Specialized IVF Lab Procedures

In addition to the insemination and culture of embryos, the Continuum Reproductive Center’s on-site laboratory and embryology team also offer the following cutting-edge procedures:

Intracytoplasmic sperm injection (ICSI): At the CRC, the latest micromanipulation techniques can be used to inject a single sperm into the cytoplasm of each available egg, thus improving the chances of fertilization. ICSI is indicated when the number of available, healthy sperm is low. In such instances, standard sperm-egg culture procedures are not sufficient to allow normal fertilization to occur. In addition, ICSI is required when sperm have been extracted directly from the testicles, a procedure performed in men who produce little or no sperm by ejaculation. 

Assisted embryo hatching: Before an embryo may implant into the uterine tissue and establish a pregnancy, the embryo must first shed its outer protein coat, or zona pellucida. This process is known as hatching. In some cases, particularly in older women and in those women whose embryos have a thickened zona pellucida, the process of hatching can be assisted, typically with the use of laser technology or mild acid solutions.

Assisted Embryo Hatching via Laser Ablation - Assisted hatching can be done during the embryo-culture stage of IVF, if deemed necessary. IVF Video

Embryo defragmentation: When the cells that compose the embryos divide unevenly, small cytoplasmic fragments can form that might interfere with normal growth and development. When appropriate, our embryology team has the expertise to perform manual defragmentation of embryos, a procedure which studies indicate may improve the chances of an embryo implanting in the uterus.

Preimplantation genetic diagnosis (PGD): In standard IVF, embryos are graded based on the microscopic assessment of their number of cells, the size of the cells, and the amount of fragments observed in the developing embryos. While the highest-grade embryos often appear to have the greatest chances of implantation, the grading process does not always predict which embryos are the most likely to implant and which appear to be genetically normal. Preimplantation genetic diagnosis (PGD) is a technique that goes further than traditional grading, allowing certain genetic characteristics of each embryo to be determined before transfer into the uterus. PGD is recommended for couples with a history of failed implantation in IVF, recurrent miscarriages, or when one or both partners have a genetic disease or carrier status. The technique involves removing one cell from each embryo (embryo biopsy) and subjecting it to certain laboratory genetic tests. Only those embryos that appear to be normal by this limited testing will be transferred to the uterus. PGD, however, has its limitations. It does not detect all genetic abnormalities. Furthermore, the genetic assessment of a single cell might not accurately reflect the genetic composition of the rest of the embryo from which that cell was taken.

Embryo cryopreservation: High-grade embryos that are not used in the original transfer can be stored for later use. Cryopreserved embryos are typically used if the transfer of fresh embryos fails to result in a live birth or in cases in which a patient or couple did conceive with the fresh cycle and now wants to have another child or children. To prepare the uterus for implantation of a frozen embryo, the patient uses estrogen (oral) and progesterone (injection) hormone therapy. Ovulation induction medications and egg retrieval are not required. Consequently, the fees for a frozen embryo transfer (FET) cycle are lower than for a cycle in which fresh embryos are used. Note that cryopreservation is generally not covered by insurance. Although the pregnancy rates associated with an FET cycle are generally lower than for a fresh cycle, the cryopreservation process is continually improving. 

Oocyte cryopreservation: Oocyte cryopreservation is a process by which a woman’s oocytes (eggs) are frozen for future use. A relatively new procedure, oocyte cryopreservation may allow many women to retain their reproductive potential for years to come. Later, when a woman is medically cleared and/or ready to achieve a pregnancy, in vitro fertilization of the oocytes can take place. Click here to learn more about Oocyte Cryopreservation

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