What is infertility?
◎Failure to achieve a successful pregnancy after more than 12 months of regular unprotected intercourse.◎Earlier evaluation and treatment may be warranted based on medical history and physical findings and is warranted after 6 months for women over age 35 years.
Treatment Methods
◎ In accordance to the Assisted Reproduction Laws in Taiwan, a legal marital status must exist between the recipients of assisted reproduction technology. The husband and wife must present a government issued marriage certificate prior to initiation of treatment.1. Intrauterine insemination (IUI):
Ovulation induction → detect follicle number and size by ultrasound → adjustment of ovulation drug dosage → predict of ovulation date → sperm washing and concentration → performing intrauterine insemination.
2. In vitro fertilization (IVF):
Ovulation induction → detect follicle number and size by ultrasound → adjust ovulation drug dosage → predict ovulation → schedule ovum pick-up date & sperm → ovum pick-up and sperm obtainment → embryo transfer at the third or fifth day after ovum pick up → luteal phase support with progesterone.
Ovulation induction → detect follicle number and size by ultrasound → adjust ovulation drug dosage → predict ovulation → schedule ovum pick-up date & sperm → ovum pick-up and sperm obtainment → embryo transfer at the third or fifth day after ovum pick up → luteal phase support with progesterone.
3. Intracytoplasmic sperm injection (ICSI)
◎We inject sperm directly into the oocyte by microsurgical instruments under the microscope. The fertilization rate will thus increase and embryo transfer will be performed after the zygotes develop to embryos. ◎Indications:
- Male infertility such as azoospermia, athenospermia, and high rate of abnormal sperm morphology
- Anti-sperm antibodies: If male and female patients have high concentrations of anti-sperm antibodies, sperm penetration of eggs will decline substantially.
- Repeated IVF fertilization failure despite normal sperm number and activity
◎ For male patients with non-obstructive azoospermia, we can extract sperms from testis or epididymis by minor surgery.
◎We inject sperm directly into the oocyte by microsurgical instruments under the microscope. The fertilization rate will thus increase and embryo transfer will be performed after the zygotes develop to embryos. ◎Indications:
- Male infertility such as azoospermia, athenospermia, and high rate of abnormal sperm morphology
- Anti-sperm antibodies: If male and female patients have high concentrations of anti-sperm antibodies, sperm penetration of eggs will decline substantially.
- Repeated IVF fertilization failure despite normal sperm number and activity
◎ For male patients with non-obstructive azoospermia, we can extract sperms from testis or epididymis by minor surgery.
4. Laser thinning of embryonic zona pellucida for assisted hatching (AH).
Sometimes even good quality embryos would fail to implant upon transferred to uterus. Assisted hatching is the process in which the embryonic zona pellucida is first thinned by laser, and then embryo is transferred to uterine cavity to improve embryo hatching and implantation.
Indications:
◎ Failed of in vitro fertilization more than two times
◎ Embryonic zona pellucida is too hard or too thick
◎ Age more than 38 years old
Sometimes even good quality embryos would fail to implant upon transferred to uterus. Assisted hatching is the process in which the embryonic zona pellucida is first thinned by laser, and then embryo is transferred to uterine cavity to improve embryo hatching and implantation.
Indications:
◎ Failed of in vitro fertilization more than two times
◎ Embryonic zona pellucida is too hard or too thick
◎ Age more than 38 years old
Treatment Procedures
Clinical examinations:1. Ultrasound examinations of uterus, ovary, and other pelvic structures, as well as lesions such as myoma, endometrioma.
2. Blood analysis for thyroid function, prolactin and AMH
＊AMH(anti-Mullerian hormone): for prediction of the ovarian follicle reserve. Presently AMH has the highest accuracy among all blood tests for ovarian reserves.
＊AMH(anti-Mullerian hormone): for prediction of the ovarian follicle reserve. Presently AMH has the highest accuracy among all blood tests for ovarian reserves.
3. Semen analysis and sperm staining examination— Sperm are stained and enlarged up to 1000 times to assess the normal morphological proportion, to predict the probability of oocyte fertilization ( General sperm analysis only checks up to 100-fold amplification, and staining is not performed )
4. Hysterosalpingography—To assess the patency and function of the fallopian tubes, and to evaluate the contour and the shape of uterine cavity, as well as the presence of polyps or intra-uterine adhesions.
5. Basal body temperature measurement
6. Reture to clinic for report and recommendation by doctor for treatment options.
At Mackay Medical Services for Reproductive Medicine, we offer:
＊ Intrauterine insemination (IUI)＊ In vitro fertilization (IVF)
＊ Microscopic technique
＊ Sperm staining examination, sperm antibody test
＊ Sperm cryopreservation, embryo cryopreservation
Special team for Reproductive Medicine Center :
Experienced infertility specialistUrologist
Consultants
Trained certified technicians.
Success Rates: (<38 years old)
Intrauterine insemination(IUI)—The pregnancy rate was 17~20%
In vitro fertilization (IVF)—The pregnancy rate was 48%
Intracytoplasmic sperm injection (ICSI) )—The pregnancy rate was 47%
Assisted hatching (AH) —The pregnancy rate was 44%
You can contact us via (mmhimsc@mmh.org.tw) for the detail of treatment or Make Appointment at our official site.
You can contact us via (mmhimsc@mmh.org.tw) for the detail of treatment or Make Appointment at our official site.
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