A lot of couples and singles who are diagnosed infertile are still unable to get pregnant after such therapies as ovulation induction, intrauterine insemination, or reproductive surgery. In this case it is time to address assisted reproductive technologies (ART) among which are in vitro fertilization (IVF), egg donation, surrogacy and other laboratory practices aimed at resolving the situtiation and achieve best possible results.
Preimplantation Genetic Diagnosis
Preimplantation genetic diagnosis (PGD) allows identifying genetic defects in embryos that were created through in vitro fertilization (IVF) before they are transferred. Only unaffected, healthy embyos should be transferred to the uterus for implantation, so PGD is an alternative to current post-conception diagnostic procedures, i.e., amniocentesis or chorionic villus sampling, which may cause pregnancy termination if results obtained are adverse.
Both fertile and infertile couples may address PGD, it is performed along with IVF and is recommended when there is a suspicion that embryos might be affected by a particular hereditary genetic condition. PGD allows only normally developing embryos to be transferred into the uterus, which significantly reduces the risk of undesired outcome such as miscarriage, pregnancy termination after positive prenatal diagnosis or birth effects both physical and mental.
In sex selection cases, embryos resulting from IVF procedures are genetically tested for X or Y Chromosomes. The embryos of the desired sex are then implanted.
Intracytoplasmic Sperm Injection
Achieving fertilization can be also helped with ICSI being equal to traditional IVF when a couple has low sperm count or poor quality sperm. ICSI is also a solution for those couples who did not manage to get pregnant with previously carried IVF attempts or have egg abnormalities or low egg number.
Once the follicular fluid is removed from the follicle, the eggs are placed into an incubator. The eggs are to be fertilized with sperm later the same day. The male partner provides a sperm sample from which the healthiest sperm will be extracted. If no sperm can be available through a natural way, a sperm retrieval procedure may be recommended such as testicular biopsy, microdissection, testicular sperm extraction (TESA) or percutaneous sperm aspirations (PESA) which is performed around the time of egg retrieval.
The ICSI technique is used to fertilize mature eggs directly. Under the microscope, an embryologist picks up the best single spermium and injects it directly into the cytoplasm of the egg using a small glass needle. The ultimate medical recommendations are to grow embryos for five or six days until they reach blastocyst stage.
Additional Advanced Technologies
In many situations, especially when a female patient is in her late 30's and early 40's, infertility may result from a decrease in ovarian function and a consequent fall in egg quality. In the event of a severe compromise in ovarian function, successful pregnancy is very unlikely. A treatment that often offers an excellent chance of success is to use eggs from a donor who is capable of producing good quality eggs. This is a complex treatment option from medical and psychological points of view, but one that provides a very good chance for pregnancy.
Surrogacy is a method of reproduction whereby a woman agrees to become pregnant and deliver a child for a contracted party. As a gestational carrier, she will carry the pregnancy to delivery after having been implanted with embryos.
(AH) is a procedure performed prior to transfer in selected cases. An embryo needs to escape or "hatch" from it's protein shell, called the Zona Pellucida, before it can implant in the uterus. In AH, a chemical or a laser can be used to dissolve part of the zone, to facilitate the hatching process later. This technique is often used with prior failed IVF cycles, female age over 38, and with abnormally thick zone.
Percutaneous Epidydimal Sperm Aspiration and Testicular Sperm Extraction (PESA and TESE)
Some men have no sperm in the ejaculate but still produce them in the testicles. This may occur due to a vasectomy, to a congenital obstruction of the sperm ducts leaving the testicles, or to inadequate development of the sperm such that they cannot leave the testicles. In these situations, a urologist can remove sperm by placing a needle into the testis or the tubes that drain it. These procedures are done under anesthesia and can be very effective when combined with ICSI.
Embryos that are not transferred but continue to thrive in the laboratory can be cryopreserved (frozen). We'd recommend freezing for any high quality embryos that survive to the blastocyst stage. These embryos are stored in liquid nitrogen and can be thawed at a later date. While the pregnancy rates with frozen embryos are not as high, the procedures involved in preparing for a frozen embryo transfer are much simpler and less expensive. Freezing only embryos that survive to the blastocyst stage maximizes the chance for success in a thaw cycle.
The founder of our center, Mrs Mariam Kukunashvili is a member of the European Society of Human Reproduction and Embryology, Doctor, PHT in Healthcare Management and policy with many years of experience in fertility treatment and in further fields of Healthcare.
Mariam understands well the heartache and disappointment Intended Parents experience in their infertility journey. After 11 unsuccessful IVF attempts, suffering endometriosis and 4 surgeries, then one successful but ectopic pregnancy, she turned to surrogacy. With the help of 2 wonderful surrogates, they now have a daughter and twin boys, born in 2011.
Svetlana PiroJenko- Deputy Director
Svetlana is your primary contact when you start making your first steps towards your surrogacy or egg donation program in Ukraine.
She is most aware of all details of surrogacy and egg donation programs that are carried in Ukraine, so you can easily address her with all your questions and be sure you will full answers to all your questions. Svetlana takes and manages every program as her personal case, you will be touched by her caring and tactful guidance of your program, as well as timely and informative feedback.