Family Balancing/Gender selection is the attempt to control the sex of the offspring to achieve a desired one. It is permissible in most of the world, and practiced in Western countries including the United States. It can be accomplished in several ways, both pre- and post-implantation of an embryo.
In the IVF/PGS method, after ovarian stimulation, multiple eggs are removed from the mother. The eggs are fertilized using the father's sperm, and as the embryos develop through mitosis, they are separated by sex. At Life IVF, the fertilized eggs are biopsied for genetic testing/screening at the blastocyst stage with pre-implantation genetic testing (PGS) for safer results and greater implantation success. Then, a FISH, CGH or Micro-array test is available to test the extracted cells for genetic abnormalities and for a definite analysis of the embryo's gender. Embryos of the desired sex and with acceptable genetics are then implanted back into the mother's uterus.
Gender selection success rates for IVF/PGS are very high, around 97-99%. This technique is recommended for couples who will not accept a child of the undesired gender.
ICSI is one of the most significant advances in ART history in the last 30 years. Only mature eggs can be inseminated. Insemination, whether it is natural or Intra Cytoplasmic Sperm Injection (ICSI), occurs in the afternoon of the retrieval day (Day 0).
During the ICSI procedure, an egg is stabilized under the microscope with a special micro-holding pipette; and a single sperm is picked up by a small needle and injected directly into the egg. Fertilization will be evaluated after18 to 22 hours. ICSI is recommended for male patients who had poor semen analysis parameter, prior failure in fertilization experiences, or significant anti-sperm bodies.
ICSI has a significantly higher fertilization rate; we recommend most of our patients to undergo ICSI. If patients do not want ICSI, please notify our embryologists on the same day of Egg Retrieval.
A fertilization check will be done by the embryologists in the following day (Day1). Patients will be notified by an E-mail regarding the fertilization status in the afternoon.
Our center policy is once patients have had a failed frozen Day 2 embryo transfer before or a fresh Day 2 embryo transfer, we strongly suggest to culture all embryos to blastocyst; and then transfer. If the embryos become blastocysts during Day 5 to Day 7, we will freeze the embryos for your next cycle, for a frozen embryo transfer (FET).
When the embryo develops to the point that it is ready to implant in the endometrium of the uterus, it must hatch out of the egg shell (zona pellucida). If the zona is abnormally thickened or it is a frozen-thawed embryo, it may make it more difficult for the embryo to hatch out and implant in the uterus. Assisted hatching is performed in the IVF lab using micromanipulation instruments. Our embryologist will make a hole on the zona before the embryo transfer. There is some evidence that embryos that have undergone zona manipulation for assisted hatching tend to implant one day earlier than unhatched embryos.
LIC uses vitrification, the most advanced method of cryopreservation. This will allow oocytes/embryos to be utilized at a later date. Most recent studies have shown that the frozen embryo transfer has higher pregnancy rate than a fresh embryo transfer. LIC offers both egg and embryo vitrification program. The vitrification process has a higher survival rate compared to the old method of "slow freezing". After Egg Retrieval, patiens will have an opportunity to discuss with embryologists regarding the embryo culture plan and the stage of embryos, to be cryopreserved.
After eggs are fertilized, the embryos can be frozen at different stages. At LIC, we frequently freeze at the 4 cells stage (D2) or blastocyst stage (D5).
The blastocyst transfer has a higher pregnancy rate than a Day 2 or Day 3 embryo transfer, but not all embryos can grow into blastocysts. Based on the patient's specific circumstance, the embryologist will suggest a particular plan for each individual patient. Please respect and follow the embryologist's recommendations because of their many years of professional experience. All decisions are made with your best interest in mind!