In Vitro Fertilization/Intracytoplasmic Sperm Injection for Male Infertility

By Goral Gandhi (Indo Nippon IVF) – Progress in the field of assisted reproduction, and particularly micromanipulation, now heralds a new era in the management of severe male factor infertility, not amenable to medical or surgical correction.

By overcoming natural barriers to conception, in vitro fertilization and embryo transfer (IVF-ET), subzonal sperm insemination, partial zona dissection, and intracytoplasmatic injection of sperm (ICSI) now offer couples considered irreversibly infertile, the option of parenting a genetically related child.

However, unlike IVF, which necessitates an optimal sperm number and function to successfully complete the sequence of events leading to fertilization, micro manipulation techniques, such as ICSI, involving the direct injection of a spermatozoon into the oocyte, obviate all these requirements and may be used to alleviate severe male factor infertility due to the lack of sperm in the ejaculate due to severely impaired spermatogenesis (non-obstructive azoospermia) or non-reconstruct-able reproductive tract obstruction (obstructive azoospermia).

ICSI may be performed with fresh or cryopreserved ejaculate sperm where available, micro surgically extracted epididymal or testicular sperm with satisfactory fertilization, clinical pregnancy, and ongoing pregnancy rates.

However, despite a lack of consensus regarding the genetic implications of ICSI or the application and efficacy of preimplantation genetic diagnosis prior to assisted reproductive technology (ART), the widespread use of ICSI, increasing evidence of the involvement of genetic factors in male infertility and the potential risk of transmission of genetic disorders to the offspring, generate major concerns with regard to the safety of the technique, necessitating a thorough genetic evaluation of the couple, classification of infertility and adequate counseling of the implications and associated risks prior to embarking on the procedure.

The objective of this review is to highlight the indications, advantages, limitations, outcomes, implications and safety of using IVF/ICSI for male factor infertility to enable a more judicious use of these techniques and maximize their potential benefits while minimizing foreseen complications.

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IVF Lite – A New Strategy for Managing Poor Ovarian Res ponders

IVFLite – Background: Previous trials have shown that neither conventional IVF nor natural cycle IVF is an effective treatment option for poor ovarian responders. However, none of the trials has examined the efficacy of accumulating embryos with serial minimal stimulation cycles, vitrifying the resulting embryos and transferring them in a remote cycle (IVF Lite protocol). Women with poor ovarian reserves, who commonly do not respond to conventional stimulation protocols, are left with few options when planning a family. The current study was undertaken to evaluate the efficacy of serial minimal stimulation in vitro fertilization (ms IVF) cycles with vitrification of embryos for treatment of poor ovarian responders (PORs) as compared to conventional IVF protocols.

Materials and Methods: This is a retrospective data analysis of PORs from June 2010 to November 2012. A total of 222 patients were included in the study. Ninety-seven patients underwent serial minimal stimulation cycles with verification and embryo banking (IVF Lite Group) and 125 patients underwent conventional controlled ovarian stimulation for IVF. The patients identified as PORs based on the Bologna criteria were included in the analysis. In the IVF Lite group, embryos were vitrified using Cryotec vitrfication protocol on Day 3. Once six embryos were banked with us, a frozen embryo transfer was planned. A maximum of 3 embryos were transferred. Main outcome measure was the clinical pregnancy rate defined as positive fetal heartbeat at 12 weeks of pregnancy.

Results: There was no significant difference in the number of meta phase II (MII) oocytes retrieved between the both groups. The difference in the number of gonadotropins units required to produce one MII oocyte between the two groups was statistically highly significant: 680.4 units for the IVF Lite group and 4956.2 units for the conventional IVF group. The IVF Lite group had a higher percentage of good grade embryos. In the IVF Lite group, each patient underwent an average of 2.96 cycles of embryo accumulation before planning a frozen embryo transfer. An average of 6.2 embryos were accumulated for each patient. The clinical pregnancy rate (CPR) per embryo transfer was higher in the IVF Lite group (27.81%) than the conventional IVF group (15.15%). The CPR per patient was much higher in the IVF Lite (48.45%) than the conventional IVF group (24.0%).

Conclusion: The results obtained in the current study demonstrate that the IVF Lite protocol consisting of ms-IVF, ACCU-VIT and rET is a very successful approach in treating poor responders. Very favorable rates of pregnancy can be achieved with IVF Lite protocol.

More Details about the details – Indo Nippon IVF Clinic

Stuck with Infertility? Get the Best IVF Treatment in India

IVF is a magic word to a lot of people/ couple, suffering from fertility issues. Many people still wonder whether this process is right for them or at least safe but the truth is that many women have found success after trying the IVF technique and became pregnant.

What happens during IVF? :

During the process, the eggs are removed from the body of the women and fertilized in the laboratory by the sperm provided by the sperm donor.