IUI (Intrauterine Insemination) PMA (Medically Assisted Procreation) technique which consists of inserting the most mobile and laboratory-selected spermatozoa into the uterus during ovulation.
Generally we stimulate the ovaries with drugs suitable to produce 1 or more follicles and we carry out careful follicular monitoring even after IUI to see if ovulation has really occurred.
It is a minimally invasive technique whose use must be chosen well to obtain maximum results ICSI (In vitro fertilization with intracytoplasmic microinjection) PMA technique which consists of in vitro fertilization (i.e. outside the body) of the oocytes by the spermatozoa through the direct insertion of a single spermatozoon into each oocyte (microinjection).
The oocytes are previously collected from the ovaries (pick-up) with a thin needle mounted on the vaginal ultrasound probe on an outpatient basis and under local anesthesia or with brief sedation.
Once the egg is fertilized, it becomes an embryo and is transferred into the uterus to continue its growth.
Embryo transfer can be performed after several days. We generally perform it two days after ICSI to put less stress on the embryos and we always do it ultrasound-guided to be more sure of the point at which the embryos are placed in the uterus.
It is used in the most severe cases of andrological infertility and also when cryopreserved oocytes are used.
The most current results of this Biofertility technique are satisfactory despite the high average age of the patients treated (37.3 years vs 36.7 which is the average of the Italian centers), despite the difficulties of the many cases that come to us with low ovarian reserve and those not numerous previous failures that come to our observation (2.2 on average).
The careful choice of spermatozoa to be used in the microinjection and the care with which this is performed provides us with over 95% fertilization of the oocytes chosen for the formation of the embryos to be transferred.
The percentage of deliveries per transfer is 26.8 (17.7% in Italy and 22% in the United Kingdom). We have quite a few pregnancies even at older ages and up to 44 years of age.
ICSI in natural cycle The oocyte produced monthly by the ovaries is used, without hormonal stimulation.
It can be useful when it is risky to stimulate the ovaries or when they do not respond to stimulation.
It can be carried out every month and does not require any type of anesthesia IVF (In Vitro Fertilization with Embryo Transfer) Technique similar to that described for ICSI in which the appropriately prepared spermatozoa are simply placed near the oocytes.
The oocytes are thus fertilized autonomously by the spermatozoa just as happens in natural fertilization.
This technique is used less and less for various reasons including the greater certainty of fertilization that is obtained with ICSI USET Intracorporeal assisted fertilization technique which allows the embryos not to be manipulated outside the body.
The eggs and sperm are well separated before being transferred to the uterus and meet in the woman's body.
It is the ideal type of technique for those who wish to overcome infertility problems such as tubal problems while maintaining maximum respect for certain ethical standards.
There are quite a few pregnancies obtained with this IOT (Inseminated Oocyte Transfer) technique: Transfer of newly inseminated oocytes into the uterus with ICSI.
It is a very rapid PMA technique because it is completed immediately after the collection of the oocytes which are transferred to the uterus as soon as they are inseminated with ICSI.
It is very suitable for putting minimal stress on fragile oocytes and embryos as at older ages.
We have obtained several pregnancies without this technique TESE and MICROTESE Techniques for surgical extraction of sperm from the testicle in case of azoospermia.
The testicle is often incised under local anesthesia and samples of this tissue are taken to look for the few sperm that are often still present.
They are used immediately for ICSI or cryopreserved for later use. In microthesis, the operating microscope is used to better search for spermatozoa.
In practice, the seminiferous tubules of the testicles are chosen which show the largest dimensions under the microscope and where it is thought there is a greater probability of recovering the spermatozoa for use in PMA.
It is a more invasive and expensive technique which often does not prove superior to traditional TESE for the discovery of male gametes.
In the most difficult cases of azoospermia, i.e. secretory type, we have found usable spermatozoa in over 40% of cases and obtained good results in terms of pregnancies thanks to our TESE surgeon who was one of the first to perform it in Italy.
Our biologist contributed decisively to these results also by virtue of twenty years of experience with thousands of these cases in various countries around the world. cryopreservation of seminal fluid Technique that allows sperm to be preserved and kept alive using extremely low temperatures (-196 °C).
Patients who undergo this treatment will be able to reuse the spermatozoa for a future pregnancy through PMA techniques and it may be indicated in various circumstances such as the need to preserve fertility for major operations on the testicles, the progressive worsening of the spermiogram or, simply, the difficulty in taking a seminal fluid sample at the moment in which the PMA must be performed oocyte cryopreservation Sophisticated laboratory procedure which consists in the rapid cooling with a vitrification technique of the oocytes taken from the ovaries and with their maintenance in liquid nitrogen at -196°C.
It is performed in various circumstances, mainly when there is a large number of oocytes available to be fertilized with ICSI for a new PMA attempt if the first was not successful or other pregnancies are desired protocols for hyperstimulation syndrome Personalized plan to treat cases at risk for the onset of Hyperstimulation Syndrome.
It consists of a preliminary and precise assessment of the ovarian reserve, adequate preparation of the ovaries before carrying out stimulation especially in the case of PCOS, super-controlled ultrasound and hormonal monitoring (even daily and during the weekend) and ad hoc pharmacological measures after the pick up.
The aim is also to not postpone the transfer and be forced to cryopreserve the oocytes or embryos.
Progesterone control in PMA Protocol to avoid dangerous increases in Progesterone during stimulation or its unpredictable reductions after embryo transfer.
Thanks to preparation, stimulation, monitoring and suitable drugs protocols, we are able to limit the increase in progesterone to 1% above the dangerous threshold of 1.5 ng/ml during stimulation. Operative hysteroscopy consists of various uterine surgical techniques that are performed with the hysteroscope.
They allow the minimally invasive removal of uterine myomas that develop towards the uterine cavity, polyps and septa but also the remodeling of a uterus when it is T-shaped.
It is performed by a surgeon who specializes in these techniques. Transfer test Simulation of the embryo transfer which is performed before the real one.
It is used to ensure an optimal transfer during the PMA. The correct passage of the most suitable catheter among the many for embryo transfer is assessed, establishing the most suitable one for the conformation of the uterus and its length.
This information is of great importance when the actual transfer is carried out, because it avoids complicated and unexpected situations that can significantly reduce the chances of pregnancy.
Endometrial scratching Removal of a small part of the endometrium to favor its receptivity and the implantation of the embryo.