Sex selection is the attempt to control the sex of the offspring to achieve a desired sex. It can be accomplished in several ways, both pre- and post-implantation of an embryo, as well as at birth.
After ovarian stimulation, multiple eggs are removed from the mother. The eggs are fertilized in the laboratory using the father's sperm in a technique called in vitro fertilization (IVF). "In vitro” is Latin for "within glass". Fertilized eggs are called embryos. As the embryos develop through mitosis, they are separated by sex. Embryos of the desired gender are implanted back in the mother's uterus.
Prior to fertilization with IVF, the fertilized eggs can be genetically biopsied with preimplantation genetic diagnosis (PGD) to increase fertilization success. Once an embryo grows to a 6-8 cell size, a small laser incision in the egg membrane (zona pellucida) allows safe removal of one of the cells. Every cell in the embryo contains an identical copy of the genome of the entire person.
Removal of one of these cells does not harm the developing embryo. An embryologist then studies the chromosomes in the extracted cells for genetic defects and for a definite analysis of the embryo’s gender. Embryos of the desired sex and with acceptable genetics are then placed back into the mother.
The IVF/PGD technique is favored over the Ericsson method because of the stricter control of the offspring gender in the laboratory. Since only embryos of the desired sex are transferred to the mother, IVF/PGD avoids the small likelihood present in the Ericsson method of an undesired sperm fertilizing the egg. Gender selection success rates for IVF/PGD are very high. The technique is recommended for couples who will not accept a child of the undesired gender.
Surrogacy Programmes at Dar IVF & Fertility Clinic
Surrogacy is an arrangement in which a woman carries and delivers a child for another couple or person. This woman may be the child's genetic mother (called traditional surrogacy), or she may carry the pregnancy to delivery after having an embryo, to which she has no genetic relationship, transferred to her uterus (called gestational surrogacy).
Our surrogacy program gives you the opportunity to make dreams come true for yourself and for couples and singles, who can’t have their own children.
While not biologically related to the baby they carry, Surrogates play the most critical role in the process—carrying and delivering the baby created through eggs donated by the mother or an egg donor and sperm from a sperm donor or father.
For the intended parents you’ll be working with, you provide something that no one else can—a miracle for their family. But, what you can provide for your own family is equally important. Your family will see the amazing contribution you have made to others while receiving a generous compensation package that can change the future for you and your loved one.
Our program strongly believes in supporting surrogates during each step of the process. Our exceptional team of accomplished professionals will guide you through the entire journey while providing constant, personal support for you and your intended parents. When you contact us, our first goal is to provide you with information about our surrogacy programs and to understand your expectations of the surrogacy process. We will thoughtfully match you with intended parents who desire the same experiences you do.
ICSI (intra-cytoplasmic sperm injection) is an assisted conception technique, which may be, used where a male has only a few live sperm or where sperm quality is poor or lacking motility
It can overcome problems in which a sperm cannot drill a hole through the egg to fertilise it (for example, because of abnormalities affecting the sac of enzymes on the sperm head), and where anti-sperm antibodies are present. It can also be used where a male undergoing cancer treatment has previously frozen a sample of his sperm, and wants to maximise their potential use. ICSI has been used where there is a blockage preventing release of sperm, as the sperm can be obtained from the epididymis (the tube leading from a testis) or from the testis itself using a fine needle.
During ICSI, a single sperm is injected directly into the white (cytoplasm) of a mature egg using an ultra-fine glass needle (pipette). The fertilised egg is then observed until it has undergone a certain number of divisions before being transferred into the woman's reproductive tract.
A fertilisation rate of 50 per cent is usual, with 80 per cent or more fertilised eggs starting to divide as normal. Factors such as the woman's age (and therefore the age of her eggs) affect the success rate. The average live birth rate is 22 per cent, per embryo transfer, but the success of ICSI depends on the skill and experience of its practitioners
Sperm can be frozen for future use either in artificial insemination or other fertility treatments, or be donated
Donated sperm has to be stored for six months before it can be used in treatment, in order to screen the donor for infections.
Sperm cells have been frozen and thawed successfully for more than 40 years.
By storing your sperm, you may be able to use them for treatment in the future. You may want to discuss freezing your sperm with your GP or clinician if:
You do not need to spend time and money on an outside egg donation agency. We do it all here.
