Cryobank

 

Embryo, oocyte and sperm cryopreservation

 

In most ART cycles stimulation of superovulation is conducted for the maturing of a high number of oocytes, therefore resulting in a big high number of embryos. As usually not more than three embryos are transferred to the uterine cavity, many patients have “excess” embryos.

 

These “excess” embryos can be cryopreserved (frozen) and preserved for a long period of time in a liquid nitrogen at the temperature of – 196 °C. As a result they can be unfrozen and used for the same patient if the IVF cycle hasn’t resulted in pregnancy or if after the childbirth she wants to have another baby. Thus she can again undergo the cycle of embryo transfer without stimulation of superovulation.

Embryo cryopreservation is one of the well developed methods of assisted reproductive technologies. The birth of the first baby after the transfer of unfrozen embryo was registered in 1984. The most of IVF clinics practice cryopreservation of embryos left after the IVF cycle for their further transfer to the uterus.

 

The chance of pregnancy after the transfer of unfrozen embryos is higher than in case of transfer of fresh embryos, and therefore we highly recommend patients, particularly those, who have “excess” embryos to conduct cryopreservation with the newest method of quick freezing (embryo vitrification). The cycle of cryopreservation and transfer of unfrozen embryos is considerably cheaper, then undergoing a new IVF cycle: Thus the availability of frozen embryos becomes a sort of “insurance” for cases if patients fail to get pregnant. However as it’s sensible to freeze only embryos of high quality, cryopreservation is a “bonus” which is available only for about 50% of IVF patients.

 

About the half of embryos of high quality normally undergo the cycle of freezing/unfreezing. The risk of inborn pathologies doesn’t increase in case of embryo cryopreservation.

 

Advantage of embryo cryopreservation

 

• That enables to maximize chances for pregnancy after IVF and prevent “death” of normal embryos remaining after the IVF cycle. That’s the most important advantage of cryopreservation. About 50% of patient can have additional embryos for cryopreservation. The efficiency of transfer of unfrozen embryos constantly grows getting closer to the efficiency of “fresh” IVF cycles.
• Cryopreservation of all embryos for their further transfer to the uterine cavity can be recommended to women with high risk of severe level of Ovary Hyperstimulation Syndrome after the induction of superovulation.
• Cryopreservation is recommended in cases when the probability of embryo implantation is low, for instance, polyps of endometrium , insufficient thickness of endometrium at the time of embryo transfer, dysfunctional bleeding at that period.
• In case of complications connected to the embryo transfer during the IVF cycle, for instance, stenosis of cervical channel
• Embryo cryopreservation can be included in the oocyte donation cycle, if for some reasons it’s difficult to synchronize donor’s and recipient’s menstrual cycles.
• After the IVF cycle, which has ended with the childbirth, and if couples don’t want to have any more children frozen embryos can be provided as a donation to another infertile couple.
• Before undergoing chemotherapy or radiotherapy conditioned with cancer

 

How long can frozen embryos be preserved?

 

 Frozen embryos can be preserved as long as required, even for several decades. When they are preserved in liquid nitrogen at the temperature of -196 ^оС the whole metabolic activity of cells stops in case of such low temperature.

 

It’s very important for patients to keep contacts with the clinic regarding the faith of their preserved embryos. After the expiry of each paid period of preservation patients should inform clinic how they’d like to use preserved embryos:

 

• To continue preservation of cryopreserved embryos
• To transfer cryoembryos to the uterus till the expiry of the paid term of preservation
• To utilize preserved embryos

 

Transportation of embryos from one clinic to another

 

Couples have the right to transport their embryos from one clinic to another.

 

For the embryo transportation patients should sign agreement on the delivery of embryos preserved by the clinic. Embryos are transported in a small container with liquid nitrogen. The entire responsibility for embryos after their delivery lies on patients.

 

Which is the percent of survival of embryos after freezing and unfreezing?

 

In the clinic with well developed cryopreservation (vitrification) program the percent of embryo survical after unfreezing is not less than 98%. Embryo can be damaged during freezing or unfreezing, but during the period of embryo preservation. As a rule not more than one embryo of high quality (at the stage of blastocyst) is unfrozen and transferred to the uterine cavity.

 

Oocyte cryopreservation with the vitrification method

 

While embryos easily undergo cryopreservation and further preservation in liquid nitrogen oocytes couldn’t be successfully frozen without any damage for a long time. Only recently an oocyte cryopreservation technology with the method of ultraspeed freezing (vitrification) has been developed which is now effectively used in VitroMed clinic.

 

 

Sperm Cryopreservation

 

VitroMed clinic offers spermatozoa freezing with the modern method of vitrification for their further use in infertility treatment programs.

