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IVF

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ICSIx

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PICSIx

What is PICSI?

PICSI is the abbreviation for "Physiological ICSI".

 

How does PICSI work?

In addition to the morphology of the sperm cells, the maturation of the sperm cells is also important when using ICSI. The shell of the egg contains hyaluronan (hyaluronic acid) and in case of a natural fertilization, only mature sperm cells that contain the correct receptors (hyaluronidase) can come into contact with the shell of the egg and enter the egg hence leading to fertilization. The ability of sperm to ingest hyaluronan, therefore, reflects the natural fertilization process, and better predicts sperm behaviour during fertilization. In the laboratory it is possible to mimic this by means of a specially developed Petri dish, and to select these mature sperm cells for use in the ICSI procedure, given a sufficient amount of sperm cells to select from.

 

Why PICSI?

Studies show that sperm cells with the correct receptors appear to contain less DNA damage and fewer chromosomal abnormalities than sperm cells selected by eye under the microscope. This appears to increase embryo quality, the chance of implantation and the chance of the birth of a healthy child, while the risk of miscarriage appears to decrease with the use of PICSI.

 

For whom and when is PICSI recommended?

PICSI is advised in case of a high degree of DNA fragmentation, low normal sperm count (morphology), low fertilization rate with regular IVF/ICSI, suboptimal embryo development or poor embryo quality in prior IVF/ICSI attempts, implantation failure and/or repeated miscarriages. The indication is set by your attending gynecologist. The additional costs of PICSI are usually not reimbursed by your health insurance company.

 

Please contact us for more information.

Microfluidic Sperm Sorting Chipx

What is the Microfluidic Sperm Sorting Chip?

The Microfluidic Sperm Sorting Chip (also called "Fertile Chamber") is a sperm selection method for IVF and ICSI treatments. There are also chips that can be used for insemination treatments.

 

How does the Microfluidic Sperm Sorting Chip work?

With a specially developed instrument, which looks like a transparent chip with microchannels (free of chemicals) up to a size of a few hundred µm, sperm cells without DNA damage can be selected and then used for fertility treatment, such as insemination (IUI), IVF or ICSI. The chip operates with very small volumes, imitating the natural flow and cell size, given a sufficient number of sperm cells to select from. The advantage is that the chip does not at any time damage vital sperm cells, and does not ignore the barriers to sperm cells that are present in nature. In this way natural selection can be imitated.

 

Why the Microfluidic Sperm Sorting Chip?

With regular fertility treatments, the sperm must be processed to make it suitable for insemination, IVF or ICSI. These are usually more lengthy methods in which the sperm cells are for instance centrifuged and possibly damaged. Part of the sperm cells naturally have DNA damage (oxidative damage), which can increase by processing the sperm cells. This may lead to DNA fragmentation and therefore poorer results in fertility treatments. The chip is able to mimic the natural sperm cell selection in a fast and gentle way, so that the sperm cells with better motility, and without DNA damage or chromosomal abnormalities, have the advantage. This seems to increase the embryo quality, the chance of implantation and the chance of the birth of a healthy child, while the chance of miscarriages with the use of the chip seems to decrease.

 

For whom and when is the Microfluidic Sperm Sorting Chip recommended?

The use has a certain overlap with the PICSI method. The chip is therefore recommended in case of a high degree of DNA fragmentation, low normal sperm count (morphology), low fertilization rate with regular IVF/ICSI, suboptimal embryo development or poor embryo quality in prior IVF/ICSI attempts, implantation failure and/or repeated miscarriages. The indication is set by your attending gynecologist. The additional costs of PICSI are usually not reimbursed by your health insurance company.

 

Please contact us for more information.

Kalzium-Ionophorx

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Time-Lapse Imagingx

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(Mikro-) TESEx

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Kryokonservierung / Kryopreservierungx

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DHEA (Dehydroepiandrosteron)x

What is DHEA?

DHEA is the abbreviation for "dehydroepiandrosterone", and is a steroid hormone which is – amongst other organs – produced by the adrenal glands from cholesterol. DHEA can be converted into androstenedione, testosterone and other steroids (including estrogens). The storage form of DHEA is DHEAS. Between the ages of 20 and 30, the adrenal glands show a peak in DHEA production, after which the production capacity declines steadily. DHEA is used "off-label" for all kinds of purposes (including depression, immune problems, prevention of cardiovascular disease and the prevention of osteoporosis). Contrary to popular belief, DHEA is not an anabolic steroid, even though it is sometimes used in the gym. However, it has never been shown that this hormone has a muscle-building effect.

 

DHEA and fertility

For many years there has been extensive attention to the role of steroid hormones in reproductive medicine, especially in women with low AMH and / or age > 35 years. The idea is that the environment that plays a role in the development of an egg may be positively influenced by DHEA. As a result, more eggs may become more sensitive to stimulation during a treatment, and possibly fewer genetically abnormal eggs may be develop. There are many studies that show that the number of pregnancies and live births in IVF and ICSI, provided the correct indication and under supervision of a doctor, are positively influenced by DHEA. However, it is not yet so far that the use of DHEA is seen as "evidence-based medicine", although there are plenty of studies which unmistakably report a positive effect. That has also been our experience for years.

 

Indication, dosage and control

DHEA is a precursor hormone/prohormone and should therefore not be taken on your own initiative. First, it should be determined by blood tests whether there is a possibility to take DHEA at all, without a major risk of side effects. It may then also be better determined which dosage can be useful. Quite typically, dosages of 25-75 mg per day are used for at least 6 weeks before a new hormone stimulation can be started as part of an IVF/ICSI treatment. It is often started with 25-50 mg per day, depending on the blood values. A few weeks after starting the medicine, another blood test should be performed to test the levels and adjust the dose if necessary. The use of DHEA is strictly "off-label".

 

Side effects

DHEA is certainly not suitable for everyone; therefore assessment and monitoring is important. Side effects may occur, although they are practically rarely seen (<10% of patients), and such is also our experience. Possible negative side effects may include unwanted hair growth or hair loss, acne/oily (scalp)skin, cycle and menstrual bleeding disorders, voice change (<1%) and agitation (irritability and restlessness), which have been reported in the literature. Theoretically, the risk of (hormone-sensitive) cancers could be increased. This is essentially the case with the use of any hormone, and remains a particularly controversial topic of discussion among experts. In addition, it should be realized that the DHEA level often drops rapidly from the age of 30, and that in women around the menopause, other hormones sometimes become elevated for a long time.

Positive side effects are often also reported: many women report more energy, a better mood, sometimes increased sexual desire, better brain function and more endurance.

 

Please contact us for more information.