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Treatment Methods

Infertility can be treated in many ways. We offer a wide range of possible treatments, ranging from the most basic, to highly specialised medical techniques. However, our philosophy is that the patients should be treated only with methods that are really necessary and beneficial.

The method of in-vitro fertilisation, where the sperm is left alone to spontaneously merge with an egg, has been enhanced by additional methods to reach higher success rates. That is the reason why it is standard for IVF CUBE to use the ICSI method, Assisted Hatching (AH), prolonged cultivation and vitrification of the remaining embryos. Thanks to these additional methods we are able to reach over 84% success rate.

IVF Methods

Additional Methods

Genetic testing

IVF Treatment Methods

IVF-ICSI with own eggs

  • The complete therapy including ICSI
  • Blastocyst culture (5 days)
  • Assisted Hatching (by laser)
  • Vitrification of the remaining embryos
  • 1 year of storage

This method includes the hormonal stimulation of the ovaries according to the established protocol, followed by the egg collection. The eggs are fertilised outside of the patient’s body - in vitro. The fertilized eggs are cultivated in a special laboratory environment, where we ensure the embryos develop optimally. The chosen embryo is then implanted into the patient’s uterus. The length of the entire process, starting with the initial consultation up until the embryo transfer, differs with regards to the patient’s menstrual cycle. An indication of the estimated time may be somewhere between 1 to 2.5 months.

IVF-ICSI with donated eggs (ED)

  • The complete therapy including ICSI
  • Guarantees: 8 eggs, 2 blastocysts
  • The medical examination of the donor + medication
  • Blastocyst culture (5 days)
  • Assisted Hatching (by laser)
  • Vitrification of the remaining embryos
  • 1 year of storage

With this method, we use freshly collected eggs from an anonymous donor, which are fertilized by the partner’s sperm. The preparation and synchronization of the patient and donor can take approximately 2 months. The patient only uses medication for the endometrium preparation for the embryo transfer, they will not undergo hormonal stimulation. The protocol for the donors at IVF CUBE is as follows; we only accept donors between the ages of 20-34 after they undergo the examinations and testing required by law. Selection of the donor is based on phenotypic criteria according to the couple’s features and their requirements. In addition to the state required testing, our donors are also examined by our clinical psychologist. Information from the psychological profile developed by the psychologist is also available for the patient upon request. The guarantees of the program are: a minimum of 8 eggs and at least 2 high quality embryos in the blastocyst stage (if the partner's sperm is normozoospermia). Find out more about the treatment process.

Intracytoplasmic sperm injection – ICSI

With the ICSI method the sperm is put into the egg cytoplasm. The ICSI method is performed with the help of a microscope equipped with multiple enlargement glass, together with the use of a micro syringe. The ICSI method is used at IVF CUBE as standard procedure because it dramatically increases the success rate. 

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Blastocyst culture - BC

A 5 day embryo cultivation process, from the egg fertilization until the embryo transfer at the blastocyst stage. Embryos can be transferred earlier, for example on day 3, however the blastocyst culture gives us a higher chance of the embryo attaching to the endometrium. It also allows a longer window to choose the best morphologically appropriate embryo for transfer. If applicable, IVF CUBE uses the blastocyst culture method for all treatments.

Assisted Hatching – AH

A micromanipulation method in which the protein cover (pellucid zone) of the egg is opened by laser. The hatching process is then facilitated by the opening of the cover in the inner cellular part so that the embryo can easily get through the pellucid zone. Assisted hatching is performed on all the available embryos on day 4, when embryos reach the compact stage.

Vitrification

A method of quick freezing (of embryos, eggs, sperm). Quick freezing is much more compatible to the human cells, because it prevents any crystals forming and increases the safety of the cells with further unfreezing and usage in the following IVF cycles. Vitrification is a standard part of all cycles performed at IVF CUBE.

IVF-ICSI in soft protocol

In this therapy plan, the patient is on minimal hormonal stimulation. Patients take the medication orally, and minimal stimulation injections may be added throughout the treatment process. The egg maturation is then enhanced by the one time application of a injection 36 hours before the egg collection.

