After oocyte and sperm collection it is possible to utilize some of special fertilization techniques and methods described below.
It can be done by several methods:
Ovum is incubated together with sperm in special solution. Fertilization occurs in laboratory with significant involvement of natural processes of the ovum and sperm. Sperms travel by themselves to the ovum and penetrate its protective layer. This method is not suitable if there are suspicions about ova and sperm quality. It is basic IVF technique, which is not very used nowadays.
It is injection of single sperm through the protective layer (zona pellucida) to the ovum cytoplasma. This method helps many couples whose treatment was considered hopeless several years ago and were forced to use donated sperm instead.
ICSI method is micromanipulative technique. The sperm is sucked up into very thin and sharp glass capillary which is injected into the ovum.
ICSI indications are sperm inability spontaneously penetrate ovum (low count, low mobility), immunological infertility causes, fertilization failures – by classical IVF method, recurrent unsuccessful IVF attempts, patient in advanced age, low count of collected ova, use of cryopreserved sperm, use of sperm collected by MESA/TESE method, use of donated ova, etc. This method has very high rate of fertilization success. On the basis of present knowledge it is possible to say ova fertilization by ICSI method doesn’t increase the risk of fetus with inborn disorders in comparison with spontaneous fertilization.
It is improved ICSI method when the best sperms are selected (with use of microscope). These are injected into the oocyte cytoplasma. This method allows to avoid injection of defected sperms. This technique has even higher success rate than ICSI method.
It is a laboratory technique (improved ICSI or IMSI), which allows to select and inject only a high quality and mature sperm into the oocyte. This method increases the treatment success rate.
Naturally only mature sperms can fertilize the ovum. Mature sperms can specifically bind to oogenetic complex (hyaluronan). Non mature sperms doesn’t have hyaluronidase receptor and thus cannot bind to oogenetic complex and fertilize the ovum.
PICSI puts together the advantages of ICSI or IMSI with the possibility to select a mature sperm. This technique can be used if there is sufficient concentration of mobile sperm in the ejaculate.
After successful fertilization, the ovum starts to divide and changes to embryo. Embryo cultivation is done by laboratory procedures.
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