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The medical team of ovo fertility was at the origin of two world premieres that opened new horizons for couples with infertility:
Ovulation induction and planned intercourse are often recommended as the initial treatment of infertilty for a couple. As a matter of fact, a large proportion of infertility problems are related to hormonal imbalance causing ovulation disorder. Certain medication can help to restore this natural process.
If needed, an Ovo fertility specialist can monitor your monthly cycle using ultrasound to determine the ideal time for you and your partner to have intercourse. Sometimes, an injection of chorionic gonadotropin hormone (hCG ) may be administrated to trigger ovulation.
Development and implantation of the embryo
Image © Dr. J. Herrero Garcia, provided by EMD Serono, Canada
LHRH pump for amenorrhea
The L.H.R.H. pump is available and the drug is reimbursed by the health insurance plan. This treatment is intended for women who have problems of amenorrhea caused by pituitary gland dysfunction . Through the use of the L.H.R.H. pump, we can reproduce the natural cycle which leads to the ovulation of a single egg. The risk of multiple pregnancies and ovarian hyperstimulation are almost nonexistent.
Artificial insemination involves artificial introduction of sperm (from spouse or donor) directly through the cervix into the uterine cavity using a flexible plastic catheter. This painless procedure brings the sperm closer to the fallopian tubes where fertilization occurs, thereby increasing the chances of pregnancy. Insemination is generally recommended as a « first line » treatment for couples whose infertility is unexplained or in the presence of mild male infertility factor.
We usually start insemination treatment with medication to stimulate the ovaries (ovulation induction). There is also an ultrasound monitoring to assess progress and schedule the date of insemination. Ovulation is triggered by medication and 35 to 40 hours later insemination is performed. In the morning, spouse gives a semen sample to be washed and concentrated, then we proceed with insemination inside the uterus using a catheter through the cervix.
Intrauterine insemination (IUI)
Image © Dr. J. Herrero Garcia, provided by EMD Serono, Canada
IUI is not recommended for patients over 43 years-old.
«You made our dream a reality! Million thanks!»
Stéphanie Lamothe – ovo fertility patient
Natural cycle IVF (nIVF) was used for the very first test-tube baby born in England over 35 years ago. nIVF is an excellent treatment because of its natural process (respecting the normal ovulatory cycle) and minimally invasive characteristics (no ovarian stimulation with drugs).This technique was replaced by IVF following ovarian stimulation. The idea is to produce many eggs using drugs, which is necessary for many infertile couples.
At the forefront of research and technology, the medical team of Ovo fertility contributes to innovation in assisted reproduction treatments.
In vitro fertilization is the fertilization of an egg by a sperm outside the body, in the laboratory. In most cases, a drug which stimulates the ovaries to produce several follicles will be prescribed, and the eggs will be collected and fertilized in the laboratory to create embryos. Usually 5 days later, an embryo will then be transferred to the woman’s uterus. Supernumerary embryos can be frozen for later transfer.
It also happens that it is necessary to freeze all the embryos and thus, not to make a fresh transfer. Several factors may indicate that it is better to postpone the transfer until the next month. This happens in about 50% of IVF cycles and will be discussed with you if necessary.
Egg Retrieval
Image © Dr. J. Herrero Garcia, provided by EMD Serono, Canada
Fertilization — in vitro fertilization (IVF) and intracytoplasmic injection of a spermatozoid (ICSI)
Image © Dr. J. Herrero Garcia, provided by EMD Serono, Canada
«Thanks to you and your website. Miracles exist. We had 3 nIVF to ovo and we had three beautiful boys with this technique. We are a family filled with happiness. Thanks to ovo. Thank you life.»
Marie-Claude – patiente ovo fertilité
The woman’s ovaries are stimulated with hormone injections she gives herself to produce several oocytes (or eggs). The stimulation process lasts between 2 and 5 weeks. The rationale behind the stimulation is that the more eggs obtained, the greater the number of embryos produced and the easier the choice for the transfer.
During this period, the growth of the follicles is monitored by ultrasound. It may require between 2 and 4 ultrasounds, as needed.
Once the stimulation is completed, egg retrieval takes place whereby eggs are obtained from the follicles. This procedure is carried outtransvaginaly, under local anesthesia and intravenous sedation. All the follicles are emptied and the eggs are cultured in the laboratory and put in contact with sperm collected on the same day.
In the case of a fresh embryo transfer, 5 days later the embryo obtained in the laboratory is transferred in the uterus of the patient to be implanted. Supernumerary embryos will eventually be frozen. In about 50% of cases, we will have to wait 1 month for the embryo transfer. Drugs are needed after embryo transfer to improve implantation. Two weeks after the egg retrieval, a pregnancy test will allow us to determine if the implantation has occurred.
Embryo transplant
Image © Dr. J. Herrero Garcia, provided by EMD Serono, Canada
«For me and my partner, participation to a research project was a positive experience. Our involvement in the research project gave us another chance to realize our dream of having a baby. Our commitment may have contributed to the progress of science and future benefits for other couples. We had a customized monitoring and a privileged access to a dedicated nurse.»
ovo r&d patient
In nIVF, the naturally selected egg is recovered after a minimal medical intervention to be fertilized in the laboratory, and then transferred into the uterus after becoming an embryo. This method is more gentle than conventional treatment, because it excludes the stimulation of the ovaries using drugs.It eliminates the side effects of ovarian stimulation in addition to removing the risk of multiple pregnancies except monozygotic pregnancies (identical twins).
The risk of ovarian hyperstimulation syndrome is removed by the same lack of stimulation. Another benefit is the possibility of carrying out cycles in consecutive months.
