the ERA test is receptive, embryo transfer will be carried out under the same conditions as the study.
If you have already started assisted reproduction treatment or are about to start it, we invite you to visit some of our clinics so that our doctors can assess your case. Free first visit.
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