The first step towards IVF begins with the investigation of the reasons why up until now a healthy pregnancy and a child at home have not come about.
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The first step is examining the levels of the reproductive hormones.
At Embryolab we have a modern and accredited Hormone and Immunology lab to cover all requirements promptly, directly and effectively by testing the level of the reproductive hormones both in women and men.
At the same time, we test thyroid gland function, and check its hormone level also.
We scrupulously follow international guidelines as well as Greek legislation by testing both the woman and the man for four infectious diseases, namely AIDS, hepatitis C, hepatitis B (Australia Antigen) and syphilis.
Cystic fibrosis is the second most common genetic disorder (after thalassemia) in Greece. At Embryolab we screen both the woman and the man as potential carriers of the disease. For the man, in particular, fertility would be reduced were he to be a carrier.
Karyotype screening examines if there are any numerical or structural chromosome abnormalities.
Chromosome abnormalities may affect fertility and lead to miscarriages.
Thrombophilia covers a broad range of conditions which affect blood coagulation, creating clots. Usually thrombophilia affects pregnancy by triggering miscarriages. By monitoring thrombophilia at Embryolab we examine a wide spectrum of its possible causes in order to deal with each case successfully.
Blood, biochemical and molecular tests
As a part of a wider investigation, we request a series of blood tests (general, electrophoresis and hemoglobin), biochemical tests (sugar, iron, etc.), as well as molecular analyses (such as Y chromosome microdeletion check) so we can examine numerous parameters which might complicate the IVF effort.
The ultrasound check is carried out to monitor ovulation induction parallel with the hormonal screening to determine ovarian response during treatment.
By using the ultrasound system Voluson Expert and volumetric calculation software provided by the system together with 3D imaging, we can accurately measure the number and volume of follicles.
Thus, we avoid any discrepancies arising from manual 2D analysis, due to the irregular shape of follicles.
The accuracy of our analysis enables us to implement the most appropriate and safe pharmaceutical protocols for every woman on IVF treatment.
Endometrial Function Test (EFT)
The control method of endometrial function applied at the Yale School of Medicine seems to be the most effective way to evaluate the receptivity of the endometrium in order to select the appropriate treatment program for IVF.
Embryolab has adopted this method in order to select the most appropriate treatment regime for assisted reproduction.
The endometrium is the ultimate target of the whole process, as this is where the fertilised oocytes are implanted. To complete a healthy pregnancy, the endometrium needs to function normally. With the help of the EFT (Endometrial Function Test), any endometrial function abnormalities can be diagnosed.
By applying the appropriate treatment, the endometrium can be restored to normal function and can then allow the normal development of embryos in an appropriate environment.
We check the uterine cavity for the presence of anatomical disorders, such as the presence of polyps, adhesions and fibroids.
If an abnormality is identified, the appropriate surgery is applied, while at the same time the functional stimulation of the endometrium is performed through endometrial scratching.
Around one in two men have some level of low fertility. The spermogram test is the most reliable mean to evaluate a man's fertility. Embryolab assesses and deals effectively with every case of low male fertility.
A spermogram measures the concentration, motility and morphology of spermatozoa from a sample received through masturbation.
Initially we measure the sample volume. The quantity of the semen ejaculated, when the sample collection is complete, determines indirectly the good functioning of the reproductive glands, such as his prostate and the seminal vesicles. The volume of the test sample should be between 1.5 and 6 ml.
Following, we examine the volume of spermatozoa produced in one ejaculation, as well as their motility and morphology.
The numberof spermatozoa produced in one ejaculation, indirectly determines the level of the testicular function of a male. According to the most recent criteria of the WHO, the number of spermatozoa should exceed 15 million spermatozoa per milliliter.
The motility of spermatozoa is an important parameter regarding the sperm's strength. The total of the progressive motile spermatozoa in a fertile sperm should exceed 32% in the first hour of observation (WHO, 2010).
The morphology of spermatooza is also a very important factor. In a fertile sample, spermatozoa with a normal morphology should exceed 5% (WHO, 2009).
In order to be confident and secure in our measurements, we participate actively in the international external quality assessment service (NEQAS) for sperm parameters.>
The FISH analysis (Fluorescent in Situ Hybridization) allows us to check the number of chromosomes in the spermatozoa, something which can't be done with a conventional spermogram. The existence of an increased percentage of spermatozoa with a number of abnormal chromosomes or with an increased number of DNA fragments may indicate low fertility and the likely cause of failed IVF attempts. The accuracy of our measurements is confirmed by our participation in a pilot External Quality Assessment Service (EQAS).
Y chromosome microdeletions
Specific Y chromosome microdeletions have been correlated with severe male low fertility and azoospermia.
Determination of the percentage of spermatozoa with sperm DNA fragmentation (SDF Index).
The SDF Index is a test which determines the percentage of sperm with fragmented DNA. It has been shown that samples of sperm with fragmented genetic material have a direct link with:
With the data available until now, it seems that an 'interruption' rate of over 30% is related to low fertility. In these cases, despite the oocytes' corrective mechanisms, the creation of embryos with a normal genetic makeup is not guaranteed.