HITECH IVF – IMSI
The breakthrough technology of Hi-Tech IVF Includes
- 1. IMSI
- 2. Embryoscope
- 3. Embryoglue
- 4. Preimplantation Genetic Diagnosis
- 5. Preimplantation Genetic Screening
- 6. Endometrial Receptivity Array
- 7. Stem Cell Therapy
- 8. Accpuncture
Intra Cytoplasmic Morphologically selected sperm injection (IMSI)-A new breakthrough in male infertility
The latest in the treatment of male infertility, PRASHANTH FERTILITY RESEARCH CENTRE in chennai has been successfully using the new computerized microscope system that allows infertility specialists to pick the best quality sperms while carrying out the test tube baby procedure of intra-Cytoplasmic sperm transfer (ICSI). IMSI helps magnify the image of the sperm 7200 times, thereby allowing embryologists to pick up the healthiest sperms. This is an advanced version of the ICSI equipment having the magnification capacity 16 times more than that of ICSI.
The IMSI method was first developed in 2004 by a team led by Benjamin Bartoov, of Bar-llan university in Israel, who used this technology to select the right kind of sperms with a shape and size that indicated good genetic quality. The pregnancy rate jumped from 30% to 66%. IMSI has proved to help in improving the success rate among men with the worst prognosis and is said to be more beneficial than ICSI in patients with previous IVF and ICSI failures. IMSI has also resulted in better fertilization rates, better quality embryos, better rate of blastocyst formation and therefore better pregnancy rates. Since the best sperms are selected, good embryos are generated thereby decreasing miscarriage rates. This is particularly useful for patients with recurrent miscarriages.
PATIENT WHO WILL BENEFIT FROM IMSI
- Low sperm count
- Zero sperm count
- Low sperm motility
- Abnormal sperm in semen
- Repetitive fertilization failure
- Unexplained infertility
- Previous IVF failure
- Recurrent miscarriages
The latest technology to create the best baby
Embryoscope is the latest technology by which the most viable and the best quality embryo may be identified for embryo transfer. This also plays an important factor in improving the pregnancy rates in Assisted reproduction. Prashanth Fertility Research Centre can boast of being one of the 125 exclusive centres in the world to have this technology. The embryoscope is an IVF Incubator with a built in camera for automated time lapse imaging of fertilized oocytes in a safe incubator environment from conception to embryo transfer. Failure to select a viable embryo in a given fertility treatment limits the success rates of current Procedures. Fertility clinics generally rely on the morphological appearance of embryos at a few distinct time points during the development to pick up a good embryo for transfer. However embryo development is a very dynamic process and critical stages between observations go unnoticed.
This novel equipment overcomes the short comings of the current IVF protocols and substantiates as to how improved embryo selection is possible based on a kinetic analysis of time lapse images of embryo development. By choosing the best embryos, the technology eventually increase the current success rates of infertility treatment and the first baby conceived using the technology of the embryoscope have already been born, proving the efficacy of this amazing technology.
Normally embryos are assessed at particular time points and increasing the number of times of assessment gives more information and helps to score the embryos. Embryos with top scores are the best embryos and transferring these embryos into the uterus gives remarkable pregnancy rates. After the egg is inseminated with the sperm, early division to the 2 cell stage is assessed at 25-27 hours.
Early division gives good pregnancy rates. At 62 hours cell numbers are studied. Duration and timing of cell division also contributes to pregnancy rates and prolonged duration is detrimental.
- Embryo with high or very low cell numbers are more likely to be genetically abnormal.
- Embryo division should happen in synchrony to give good pregnancy rates.
- Embryos with even cell numbers are considered good embryos.
- Second and third cell division usually occurs early morning and is therefore missed in the routine IVF labs.
- Some embryos are 3 cells for a short duration which may likely to be missed unless the embryos are continuosly monitored 3 cell embryos are abnormal.
- Blastomeres which are the cells in the embryos must be even sized to give good pregnancy rates.
- Transient fragmentation which may occur may be missed if they are joined later. Fragmentation is a sign of poor quality embryos.
- Multinucleated embryos are also poor embryos and this can be missed if observed only at specific time points.
In a normal IVF lab, after injecting the sperm into the egg, embryos are seen once at 16- 18 hours, once at 65-68 hours and then on Day 5 only so several vital parameters may be missed. This is where an Embryoscope has proved to be a boon. In an embryoscope the images of each embryo is automatically recorded at 20 minutes interval. By the click of a button, the images of each embryo can be recalled and studied at numerous time points 27-28 hrs, 36 hrs,62 hrs and so on. This helps identifying all the important parameters which could have been missed otherwise. Embryos are scored based on these parameters and the top scoring embryos are selected for transfer into the uterus.
Generally in all IVF labs embryos are observed by removing them outside the incubator. In an embryoscope, observations are made inside the incubator avoiding exposure of the embryos to the outside temperature. The embryoscope also ensures stable gas composition as it is not opened till the day of the embryo transfer. It also ensures pure gas as it has volatile organic compound filters, HEPA filters and UV illumination. It maintains a non humid environment and decreases the risk of bacterial and fungal contamination. The exclusive system therefore protects embryos from damage, giving top class embryos thus resulting in better pregnancy rates. The embryoscope by advanced embryo analysis and by maintaining the embryos in a stable and clean environment, helps to select top quality embryos, giving upto 75% remarkable pregnancy rates and decreases miscarriage rates by 8- 10%.
