New ground-breaking IVF Technologies

Medicine is always moving forward. Every year, huge sums of money are spent on scientific research and development for the benefit of mankind. The sphere of reproduction is no exception. Thanks to new technologies, experts have learned the way to select reproductive cells, by choosing only best quality cells, thereby increasing the chance of pregnancy.

You can delay childbirth, if the circumstances require. Modern methods of cryoconservation (vitrification) allow a delay of parenthood because of social reasons as well as medical reasons – cancer or other disease treatment.

Future parents now can be sure about the health of their baby, especially if one of the family members has a genetic disease. Modern technology can to check all chromosomes and detect deviations at the stage of the embryo.

Created different mediums, synthesized more effective medicines and new methods of treatment, increasing the likelihood of better result.

All of these are modern advances in artificial insemination – this is another step for anyone who want to experience joy of parenthood. Thanks to advances in the field of reproduction, you have the chance to find happiness by becoming a mother or father.

Assisted Embryo Hatching

The Emergence of The Blastocyst (Hatching)

During the stage of early development, the human egg and embryo are surrounded by a protein shell (zona pellucida) – an egg shell coming from the a bird has a similar analogue. To guarantee the successful implantation (attachment) to the uterus, the embryo must hatch from its protein shell – this it is called hatching.

Sometimes it is considered that problems with hatching may cause problems with the occurrence of pregnancy in some couples. Assisted embryo hatching is the micro-manipulation procedure during which „embryo surgery" or zona drilling is performed to soften the shell of the embryo before the transfer into the uterine cavity. This will make the process of natural hatching and implantation easier.

What are the Advantages of Blastocyst Culture?

Nowadays, it is possible to grow embryos in the laboratory until they reach the blastocyst stage – the embryo is cultured for five days, at which point it reached its highest stage of physiological development, after which it may be transferred into the uterus. Some scientists consider that after this manipulation there is a higher chance for the occurrence of pregnancy. By culturing embryos for a longer period of time, it makes it possible to choose the best ones for transfer into the uterine cavity.

Array Comparative Genomic Hybridization (aCGH) CGH Microarray

Preimplantation Genetic Screening (PGS) by aCGH

Within the IVF cycle, iVF Riga clinic offers unique examinations of embryos before their transfer to the uterus: preimplantation genetic screening by microarray-based comparative genomic hybridization (aCGH). This method provides high accuracy for the identification of chromosomal abnormalities prior to embryo transfer and implantation. In the near future, genetic analysis will allow for obtaining positive IVF results in the first cycle, eliminating failed attempts and termination of pregnancy after embryo implantation.

Cult-Active – an innovative method used in order to activate the Eggs (Oocytes) after fertilization

Recommended in cases with low amount of fertilized eggs in previous Artificial Insemination cycles
Cult-Active is a new method which is used in patients who have a low amount of fertilized egg cells (oocytes) during previous Artificial Insemination cycles after ICSI (intra-cytoplasmic sperm injection). It indicates that eggs are immature. Oocyte (egg) activation is initiated by protein contained in sperm. During egg activation, there is a fast increase in intracellular concentration of calcium.

After ICSI (intra-cytoplasmic sperm injection), fertilized eggs are placed in the Cult-Active medium for 15 minutes, which helps to activate an egg. Thereafter, an increasing amount of fertilized eggs emulate the biochemical process of egg and sperm fertilization. Calcium ionophore contained in Cult-Active medium- connects calcium ions and delivers them to an egg, thus having activated them.

EmbryoGen – A New Option in IVF

Artificial insemination is a multi-stage process during which every step is the most important one. Until present it was possible to control and ensure optimal conditions from the moment of egg collection until embryo transfer. Today with the help of the new EmbryoGen medium it is possible to improve the development of an embryo also in the uterus of a female. Embryos are cultivated in this medium until the third day, and according to the latest researches, it significantly improves the level of cell communication between the mother and embryo. Women after the age of 35 have a higher risk of not carrying a child successfully, it is recommended for those patients to apply EmbryoGen.

EmbryoGen's composition has signal molecules which are also found in the mother's tissue. These signal molecules improve the level of cell communication between the mother and embryo, thus protecting the embryo from stress and making it stronger at the beginning of implantation and at its end. One of the reasons for a miscarriage is an immune response from a woman's body to the embryo as a foreign object. EmbryoGen is improving this communication between the mother's and child's cells, which further improves the embryo implantation process.