Intrauterine insemination – IUI

This treatment is performed during regular ovulation. The partner’s sperm is, after previous preparation in the andrological laboratory, inserted into the female uterus with the help of a narrow catheter. The IUI method is the least invasive, usually completely pain free with minimal risks.

Other Treatment Methods

Detailed Therapy Process

Additional Treatment Methods

IMSI

Intracytoplasmic injection of the morphologically selected sperm: Using this method the sperm choice is based on the detailed observation of the individual sperm morphology. The selection is performed using a highly specialised microscope, where each individual sperm is evaluated in greater detail. Only the morphologically optimal sperm is used for the micro manipulative fertilisation.

 

PICSI

Preselective Intracytoplasmic Sperm Injection: This is a technique during which we imitate the natural sperm selection of the matured sperm only. During natural fertilisation the egg is only fertilised by the matured sperm, which can attach to the hyaluronan (the substance contained in the surface layer of the egg). The PICSI method tests the ability of the sperm to attach to the hyaluronan in a special petri dish. The chosen sperm is used for the micro manipulative fertilisation.

MACS

Magnetic-Activated Cell Sorting: This method involves magnetic nanoparticles which are attached to the aging or damaged sperm. By adding the nanoparticles to the ejaculate, the aging and damaged sperm with the magnetic particles are caught by an external magnet. The healthy unmarked sperm, will pass through the magnetic field unharmed and without any obstruction and will then be used for the egg fertilisation. MACS can be combined with additional techniques such as IMSI or PICSI.

Embryoglue

A substance enriched by hyaluronan, which supports the embryo implantation in the uterus. The embryo is cultivated in the substance for several hours before the embryo transfer. The embryo, together with a small amount of Embryoglue is transferred to the uterus. Embryoglue increases the chances of successful impregnation by up to 4-8%.



Embryoscope

A device which allows the patients to watch and analyse the embryo development in real time. It is an incubator which provides the optimal conditions for ideal embryo development. The incubator is equipped with an online camera which will automatically update pictures of the embryos through a secure web page. The camera captures embryos in red light for a very short period of time – 15 ms. Embryos thus are not exposed to an excessive amount of light. Access is permitted only to authorised clients who are provided with a password. Our patients can watch their embryos’ development from the comfort of their home. Click here if you wish to see the videos from Embryoscope.

MFSS - Microfluid sperm sorting

Sperm cells are placed on a disposable chip where they are allowed to actively migrate through the passage of various micro-barriers and a membrane into the outlet chambers. During this proces, viable healthy sperm cells are separated and collected into the outlet chambers similarly as they would do naturally when reaching an egg cell in a female reproductive system.

The method is based on natural sperm selection. Selected sperm cells have better motility, genetic quality and morphology. This method increases the treatment success  by up to 20-25%.

SPERM+

Extensive sperm diagnosis SPERM+ provides an early detection of possible infertility causes in male partner. The screening consists of 4 laboratory tests. Each of these examines crucial factors causing conception problems or issues with embryo development. SPERM+ diagnosis enables us to determine the most suitable method of sperm selection and its processing.

  • Sperm DNA Fragmentation (HALO sperm test)
    Sperm DNA fragmentation is a common cause of infertility in male partner. The test checks for damages in a spermatozoon head as each of the heads carry vital genetic information. Effective embryo development relies on healthy spermatozoon.
  • Vitality Test
    This test is able to determine viable spermatozoons and it is particularly useful in suspected low quality sperm samples.
  • Oxidative Stress Level
    The ejaculate contains traces of oxygen and nitrogen, which have to be balanced in order to preserve physiological functions. Increased concentration of either is called oxidative stress which impacts negatively on sperm DNA.
  • Presence of Antisperm
    Antibodies Infertility can also be caused by immunological factors. Testing is performed to determine whether specific antibodies are present.
 

Other methods

Donor sperm

In cases where it is impossible to use the partner’s sperm, it is possible to use donor sperm from an anonymous donor. The clinic chooses the donors from our own large donor bank that includes more than 200 donors.The donors are always chosen according to set criteria required by the couple.

Acupuncture

Is a technique offered to clients as a supportive treatment for IVF treatment. Acupuncture stimulates the energetic areas that are specially chosen for the assisted reproduction cycles. The procedure is performed 30 minutes before the embryo transfer and 30 minutes after. The main goal is to promote the blood circulation of the endometrium and to ease the pelvic floor. In addition to the benefits mentioned above, it also has a positive effect on the patient’s psyche.