Embryo glue is a chemical substance which is used to coat embryos before transfer into the uterus. It increases the stickiness of embryos to be transferred into the uterus and therefore helps the embryos to implant with ease… and fix onto the lining of the uterus increasing the implantation rate.
PRE IMPLANTATION GENETIC DIAGNOSIS
- PGD for single gene diseases is an early diagnosis of an embryo prior to transfer to the uterus. Therefore, prior to establishment of pregnancy an analysis of DNA of the embryo through a PGD test will help in diagnosing any single gene disorders or mutations. PGD helps couples who have an increased risk for a genetic disease, to have a healthy pregnancy.
- The following list is a panel for which the PGD test is already developed:
- Autosomal Dominant Polycystic Kidney Disease
- Autosomal Recessive Polycystic Kidney Disease
- Becker Muscular Dystrophy
- Beta Thalassaemia
- Congenital Adrenal Hyperplasia (Gene CYP21A2)
- Cystic Fibrosis
- Charcot-Marie-Tooth type 1A
- Fragile X syndrome
- Hemophilia A (F8)
- Hemophilia B (F9)
- Huntington’s Disease
- Multiple Endocrine Neoplasia,type 2A
- RhD Incompatibility
- X-Linked Adrenoleukodystrophy
- Familial Amyloid Polyneuropathy
- Duchenne Muscular Dystrophy
PRE IMPLANTATION GENETIC SCREENING
PGS allows the specific selection of embryos which are chromosomally normal from amongst all the patient’s embryos in a given cycle of assisted reproduction. This procedure allows us to analyse all 24 chromosome types using array Comparative Genomic Hybridisation (aCGH), in order to discard the possibility of embryonic aneuploidy before implantation.
- Indications to perform PGS Advanced Maternal Age: The risk of finding chromosomal abnormalities increases as the age of the mother increases. Most embryos with an incorrect number of chromosomes fail to implant or miscarry during the first trimester of pregnancy
- Recurrent Miscarriage: Approximately 50% of miscarriages occur due to chromosomal abnormalities. In recurrent miscarriages, 68% of embryos are chromosomally abnormal, and 15% of patients have all chromosomally abnormal embryos.
- Implantation Failure: There is a risk with couples who do not have chromosomal alterations but generate chromosomally abnormal embryos that fail to implant in the uterus.
- Male Factor:
Male reproductive function requires a normal sperm function (quantity and quality of sperms).
- Employing PGS for aneuploidy screening in IVF can double ongoing pregnancy rate.
- PGS achieves better reproductive success than FISH.
- ArrayCGH is proven to be scientifically superior to FISH. FISH can only analyse a limited number of chromosomes, whereas aCGH can detect aneuploidies of all the 24 chromosomes.
ENDOMETRIAL RECEPTIVITY ARRAY
- The Endometrial receptivity genome analysis (ERA) involves assessing a woman’s endometrial receptivity status from a molecular viewpoint. This molecular tool allows us to diagnose whether the endometrium is receptive or not, by analyzing the expression of a group of genes responsible for this function. This diagnostic method patented by iGenomix focuses on women who visit the clinic for their fertility problems.
- With the endometrial gene expression diagnosis, problems that may affect the embryo implantation before starting the fertility treatment can be detected. As a result, corresponding measures can be taken to carry out the fertility treatment successfully. It also enables an early diagnosis of diseases originating in the endometrium.
- This is advised for women who do not conceive despite all tests being normal.
STEM CELL THERAPY
Stem cell therapy is used to improve endometrial lining in those with thin endometrium causing implantation failure which doesn’t respond to routine treatment.
Acupuncture Increases IVF success: Acupuncture was delivered either just before or just after embryo transfer – a step in vitro fertilization (IVF) whereby one or several embryos is placed into the uterus. It is thought that acupuncture stimulates the neurotransmitters that trigger production of gonadotropin-releasing hormone that controls menstrual cycle and a woman’s ovulation. It is also thought to stimulate blood flow to the uterus and boost endogenous opioids, inducing body to relax.
Acupuncture SuJok is a traditionally method in which very fine micro needles are inserted at certain energy meridians, energy gates, joints of affected organs, or energy flow of SuJok in miniature form on hands and feet’s. Its energy concept is one such treatment, which is effective at all the three levels of Body, Emotions, and Neuro. OnnuriSuJok itself is an independent powerful tool to offer positive effective results to have fertility. The remission of the problem can be achieved in an effective way. The course of treatment may definitely be uneventful. High effect – on pricking 1mm small micro tiny needles only on the hand to adjust the energy flow system of the body or can be done with small magnets similar to pulse size to put on fingers only. One must opt for it as the system itself is powerful and safe with no side effects, as no medicine is ever given or recommended. If it does not give positive results, it will not harm in any way, still the process will boost the emotional aspect. It is said that acupuncture also improves sperm quality.