Additional technologies regarding in vitro fertilisation aim at increasing treatment effectiveness in a specific clinical situation. This means none of them is documented enough to be used for all patients or selected patient groups. However, scientific reports indicate that in individual, justified situations they can improve treatment effects.
As part of in vitro fertilisation at CM Macierzyństwo, our patients can benefit from the Primo Vision time-lapse embryo imaging system. Due to the system of microscopes-cameras, Primo Vision allows continuous observation of embryo development without removing them from the incubator. The imaging material collected throughout the culture duration enables detailed analyses of cell divisions and generation of a video presenting all stages of the development.
During standard embryo culture (without Primo Vision), fertilised cells are placed in the incubator where the temperature of 37 degrees as well as increased carbon dioxide and reduced oxygen levels are maintained. During next days, the course of fertilisation and development is assessed once a day under a microscope. Based on these evaluations, properly developing embryos are transferred or frozen.
After their fertilisation, the cells are placed in the incubator equipped with the system of microscopes-cameras. Due to this, their development is monitored all the time – the camera takes images every 5 minutes and the current culture status is displayed on the screen. The embryos are not removed from the incubator until the day of their transfer.
The system ensures:
Assisted hatching of embryos involves making a laser cut in the so-called zona pellucida immediately before its transfer to the uterus. The zona pellucida is an outer layer of cells surrounding the egg and then the developing embryo. If the embryo is to implant in the uterus, it must break out of the surrounding shell. Embryo hatching is a natural stage of development; embryos manage to handle this on their own both during natural conception and in vitro fertilisation.
Assisted hatching is considered in the following situations:
EmbryoGlue is a special medium used for embryo transfer to the uterus. Its composition makes it mimic natural uterine secretions – EmbryoGlue contains high levels of hyaluronan and recombinant human albumin. Due to these components resulting in higher viscosity, it should enhance implantation of an embryo in the uterus. EmbryoGlue is particularly recommended for couples with previous failures of in vitro fertilisation.
The ICSI (Intracytoplasmic Sperm Injection) method involves injection of a single sperm cell into the egg using a fine micropipette. The sperm is selected by the embryologist based on its morphology, i.e. its ‘appearance’ and motility. Thus, ICSI mimics natural mechanisms of sperm selection during conception but it does not allow selection of a sperm cell based on its chromatin integrity and/or full maturity.
IMSI (Intracytoplasmic Morphologically selected Sperm Injection) uses extra magnification before fertilisation. A special lens and software enable observation of vacuoles in the sperm head; their presence correlates with its chromatin damage. Vacuole-free sperm cells are selected for fertilisation as they bear a smaller risk of chromatin damage. IMSI is particularly recommended when the result of previous sperm chromatin testing is abnormal.
PICSI is based on the ability of mature sperm cells to bind to hyaluronan. A fully mature sperm has got better chances of fertilising an egg successfully. For PICSI fertilisation, a special dish is used to select sperm cells based on their binding to hyaluronan which means the end of sperm maturation process. PICSI is particularly recommended when the result of previous sperm HBA is abnormal.