17.10.2011

Year of synchronized oocyte donation - results

Since the summer of 2010, we began to routinely apply synchronization of the donor's and recipient's cycle in the egg donor program. In 1 year we performed a total of 45 transfers in 42 patients. We are still awaiting the result in 3 cases. 18 transfers ended successfully, that is in pregnancy, which represents a success rate of 43% per synchronized transfer. We have frozen additional embryos in most pairs so an overall, so-called cumulative success rate, exceeding 50% can realistically be expected. Our results demonstrate that the egg donor program is a highly effective treatment in cases, where the woman no longer has her own high-quality oocytes available to her. The good news is that we are still able to secure this treatment within a very short period, without the need of waiting an unbearably long time before a donor is assigned.
MUDr. Jan Šulc



17.10.2011

Permanent monitoring of fertilization and development of embryos

Following a trial period at our worksite, we have since June 2011 routinely used permanent monitoring of fertilization and in vitro embryonic development.
We are equipped with a “Primo Vision” system.
We installed special cameras in the incubator that scan the development of embryos in a preselected interval (in our case, every 15 minutes). They are located in a cultivation dish in numbered pits – always embryos from a single patient in a single dish. The scanned pictures are stored and processed.
Selection of embryos for ET: a detailed analysis of information acquired (origination times of individual stages of development, appearance of embryos and monitored structures, synchronization of cell division, and overall dynamics of development) allows us to select the best embryos for transfer.

Benefits of using permanent monitoring:
1. We do not need to inspect the development of embryos under a microscope; the cultivation dishes do not thus have to be removed from the incubator.
2. We gain a continuous overview of embryo behaviour – we are able to select those that have the greatest chance of successful development.
3. A statistical evaluation of the acquired data group allows us to improve diagnostics of oocyte or spermiological factor, resp. during challenging development of embryos.

The only drawback of permanent monitoring, aside from its high procurement cost, is the embryological difficulty - the entire process requires high manual proficiency, extensive theoretical knowledge and practical experience.

We are convinced that the implementation of this modern technology further increases the likeliness of successful treatment.

RNDr. Lucie Zetová, MUDr. Jan Šulc



17.10.2011

Encouraging results of the PICSI method

At our clinic last summer, as one of the first in the C.R., we introduced oocyte fertilization using the PICSI method (see news events on 18.8.2010). After a year, we are able to introduce the first results.

Between the periods of 17.8.2010 to 24.8.2011, we applied the PICSI method for fertilizing eggs in 40 cases. We are still waiting on the result in 3 pairs; where the result is known, the achieved success rate is 43.2%.

It should be noted that over the past year, we recommended PICSI in an absolute majority of cases to pairs that have had a history of repeated unsuccessful transfers. The average age of the women in this group additionally approached 35 years. Even during this negative selection, the PICSI method proved to be highly effective. It can realistically be expected that during the primary selection of fertilization using PICSI we will achieve an even significantly higher rate of success.

MUDr. Jan Šulc


11.10.2011

PICSI = preselected intracytoplasmatical sperm injection


PICSI = preselected intracytoplasmatical sperm injection
So far, PICSI represents the only truly working test in laboratory conditions allowing selection of a ripe sperm. In connection to theoretical knowledge, it may be said that the genetic information of a ripe sperm is most unlikely to be damaged. Fertilizing an egg with such a sperm gives high chance of creating a quality embryo capable of proper development. Such sperm is not necessarily the fastest one, nor does it have to be the best looking to the embryologist. This means it does not have to be successful in spontaneous fertilization; and the embryologist does not need to choose it for injecting into an egg. However, it is possible to detect it using the PICSI method...
This method is based on bonding a ripe sperm onto specially treated surface of a Petri dish. The head of a ripe sperm carries a specific receptor allowing its bonding to hyaluronate. This substance represents an important part of the intercellular substance of egg shells; it is the bonding of a sperm to hyaluronate that is crucial for fertilization. During the PICSI method, ripe sperm is bonded to gel with hyaluronate, thus allowing an embryologist to select the most suitable ones, using them to fertilize the eggs by intracytoplasmatic injection (=ICSI).
dr. Šulc, dr. Zetová