Psychological consultation

For all cases we offer the possibility of an initial free psychological consultation with our experienced psychologist. M.Ed. Jana Brezinova specialises in couples therapy, but also assists in individual therapy for our IVF patients. The psychological consultations help to improve and stabilise the psychological well-being of our clients, which can be burdened during the demanding and often long infertility therapies. The psychological aspect can play an important role and can be one of the crucial factors influencing the success rate.

Fertility check

Infertility problems are, according to the statistics, equally caused by male and female problems. That is why at IVF CUBE we always investigate both male and female partners.

Female infertility investigation: The basic examination involves testing the blood for AMH (Anti-Mullerian Hormone) and ultrasound scanning for the AFC (Antral Follicle Count). On the basis of these two examinations we are able to predict ovarian reserves and establish the prognosis for the fertilisation. In cases where the results show abnormalities, it is possible to undergo more testing or treatment for the fertility malfunction.

Male infertility investigation: After we have received the sperm sample, we perform a sperm analysis examination. In this testing we evaluate and compare the levels with the WHO (World Health Organisation) standards. The parameters we evaluate are the volume, motility, sperm morphology and many others. Further information can be found in the Infertility Investigation section.

Egg freezing

A method designed for women that wish for whatever reason to preserve a good amount of eggs for further use. One of the significant indications for egg freezing may be oncological treatment, which is known to be highly toxic for the reproductive cells. Other reasons may be the purposeful postponement of maternity or the fact that a woman has not found the right life partner yet and is aware of decreasing fertility with aging. In the case of egg vitrification the patient undergoes the first part of the treatment, through the stimulation and egg retrieval. After the collection the eggs are cryopreserved in tanks with liquid nitrogen here at IVF CUBE.

Sperm freezing

The procedure allows long term, almost unlimited conservation of human reproductive cells. The cells are stored at -196 C (-321 F). Cryopreservation does not cause any harm to sperm so when it comes to fertilisation the difference between frozen and fresh sperm is extremely minimal.The cryopreservation of the sperm is applicable especially to the male partners that have unstable sperm analysis results, limited sperm count in ejaculate or for males who suffer from a psychological blockage when providing the samples. Another indication might be planned oncological treatment.

 

4D Ultrasound Examination

4D ultrasound examination enables a moving three-dimensional visual display of the baby in the womb in real time. In earlier stages of pregnancy, this technique projects the entire baby; in later stages, the images display primarily spatial representations of individual body parts, particularly the face. At our clinic, IVF CUBE, you can get a free examination recorded on a flash drive.

IVF Treatment Methods

Detailed Therapy Process

Genetic testing

NGS - Next Generation Sequencing

Is one of the most high-tech genetic testing methods. The testing is done on the cells that are taken from the embryos in the early blastocyst stage - the 5th day of development. It allows the early detection of structural problems, or any other deviations, on all 24 chromosomes. It is also highly sensitive to the detection of genetically abnormal embryos, having close to a zero mistake rate. NGS testing is especially suitable in cases where one of the partners is a carrier of a genetic disease, for couples who have had numerous miscarriages or for the more mature aged female partner. The indication for NGS is always decided by the doctor.

PCR - Polymerase Chain Reaction

A testing method aimed at the detection of specific inheritable genetic diseases. It is applicable for all known monogenic genetic mutations. If there is further suspicion from the doctor or any other reason for indication, further NGS examination is possible on the remaining healthy embryos.

 

MATCH+

MATCH+ – an additional examination of the 300 most frequent genetic mutations (suitable mainly in therapies with egg donation). The examination ensures safe matching and optimal genetical compatibility of the donor and partner, while still respecting the phenotypical and other requests of the couple.

*Every healthy person is a carrier of 2-5 mutations that do not have any impact on the person. However, in the case where two people with the same mutation partner, it may result in a higher risk of conceiving a genetically handicapped child. The MATCH + serves as an additional filter while adding genetic compatibility into the selection pattern. Match + sets a genetically based criteria according to which your donor is carefully chosen.

More about Genetic Testing

Detailed Therapy Process

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