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Blastocyst Transfer

A blastocyst is an advanced stage of embryo development wherein embryos are cultured in the laboratory upto Day 5.Earlier,embryos did not survive in artificial environment much longer than three days.But with advancement in available culture media and state of art laboratory conditions,embryos can be grown upto blastocyst stage

What are the benefits of blastocyst transfer?

The embryo has advanced to Day 5 stage which means the embryo has divided many more times into many more cells.
Blastocyst has a very thin outer shell which increases the chances of implantation.
Eliminates abnormal embryos with incorrect number of chromosomes as they fail to progress till Day 5.
Increases chances of pregnancy especially in patients with recurrent IVF failure.

Success rate of blastocyst transfer ?

The chances of pregnancy after blastocyst transfer are very high compared to Day 2 or Day3 embryo transfer with good selection of cases.
Blastocyst development is completely dependant on good laboratory conditions.
Aakar IVF Centre has a state of art laboratory with blastocyst formation rate of 70-80% and 50% pregnancy rates.

Endometrial receptivity array

It is a recent advance in the field of assisted reproduction to know the window of implantation.
The test assesses genetic profile of the endometrium and detects whether the endometrium is receptive for implantation of the embryo.
This test is helpful for patients with history of repeated failed IVF cycles despite transfer of good quality embryos and normal uterine lining.

How is it done ?

Hormonal replacement therapy i.e estrogen and progesterone supplements are given from day 2 of cycle.
Development of uterine lining is monitored by serial sonography and once adequate lining achieved,progesterone therapy is started.
ERA biopsy i.e a sample of the uterine lining is taken five days after starting your progesterone support under short general anaesthesia.
The test result suggests the optimal timing of embryo transfer to increase the chances of implantation.
According to the test results, personalized timing of embryo transfer is planned.

Benefits of ERA

It is an accurate test to determine the implantation window.
It decreases the number of IVF cycles required in cases of repeated failed IVF cases where the cause is implantation failure with good uterine lining.
ERA test claims 73% pregnancy rate on the basis of current research till date.

PRP therapy for thin endometrium

Thin endometrium is one of the major reason for repeated failed IVF cycles and cancellation of planned cycles due to non-development of the lining of the uterus.
Endometrial lining at the time of embryo transfer plays a pivotal role for implantation to occur.

Reasons for thin endometrium

Women with previous history of repeated uterine curettage for abortions.
Uterine Infections affecting the lining of the uterus.
Women having Asherman’s syndrome which is fibrosis within the uterine cavity forming adhesions.
Cancer treatments such as chemo and radiotherapy.

PRP i.e Platelet Rich Plasma: What is it ?

PRP contains activated platelets that stimulates action of growth factors in the endometrial lining.
It causes proliferation of endometrial cells and helps in increasing the thickness of the uterine lining.
It also increases the blood supply to the uterine lining thus, improving the endometrial receptivity and implantation rates.

When and how is the PRP procedure done ?

It is usually recommended during Day 8-10 of the Frozen embryo transfer cycle.
The number of PRP sessions required will depend upon the patient’s response to the treatment.
Patient’s blood is collected and is processed in the laboratory by a method called centrifugation during which the blood containing tube is subjected to spinning for 10 minutes at the rate of 1500 rpm.
This allows separation of platelets from the blood sample.
The obtained platelets are then infused into the uterine cavity through a soft catheter under sonography guidance.
The endometrial lining is re-assessed after 48-72 hours to know the response post treatment.

Our team at AAKAR IVF Centre has achieved excellent results with PRP therapy in patients with thin endometrium and repeated implantation failure.

PESA, TESA and TESE

Percutaneous Epididymal Sperm Aspiration (PESA)

It is a sperm retrieval technique wherein a needle is inserted into the man’s epididymis, a long coiled tube that stores sperm and transports it from the testis.

Steps involved

It is usually done under local anaesthesia.
A small needle is inserted into the epididymis and the seminal fluid is aspirated into the syringe.
The seminal fluid is then examined for sperms by an embryologist.
The same procedure is repeated until adequate number of sperms are retrieved.

Testicular Sperm Aspiration(TESA) and Testicular sperm extraction(TESE)

These procedures are performed if no sperms are found within the epididymis during PESA.
TESA involves aspiration of seminal fluid by insertion of the needle directly into the testicles and if no sperms are retrieved, then TESE is performed.
In TESE, surgical biopsy of the testicular tissue is taken and examined under microscope under high magnification for presence of sperms.
These procedures are performed under short general anaesthesia.

Certain FAQs

When is it done ?

It is usually done on the day of egg collection.

What is the process after sperm retrieval ?

The retrieved sperms are thoroughly inspected under microscope for motility and morphology and are then individually injected in the mature egg by ICSI i.e Intracytoplasmic sperm injection procedure.

What are the chances of fertilization ?

It depends upon the sperm quality. Cases with obstructive pathology but good quality sperms have better results.

Indications

Azoospermia which is a medical condition where in there are no sperms present in the semen. It could be due to obstruction in the sperm delivery system or reduction in sperm production in the testes.
Varicocele, a condition in which there is an enlargement of the veins within the scrotum which can cause obstruction to the flow of sperms out of the testicles, low sperm production and decreased sperm quality.
Patients with chromosomal abnormalities have decreased sperm production. TESA or TESE may help in such conditions for sperm retrieval.