What technology is available that can help with successful treatment?

Andrew Drakeley

Posted by Andrew Drakeley

13 April 2018

 

Technology

 

In the 40 years since the first successful IVF treatment, the science and technologies behind fertility treatment have made huge steps forward. Here at the Hewitt Fertility Centre, we utilise a number of these modern procedures and equipment to ensure that we can give people the best possible chance of overcoming their issues and achieving their dream of becoming parents.

While it is the amazing staff of nurses, consultants, surgeons and midwives who work tirelessly to help those suffering with fertility issues overcome them, without the scientific advancements of the last 40 years, the efficiency and comfort of treatment as well as the success rates of IVF and other fertility treatments would not have improved to the level they are at today.

In this blog, we will outline 4 of the technologies that we utilise here at The Hewitt Centre, and how their use increases the chances of you conceiving a healthy baby.

  1. ICSI

Much like IVF, Intercytoplasmic Surgical Implantation, or ICSI, involves the extraction of an egg and sperm cell, and the combining of them in a laboratory to make a viable embryo. The difference lies in how the two cells are combined. In IVF treatment, the egg and sperm are placed inside a solution that mimics the inside of a woman’s uterus; the sperm is then allowed to naturally fertilise the egg. The problem with this method is that some men produce sperm that has low or no motility, meaning that the sperm cell does not have the capacity to enter the egg under its own volition.

This is where ICSI becomes useful. In ICSI treatment, extremely fine needles are used in conjunction with powerful microscopes to isolate a single sperm cell, stun it temporarily, and then inject it directly into the female egg. ICSI treatment is often used when regular IVF treatment has consistently been unsuccessful, and is more commonly used with older patients who are more likely to suffer with more severe fertility issues.

ICSI was actually discovered by accident by a team of Belgian embryologists back in 1992. Original experiments in deliberate placing of sperm cells within eggs were limited to placing the sperm just inside of the external “shell” of the egg, in the belief that to completely penetrate the egg cell would kill it and the embryo would be unusable. Fortunately, while carrying out one of these initial experiments, a somewhat clumsy embryologist accidentally placed his syringe into the heart of the egg cell and implanted the sperm within. To everybody’s surprise, not only did the egg survive, the egg fertilised successfully and went on to develop into a healthy embryo. ICSI was born.

2. EmbryoScope

During IVF or ICSI treatment, the development of embryos needs to be monitored by the scientists within labs to ensure that they are progressing healthily. The traditional method of storing developing eggs was within incubation units, allowing the temperature, PH, humidity and atmosphere the embryo is held in to be regulated and as close to the natural environment of the womb as possible.

The issue with this was that, to examine the developing embryo the scientist would need to remove the sample from incubation, place it under a microscope for inspection, and then back into the incubator. This method was flawed for two reasons, firstly – the regular removal, and incubation of the embryo would lead to changes in the temperature of the embryo; something which is not conducive with healthy development. Secondly, the embryo could only be monitored for a very short time, a couple of times a day; this meant that if abnormalities were developing within the embryo, they could easily be missed.

Thankfully, in 2009, a new approach to incubation was invented – the EmbryoScope. This piece of equipment, used regularly here at The Hewitt Fertility Centre, utilises time-lapse imagery in conjunction with incubation. This means that we are able to keep the embryo in a safe and healthy environment constantly, whilst a special camera within the incubation machine takes a photograph of the developing embryo every few minutes to give the scientific staff an understanding of how well the embryo is developing and be able to spot any abnormalities almost instantly.

Each EmbryoScope unit can hold more than 70 embryos at once, and here at The Hewitt Centre we have dozens of units in operation at any given time.

 

3. Egg Freezing

Egg freezing, or Oocyte Cryopreservation, may seem like a relatively straightforward procedure however, it is a process that has taken more than 30 years to perfect and steps forward in the technology surrounding egg freezing and preservation are still being made today.

First attempted in the 70’s, egg freezing is utilized for numerous reasons; be it to preserve the fertility of those undergoing Chemotherapy - where fertility can be damaged, those undergoing assisted reproduction technologies who - for ethical reasons - do not believe in the destruction of unwanted embryos, or those who may be serving in the military or other life-threatening scenarios and wish to give their partner the chance to create a family in the result of their death.

More recently, social egg freezing, also known as elective cryopreservation, has become increasingly popular. Women who feel that, for reasons such as career commitment, lack of a suitable partner or just freedom of choice are opting to freeze their eggs until some point in the future that they feel happier becoming pregnant.

The process behind egg freezing involves either slowly or very quickly cooling the egg until it is frozen. Slow-freezing is a more common procedure and less costly however, the process can allow ice crystals to form from the water contained in the egg cell, this can jeopardise the safety of the egg and lead to an unusable embryo when thawed and fertilised. To overcome this issue, a process called Vitrification was introduced in the late nineties. Vitrification involves the removal of water from the egg, the rapid cooling of the cell and the introduction of chemicals called “Cryoprotectants” to protect the cell while it is being frozen. Vitrification has massively increased the success rates of fertility treatments using frozen eggs and its availability is becoming more and more widespread.

4. PGT

PGT, or Pre-implantation Genetic Testing (PGT) involves the testing of cells from embryos created following IVF to establish whether those embryos contain chromosomal abnormalities or particular gene defects that could lead to failure of an embryo to implant, miscarriage, or genetic complications in the child born.

Here at The Hewitt Fertility Centre, we offer two variations of PGT to potentially increase the chance of successful treatment and to minimise the risk of the child being born with a genetic condition. PGT may give us the potential to select the best possible embryo for transferring into the uterus to ensure that we provide you with IVF treatment that has the best chance of giving you a healthy baby.

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Andrew Drakeley

Author: Andrew Drakeley

Mr Andrew Drakeley is the Clinical Director at the Hewitt Fertility Centre, working principally at the Liverpool Women’s site but with managerial responsibility for Knutsford. He holds subspecialty accreditation in Reproductive Medicine and surgery and is a fellow of the Royal College of Obstetricians and Gynaecologists, being appointed Consultant in 2005.
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