An appropriate egg donor is chosen by the infertile couple and thoroughly screened for infectious diseases and genetically transmissible conditions.
The donor is stimulated with injected medications to develop multiple egg development. This allows us to perform in vitro fertilization with her eggs and the sperm of the infertile woman's male partner.
Intra Uterine Insemination - IUI
In an IUI procedure, the practitioner inserts specially treated sperm through the cervix into the woman’s uterus. IUI increases the likelihood of fertilization. This procedure is performed around the time of ovulation. In some cases, particularly if low sperm count is a concern, two IUI procedures can be performed several hours apart. IUI may use the partner's sperm, or if indicated, sperm from a donor.
Intrauterine insemination with partner's sperm can be used as a potentially effective treatment for infertility of all causes in women under about age 45 except for cases with tubal blockage, severe tubal damage, very poor egg quantity and quality, ovarian failure (menopause), and severe male factor infertility. In vitro fertilization with the woman's eggs or IVF with donor eggs are alternatives for couples that are not candidates for artificial insemination.
It is most commonly used for infertility associated with endometriosis, unexplained infertility, anovulatory infertility, very mild degrees of male factor infertility, cervical infertility and for some couples with immunological abnormalities.
It is a reasonable initial treatment that should be utilized for a maximum of about 3-6 months in women who are ovulating (releasing eggs) on their own. It can be reasonable to use it for somewhat longer than this in women with anovulation that has been stimulated to ovulate.
It should not be used in women with blocked fallopian tubes. Tubal patency should be demonstrated prior to performing insemination. This is usually done with an x-ray study called a hysterosalpingogram.
It has very little chance of working in women that are over 40 years old, or in younger women with a significantly elevated day 3 FSH level, or other indications of significantly reduced ovarian reserve.
If the sperm count, motility or morphology is slightly low, insemination is quite unlikely to be successful. In that situation, IVF with ICSI is indicated and has high success rates.
Most programs have the woman remain lying down for 5 minutes following the procedure, although this has not been shown to improve pregnancy rates. Since the sperm is above the level of the vagina, it will not leak out when she stands up.
This procedure, if done properly, usually seems similar to a pap smear for the woman. There should be little or no discomfort.
Success rates for intrauterine insemination vary considerably and depend on the age of the woman, type of ovarian stimulation (if any) used, duration of infertility, cause of infertility, number and quality of motile sperm in the washed specimen, and other factors. Rates for women over 35 drop off, and for women over 40 are much lower. For this reason, we are more aggressive in "older" women.
Pregnancy rates are lower when insemination is used:
The rates are slightly higher for women that do not ovulate on their own (anovulation) that are stimulated to ovulate with medication and then inseminated. This is because it is likely that the sole cause of their infertility is their ovulation disorder - which is overcome with the use of the ovulation stimulating medicine.
For a couple with unexplained infertility, the female age 35, trying for 2 years, and normal sperm - we would generally expect about:
Ovarian stimulation with clomiphene citrate versus stimulation with injectable gonadotropins (Pergonal or Follistim)
Although there is not universal agreement in published studies or among infertility experts, intrauterine insemination with partner's sperm in conjunction with ovarian stimulation seems to provide higher pregnancy rates than insemination in natural menstrual cycles (without ovarian stimulation).
Insemination combined with ovarian stimulation with injectable gonadotropins provides better pregnancy rates (and higher multiple pregnancy rates) as compared to insemination combined with clomiphene. Injectable gonadotropins usually stimulate more mature eggs to develop than does clomiphene. More mature follicles and eggs lead to more chance for a pregnancy. However, more follicles and eggs also entail more risk for multiple pregnancy. It is a double-edged sword...
How many insemination cycles should be done?
Most pregnancies with insemination using partner's sperm occur in the first 3-4 attempts. The chances for success per month drop off after about 3 attempts and considerably more after about 4-6 unsuccessful attempts. Therefore, this therapy is not usually recommended for more than a maximum of 4-6 cycles. If the reason for infertility is lack of ovulation (anovulation) then it may be more reasonable to try several more cycles (6-12 cycles total). In vitro fertilization is the next step in treatment after inseminations - and has a much higher success rate per cycle.
© 2024 Dar IVF, Fertility and Maternity Clinic Haki zote zimehifadhiwa.
