X

Assisted reproductive techniques

The medical team of ovo fertility was at the origin of two world premieres that opened new horizons for couples with infertility:

  • A successful nIVF using epididymal sperm: the nIVF becomes a simple therapeutic alternative for couples whose spouse had a vasectomy (May 2004).
  • A successful egg donation collected in natural cycle : nIVF becomes a tool to facilitate egg donation (April 2007)
  • Académie

  • Demande d’information (Accueil)

    Fields marked with an * are required
    Formulaire de questions

    *mentions obligatoires

  • Fields marked with an * are required
    Question form
    *mandatory information
  • Discover the ovo clinic

  • Contact us

    Contact us

    clinique ovo montreal

    All services offered 8000, boul. Décarie,
    Montreal Qc H4P 2S4
    ovo fertility office 100 & 200
    Monday to Friday 7:30am to 6:00pm
    Weekend on appointment
    fertilite@cliniqueovo.com
    ovo elle bureau 600
    Monday to Friday 8:00am to 4:00pm
    elle@cliniqueovo.com
    ovo cryo Monday to Wed. 8:00am to 5:00pm
    Thursday 8:00am to 6:00pm
    Friday 8:00am to 5:00pm
    Saturday 9:00am to 3:00pm
    Appointments :
    Monday to Friday 9:00am to 3:00pm
    Thursday 9:00am to 4:00pm
    Saturday 9:00am to 2:30pm
    cryo@cliniqueovo.com
    ovo biosurance office 600
    Monday to Friday 8:00am to 4:00pm
    biosurance@cliniqueovo.com
    ovo labo office 600
    Monday to Friday 8:00am to 4:00pm
    labo@cliniqueovo.com
    ovo prenatal office 600
    Monday to Friday 8:00am to 4:00pm
    prenatal@cliniqueovo.com
    ovo r&d office 600
    Monday to Friday 7:15am to 5:00pm
    r-d@cliniqueovo.com

    clinique ovo rive-sud

    3141, boul. Taschereau,
    Greenfield Park Qc J4V 2H2
    ovo fertility - certain services offered office 410
    Call to know our hours
    fertilite@cliniqueovo.com
    ovo prenatal - certain services offered office 420
    Monday to Friday 8:00am to 4:00pm
    prenatal@cliniqueovo.com
    ovo labo - certain services offered office 420
    Monday to Friday 8:00am to 4:00pm
    labo@cliniqueovo.com

    clinique ovo quebec

    ovo prenatal - certain services offered 2600 Boul. Laurier, suite 295,
    Quebec Qc G1V 4T3
    Monday to Friday 8:00am to 4:00pm prenatal@cliniqueovo.com



    clinique ovo rive-nord

    ovo prenatal - Prenatal screening 1000 Montée des Pionniers,
    Terrebonne QC J6V 1S8
    Monday to Thursday 9:00am to 3:00pm
    prenatal@cliniqueovo.com

    clinique Echo-medic

    Ovo prenatal - certain services
    Laval 1575, boul. de l'Avenir, suite 110,
    Laval Qc H7S 2N5
    t. 1.877.664.3246
    Monday to Thursday 7:30am to 4:30pm
    Friday 7:30am to 3:00pm
    Boisbriand 20865, chemin de la Côte Nord, suite 201
    Boisbriand Qc J7E 4H5
    t. 1.877.664.3246
    Monday to Thursday 8:00am to 4:00pm
    Friday 8:00am to 3:00pm
    Montreal and South-Shore: t. 514.798.2000
    Quebec: t. 418.425.0128
    f. 514.798.2001
  • Make an appointment

img_clinique_salle_ovofertilite_3

OVULATION INDUCTION

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

Developpement_implantation_embryon

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 (IUI)

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)

Insemination_intra-uterine
Image © Dr. J. Herrero Garcia, provided by EMD Serono, Canada

IN VITRO FERTILIZATION (IVF)

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.

 

 

WHAT IS IN VITRO FERTILIZATION ?

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. One or more embryos will be transferred into the uterus of the woman 2-5 days later. The supernumerary embryos can be frozen to be used later on.

 

 

Egg Retrieval

Recuperation_des_ovocytes

Image © Dr. J. Herrero Garcia, provided by EMD Serono, Canada

 

 

Fertilization — in vitro fertilization (IVF) and intracytoplasmic injection of a spermatozoid (ICSI)

Fecondation-in-vitro

Image © Dr. J. Herrero Garcia, provided by EMD Serono, Canada

STIMULATED CYCLE

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.

2-5 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. 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 occured.
.

 

 

Embryo transplant

Embryo transplant

Image © Dr. J. Herrero Garcia, provided by EMD Serono, Canada

NATURAL CYCLE (nIVF)

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

ICSI and embryo development

Image © Dr. J. Herrero Garcia, provided by EMD Serono, Canada

OOCYTE DONATION

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.

img_laboratoire_ovofertilite_2

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.

FROZEN EGGS

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.

EMBRYO DONATION

This option will be available soon in our clinic. You may contact the egg donation department for further information.

SPERM DONATION

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.

MALE INFERTILITY

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

Pathologie_testicules_canal_seminal

Image © Dr. J. Herrero Garcia & Dr. Simon Marina, provided by EMD Serono, Canada

 

 

SPERM RETRIEVAL METHODS

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.

img_laboratoire_ovofertilite_3

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.