Indications of nIVF
In general, nIVF is offered to patients with regular cycles, with normal ovarian reserve and less than 37 years old.
nIVF also appears to be a sensible alternative for certain populations of patients with a poor prognosis using ovarian stimulation.
nIVF is also an attractive alternative for women with a history of hormono-dependant cancer where you absolutely want to avoid ovarian stimulation.
The advantages of this minimally invasive treatment are undeniable and the method should be used more, often. However IVF with stimulation remains an essential tool for many infertile couples, especially when the woman is over 35 year-old.
Disadvantages of nIVF
The detractors of nIVF list the daily monitoring, the risk of premature ovulation, an increased risk of cycle cancellation, the requirement for staff to be available day and night, the risk of failing to obtain the oocyte and the chance of cancelling the embryo transfer as major negative points for nIVF. For those reasons, the proportion of cycles that reach embryo transfer from egg collection is around 50%. If there is an embryo transfer, a pregnancy will be obtained in 36% of cycles.
ICSI and embryo development
Image © Dr. J. Herrero Garcia, provided by EMD Serono, Canada
The first pregnancy resulting from egg donation occurred in 1983. Oocyte donation plays a central role in reproductive medicine since it is used to treat a diversity of infertility issues. The conditions for which we should consider egg donation treatment may be premature menopause, the presence of high risk factor for transmission of genetic disease from the mother, loss or decline of ovarian function, repeated poor quality of oocytes , or simply advanced maternal age (less frequent).
In May 2004, the Canadian Government introduced fertility regulations following the entry into force of the Canada Health Act in May 2004: it became increasingly difficult to recruit women to donate their eggs. The Act stipulates that any compensation for egg donation, whatever it could be, is illegal. One can only recompense receipted expenses. As a result, egg donation became and remains an altruistic gesture.
Thus, for legal reasons, it is difficult to encourage women to become a donor. As a consequence, the waiting list of patients seeking treatment with egg donation to conceive continues to grow longer.
A woman interested in becoming an egg donor must be 35 year-old or less. She must meet a doctor at the clinic to receive information about the detailed procedure and to undergo a few tests which are required prior to egg donation. Since the donation is anonymous, the donor’s identification is completely hidden and will never be disclosed to the recipient couple.
Some preliminary tests are required prior to donating. Genetic screening is required to ensure that there will be no transmission of genetic disease. Infectious disease screening is used with the donor and both recipient members of the couple to rule out any hidden infection. Each of them must meet the psychologist to complete their decision with sufficient information and be well prepared to deal with the legal and psychological issues that may result from the donation.
Once all the test results are satisfactory, the donor and recipient meet the doctor again. In case of directed donation, treatment can begin very quickly.
For the donor, she starts taking medication for a period of approximately one month during which there will be between 3 and 5 follow-up visits to check the development of ultrasound follicles containing oocytes. The next step is oocyte retrieval performed by aspiration of follicles vaginally under ultrasound guidance, adding a fine needle at the end of the probe connected to a pump. The procedure is usually performed under local anesthesia along with some sedation. The procedure takes 15 to 30 minutes and the patient can leave 60 minutes later.
For the recipient, mature oocytes are placed in contact with the sperm of her partner and cultured in an incubator. 3 to 5 days later, the embryos are placed in her uterus using a flexible catheter under ultrasound control. Two weeks later, a pregnancy test is performed at the Ovo clinic.
The success rates are high, up to 45%-50% per embryo transfer. Hundreds of women who want to conceive rely on the generosity of other women, perhaps like you. So on their behalf we wish to thank you whether or not you continue the process until the end.
If you need more information, do not hesitate to leave a message on the voicemail of the nurse in charge of oocyte donation at 514-798-2000 ext 132.
If you do not find altruistic donor, and you prefer to undergo egg donation in Quebec, it is possible for you to order vitrified (frozen) eggs. The eggs will be sent to our clinic and will be warmed on site and fertilized with sperm. We will also do the embryo transfer at ovo. Please contact the egg donation department for more information.
This option will be available soon in our clinic. You may contact the egg donation department for further information.
It happens that some men have no sperm in their semen. This is known as azoospermia : they do not produce sperrmatozoa. Therefore their partners cannot get pregnant without the aid of a sperm donor.
For some women, to have insemination with donor sperm is the only way to conceive.
All sperm samples must be frozen 6 months before being used in order to determine that they do not carry an infectious disease.
In order to minimize any risk of consanguinity, a sperm donor can be used for the birth of no more than 10 chiildren.
In at least 40% of infertile couples, the problem is related to the male partner. The urologist-andrologist plays a major role in the management of male infertility. Surgery can be used at ovo fertility to assist male reproduction.
Testes and seminal canal pathology
Image © Dr. J. Herrero Garcia & Dr. Simon Marina, provided by EMD Serono, Canada
When a man shows azoospermia (no spermatozoa in semen) or if the amount of sperm ejaculated is very low, it is possible to take sperm directly from the epididymis or from the testicles. These techniques are coupled with assisted reproduction (FIV – ICSI).
Percutaneous epididymal sperm aspiration (PESA)
This technique can be recommended for males with obstructive azoospermia when the spermatozoa are present and mature, but cannot get out because of an obstruction related to a vasectomy or a congenital absence of the vas deferens.
Testicular Sperm Extraction (TESE)
This is an option for men with a deficiency or complete absence of sperm production at the level of the epididymis due to previous surgery, infection or birth defect.
Testicular spermatozoa collection by microsurgery (micro-TESE)
MicroTESE is the best option for male with non obstructive azoospermia: that is those who show a defect in the spermatozoa production or maturation. This microsurgical technique helps the surgeon to find out the areas where spermatozoa are produced.
. Je vous souhaite à tous et à toutes que vos efforts soient couronnés de succès!