EmbryoGen –Indications

  • Repeated implantation failure (2 or more)
  • Repeated preclinical (biochemical) pregnancy loss (2 or more)
  • Recurrent miscarriage (2 or more)
  • Other unexplained infertility

Embryo Glue – A New Hope For Couples With Failed IVF

Embryo Transfer (placement of an embryo into the uterus of a female) is the last and one of the most important steps in Artificial Insemination. From the Egg Collection procedure until the last stage (Embryo Transfer) – Embryo Laboratory is ensures optimal conditions and environment for development of the embryo. After Embryo Transfer it depends only on the embryo and its ability to attach to the uterus of the female. Currently, with the new EmbryoGlue-technique it is possible to help the embryo implant in the uterus.

EmbryoGlue – is a specially designed medium for usage in embryo transfer which improves implantation ability of the embryo. This medium is rich with hyaluronic acid, carbohydrates and amino acids, which when applied together work as a binding agent at the moment of embryo implantation in the uterus. Hyaluronic acid is a substance found naturally in the human body. Scientific research show that at the moment of embryo implantation the level of hyaluronic acid is very high, and this can help the embryo to become implanted better.

Raised level of hyaluronic acid in the EmbryoGlue medium (in which the embryo is placed before the transfer) improves the ability of the embryo to get attached in the uterus of the female.

The New Word in the Treatment of Infertility – EmbryoScope

iVF Riga offers a new method of cultivation of embryos in the unique incubator EmbryoScope, which provides continuous monitoring of the embryo development and recording it on video. The incubator is equipped with special heating elements, which help maintain the optimum temperature and provide the necessary mix of gases in the incubator to simulate the physiological conditions in the mother’s belly. iVF Riga is the first and only clinic in the Baltic countries and Eastern Europe, which has introduced the state-of-the-art EmbryoScope technology in the process of treatment by IVF. This innovation has helped to improve the existing results by 20%. EmbryoScope incubators are considered to be the most advanced and best equipment in the sphere of artificial insemination. iVF Riga clinic is the only clinic in the Baltic countries and one of the few in Northern Europe to provide EmbryoScope treatment.

What is ERA Test?

The ERA (or endometrial receptivity array) is a genetic test that diagnoses the state of endometrial receptivity in the window of implantation in women. This molecular diagnostic tool is used to analyse the expression levels of 238 genes related to the status of endometrial receptivity. Probes for these 238 genes are hybridized with RNA obtained from an endometrial tissue sample in a custom microarray. After hybridization the signal intensities are read by a computerized predictor and the sample is classified as „Receptive” or „Non-Receptive” according to its specific expression profiles. ERA tests reveal the timing of the implantation window and permits personalised embryo transfer (pET) timing based on the individual results obtained.

Why choose the ERA Test?

The ERA test is recommended for younger women with at least 3 failed embryo transfers or for patients 37 years or more with 2 failed embryo transfers.

The ERA test has shown high sensitivity and specificity in detecting gene expression profiles associated with receptivity. Endometrial stage dating has been classically determined based on histological criteria. However, this method has shown not to discriminate between fertile and infertile patients and involves a high degree of subjectivity, meaning these results cannot be applied in the clinic. The ERA test overcomes these problems.

How are samples taken?

To perform this analysis it is necessary to take an endometrial biopsy from women in their natural cycle or hormone replacement therapy cycles, at a time corresponding to the phase of endometrial receptivity. That is, in the natural cycle at day 21, seven (7) days after the LH (luteinizing hormone) surge (LH+7, or 6 days after the follicle rupture, when this is monitored by ultrasound) or after five (5) full days of progesterone impregnation in Hormone replacement therapy (HRT) cycles. After the biopsy is taken it is immediately introduced into an "ERA cryotube" which contains a fluid that facilitates the preservation of the tissue.

PICSI – Detailed Sperm Selection Technique

ICSI (Intra-Cytoplasmic Sperm Injection) is defined as a single sperm injection into the cytoplasm of an egg. The technique requires a single sperm with the best morphology and motility to be injected into the cytoplasm of an egg. Until now, visual evaluation of a single sperm has been the only available method for choosing the best sperm cell for egg insemination. Embryologists often have to deal with immature sperm cells. Such effects from these cells are evaluated at the same time during embryo development. Sperm cells with good morphology and motility may have other defects and may not be suitable for visual evaluation, etc. – DNA fragmentation, late development. Those defects affect the quality and development of the embryo as well as the possibility of miscarriage.

Using the latest PICSI technique (injection of the physiologically best sperm cell into the cytoplasm of an egg) it is possible to select sperm cells without visible defects. This method improves the selection of sperm cells by up to 98%. In this technique, sperm cells are placed into hyaluronic acid which will attach to mature sperm cells. Only completely mature sperm cells which have reached the last stage of spermatogenesis have developed attachment receptors for hyaluronic acid. Immature sperm cells have high DNA fragmentation, aneuploidy (abnormal number of chromosomes) and immature cytoplasms. Using the latest PICSI technique will increase the possibility of getting a successful pregnancy.

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