Offering Assisted Hatching, ICSI, and PGD (Preimplantation Genetic Diagnosis)
Micromanipulation is the term for advanced techniques that can be performed in conjunction with IVF to improve the chances of pregnancy or screen out unhealthy embryos. Commonly called "cell surgery," these procedures are conducted using powerful microscopes and specialized equipment. PGD (preimplantation genetic diagnosis), ICSI (intracytoplasmic sperm injection), and assisted hatching are offered to patients who can benefit from these technologies.
Preimplantation genetic diagnosis, or PGD, is a micromanipulation technique that allows us to test embryos created with IVF for certain types of genetic conditions. Diseases such as Tay-Sach's, sickle cell anemia, or cystic fibrosis can cause severe pain, lifetime disability, and even death. For couples who know that they carry the genetic predisposition for such diseases, the chance to ensure that it will not be passed on to their children can be the difference between happiness and immeasurable suffering.
A PGD biopsy is performed once the embryos have reached the three-day stage, when there are at least six to eight cells. At this stage, there is no specialization of cells, so the removal of one or two will not harm the embryo or result in developmental damage. The testing phase of preimplantation genetic diagnosis will take place next, at which time the extracted cells will be examined for indications of the genetic disease. The type of test performed depends on what the embryo is being screened for. Once it has been determined which embryos carry the condition and which do not, the embryo transfer procedure can be performed with the healthy embryos.
It is important to recognize that PGD is not a general screening method. It allows us to check for specific conditions and is offered to couples who know that they carry a genetic disease and have a high risk of passing that condition on to their children.
Women who undergo preimplantation genetic diagnosis significantly reduce their chances of having a baby with a genetic disease. However, it is recommended that additional testing be conducted once the pregnancy is established, just to be sure. A chorionic villus sampling can be performed at 10 to 12 weeks, or an amniocentesis can be performed after 15 weeks. Each of these tests is highly effective for ensuring that the developing fetus is healthy and normal.
Intracytoplasmic sperm injection, or ICSI, is another micromanipulation technique that allows us to overcome very severe forms of male factor infertility. It is also useful when standard IVF does not result in any fertilized embryos, despite adequate supplies of both oocytes and sperm.
IVF with ICSI involves the same stages as standard IVF up until the actual combination of sperm and eggs. Instead of simply placing each oocyte in a dish with a sample of washed, sorted sperm and waiting for fertilization to occur on its own, our specialists actually select individual healthy and motile sperm cells and use an extremely fine needle to inject them directly into each oocyte.
Once each oocyte has been fertilized with ICSI, the resulting embryos are placed in an incubator where their development will be monitored over the next three to five days. The percentage of fertilized embryos that will successfully develop after ICSI is similar to the percentage that will result after standard IVF.
Assisted hatching is a technique that may help with the implantation stage of conception. Because the embryo must hatch from the zona pellucida before it can attach to the uterine wall, there is a theory that failure to implant may be due to an embryo's inability to escape from its shell. To aid in this process, we use extremely fine instruments to create a small opening in the zona pellucida prior to embryo transfer.
Assisted hatching has been helpful for women in their later reproductive years, those with thicker-than-average zona pellucidas, and those for whom implantation has been unsuccessful, despite good-quality embryos.
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Contact us today to learn more about ICSI, PGD (preimplantation genetic diagnosis), or assisted hatching.