Services

Embryo Freezing

Please note that ONLY embryos that are good enough to survive the freezing and thawing process will be frozen.

• Embryos might be frozen on day 3 or day 5, and the individual decisions are made on a patient-to-patient basis.
• It means that we freeze embryos on day 3 and day 5, thaw them and then transfer on day 5.
• You can have 4 embryos on day 5. One or two are transferred, and the remaining embryos may or may not be frozen, if the embryologist believes that their quality will not survive freezing.
• In certain cases it may be possible to keep embryos until day 6 or, in VERY RARE cases, to day 7 before freezing.
• 99% of embryos will be frozen on day 5 or day 6.

We strive to give our patients an optimum chance of getting pregnant with the use of frozen embryos, and not just freeze embryos because it is possible to do so.

IVF

Assisted reproductive techniques (ART) are lab-based fertility treatments that use eggs and sperm outside of the human body to start conception. The techniques we offer are In Vitro Fertilisation (IVF) and Intracytoplasmic Sperm Injection (ICSI).

IVF is the process of fertilisation by manually combining an egg and sperm in a laboratory dish, and then transferring the embryo to the uterus. The process begins on the second day of a woman’s menstrual cycle and takes approximately 30 days in total.

Egg retrieval

Aspiration is the process of retrieving a woman’s eggs from mature follicles in her ovaries. The woman is under anaesthesia while the procedure takes place. Hormone measurements as well as the size of the follicles determine the readiness for the egg retrieval procedure. The follicles are measured by ultrasound and considered mature when they reach 15 to 20 mm in diameter. The process is as follows:

1. With the guidance of an ultrasound, a needle is passed through the top of the vagina to get to the ovary and follicles.
2. The fluid in the follicles is aspirated through the needle and the eggs detach from the follicle wall.
3. The eggs are then sucked out of the ovary.
4. The procedure is usually done in a matter of minutes.
5. The fluid with the eggs is sent to the IVF lab, where the eggs are identified, rinsed and stored in specialised incubators.

Intracytoplasmic Sperm Injection (ICSI)

Intracytoplasmic sperm injection (ICSI) is a type of in vitro fertilisation that involves injecting live sperm into a person’s eggs in a laboratory. The aim of the procedure is to create an embryo (fertilised egg), which is transferred into the uterus. The expected result of an embryo transfer is pregnancy.

How is ICSI different from IVF?

ICSI is a type of IVF. With traditional IVF, thousands of sperm are placed next to an egg on a dish. Whether one of the sperm penetrates the egg to fertilise it is left up to chance. If none of the sperm fertilise the egg, conception (also called fertilisation) doesn’t occur.

ICSI promotes fertilisation through the direct injection of a single sperm into a single egg. Still, ICSI doesn’t guarantee fertilisation.

In both ICSI and traditional IVF, the fertilised egg (embryo) is implanted into your uterus or womb. Pregnancy occurs if the embryo attaches to the lining of your uterus.

Who would we recommend ICSI to?

ICSI is most helpful for people experiencing male infertility. Your healthcare provider may recommend ICSI if a person has:

• Anejaculation (inability to ejaculate).
• A blockage in their male reproductive system.
• A low sperm count.
• Poor sperm quality.
• Retrograde ejaculation (semen flows backward into the bladder).

You may also need ICSI if:

• Traditional IVF hasn’t led to the creation of embryos.
• The person supplying the eggs is older than 35.
• You’re using previously frozen eggs or sperm (cryopreservation) to try to conceive.

What happens during intracytoplasmic sperm injection?

During ICSI, your healthcare provider:

1. Uses a pipette (a small glass tube with a suction bulb) to hold the mature egg in place on a lab dish.
2. Immobilises and picks up one sperm using a thin needle.
3. Inserts the needle into the egg to reach the cytoplasm.
4. Injects the sperm into the cytoplasm.
5. Withdraws the needle from the egg.

What happens after ICSI?

After ICSI, your healthcare provider monitors the fertilised egg in the laboratory for signs of successful fertilisation. Within five to six days, a healthy fertilised egg should divide into cells, forming a blastocyst. Your healthcare provider will evaluate the blastocyst’s size and cell mass to determine when it’s most likely to lead to a pregnancy.

An embryo transfer occurs on either the fifth or sixth day following the egg retrieval procedure, or the transfer is commonly delayed for a month or even years. Your doctor will discuss the timing of your embryo transfer with you. Using ultrasound technology, your healthcare provider will insert a catheter (long, thin tube) into your vagina and inject the embryo into your uterus. For pregnancy to happen, the embryo needs to implant (attach) to your uterus. Your healthcare provider may recommend waiting at least two weeks before taking a pregnancy test.

What are the benefits of intracytoplasmic sperm injection?

Compared to traditional IVF, ICSI appears to be more successful in helping those experiencing male infertility become parents. Some centres do ICSI for all people, regardless of infertility diagnosis.

Donor Co-ordination

Egg Donation

Egg donors donate their eggs in instances where the intended mother cannot produce good quality eggs for fertilisation. After the donor has undergone egg retrieval, the donor eggs are fertilised through IVF with either the partner’s sperm or donor sperm. Through fertilisation an embryo forms and is placed into the intended mother’s womb.

Good quality eggs are crucial for fertilisation in the pursuit of pregnancy. There are various factors which could lead to a decreased amount and/or quality of eggs. These could include age, early menopause, treatment of medical conditions such as chemotherapy, which could damage eggs, and many more.

The process of egg donation

1. Application and consent.
2. Screening: testing for infectious diseases such as HIV, blood group, a fertility test (AMH) to check ovarian reserve, a physical examination and a psychological examination.
3. Stimulation.
4. Egg collection (aspiration).

Stimulation

The egg donation process starts on day one of the menstrual cycle. If you are on contraception, you need to inform the donor coordinator so it can be taken into account when planning your cycle. Stimulation through hormonal injections starts from day 3 or 4 of the menstrual cycle and continues for about 10 days. Dr Deo will give you careful guidance on how to administer these injections. The injections help the ova to develop into follicles.

Throughout the stimulation process you will be required to come in for 2 to 3 transvaginal scans to measure follicle growth.

Surrogacy

Surrogacy is a legal arrangement whereby a woman agrees to carry a pregnancy on behalf of another person or people. The person or people then become the child’s parent or parents once the child is born. This service is suggested to people for whom pregnancy is medically impossible, such as a single man or male couple, or for whom pregnancy poses a high health risk.

The legal process

• The donor recipients (the people who will be the child’s parents) are to consult with a psychologist jointly and/or apart. The surrogate is also required to see a psychologist together with her spouse, if she is married.
• A consultation with Dr Deo is required for her to provide a letter stating that the donor recipient is incapable of conceiving.
• The surrogate also needs to consult with the doctor to determine if she is fit for pregnancy.
• Legal documentation needs to be submitted to a judge with the assistance of an advocate.
• It is advisable to seek legal counsel, as this process can be lengthy and involved.
• The costs associated with surrogacy are covered by the recipients.

Once the legal process is complete and we are furnished with a High Court order, our process begins.

The gynaecological process

At this point Dr Deo will have had initial consultations with both the donor recipient(s) and the surrogate.

• The donor undergoes IVF to stimulate as many eggs as possible.
• The resulting embryo is transferred into the surrogate with the intention of pregnancy.
• Remaining embryos may be frozen if they are of good quality.