 

Sperm cryopreservation is conducted based on different indices – for insemination with husband’s or donor’s sperm, for conducting IVF with husband’s or donor’s sperm, for preservation before the operation, which may casue sharp decrease of male fertility.

 

Prior to cryopreservation sperm indices are checked. If their characteristics are good the ejaculate is thickened for increasing concentration of spermatozoa, is processed with special methods and places in the special container. That’s a plastic tubule with small diameter with special marking to prevent any errors during their further use. The tubule is placed in liquid nitrogen at -196 degrees. In such conditions the sperm can be preserved for years without losing its quality.

 

Sperm cryopreservation is also used for the increase of the number of mobile and normal spermatozoa, if the case is about oligozoospermia and teratozoospermia. In this case man provides several portions of the sperm. Afterwards each ejaculate is processed, as mentioned above, and preserved till the moment of their use. After unfreezing additional sperm processing is conducted, it’s thickened etc. As a result the indices of a poor quality sperm may improve almost achieving normal/acceptable level. Of course, this increases chances for conception in case of both insemination and IVF.

 

In practice sometimes it’s necessary to undergo sperm cryopreservation in cases when man can’t be present at the clinic on the day of female follicle puncture or artificial insemination with husband’s sperm. In this case cryopreserved sperm doesn’t decrease conception probability.

 

Thus sperm cryopreservation can increase chances for pregnancy and save funds.

 

VitroMed clinic offers long-term preservation of frozen spem connected to possible injuries of the male reproductive system (operation, irradiation, service in “hot spots”, extreme lifestyle etc). 

Briefly about egg donation

Donor egg bank is a laboratory where in special conditions healthy oocytes are stored. These thoroughly checked oocytes are taken from female donors. To become a healthy biomaterial, egg donors must meet special requirements most important of which are health condition and young age. These conditions are due to concerns about the quality of the egg: the oocytes are formed during intrauterine development then they are affected by lifestyle of the women. As a result the younger the donor, the higher the health and the vitality of his eggs. Many who are interested in IVF are concerned about the cost of the donor eggs. The price in different clinics of capital city is almost the same, but the total cost of IVF is different. Today many reproductive clinics of Moscow perform IVF with donor egg. The cost differs due to included medical services. Who needs egg donor Efficiency of IVF hangs mainly on quality of the donor egg. Formed during the period of fetus formation they are consumed throughout menstrual cycle, till the entire supply is wasted and ovaries stop functioning. Age of the donor is the main factor of vitality and quality of the egg. Younger donors not only have better quality of eggs but also low frequency of eggs with chromosomal abnormalities. For instance most cases of Down syndrome occur in women who became pregnant after the age of 38 years. Decrease of fertility is a natural process. Today there is no method to rejuvenate the ovaries. This is why the efficiency of infertility treatment in women after the age of 35 years is extremely low. The maximum results in this case are achieved with donor oocytes. Transplantation of donor eggs is performed in case of different reproductive problems: .Decreased ovarian reserve .Premature ovarian failure .Low quality of oocytes .Chromosomal translocations and genetic diseases Firs positive result of egg transplantation was received in 1984. Since then only in USA 50 thousand babies were born through this method, while donor eggs were used only in 10% of the cases.

Phases of ‘’Egg donor’’ Program o Synchronization of the menstrual cycles of donor and recipient through use of oral contraceptives or agonists of GNRHR. o Stimulation of ovulation in donor with gonadotropins o Introduction of ovulatory dose of chorionic gonadotropin to donor o Preparation of recipient endometrium with progesterone or estradiol o Puncture of the ovaries of the donor, fertilization of the oocytes with sperm, transportation of the embryo into the recipient uterus Egg donors go through standard IVF cycle. Recipient becomes progesterone or estradiol to prepare the endometrium of the uterus to implantation. The donor ovarian stimulation is necessary for receiving several oocytes at the same time. Then the oocytes are extracted through method of vaginal puncture and fertilized. Then during 3-5 days embryo is cultivated in the laboratory and implanted into the recipient uterus.

Indications for IVF with donor oocytes:

1. Lack of oocytes conditioned with the natural menopause, the syndrome of premature ovary emaciation, the state after the removal of ovaries, radio- or chemotherapy, as well as anomalies of the development.

2. Functional inferiority of female ovaries, genetic abnormalities, which can be transferred to babies.

3. Inefficiency of previous IVF and embryo transfer cycles with the insufficient ovary response to the stimulation of ovulation, embryos of a low quality which doesn’t result in pregnancy.

Contraindications:

1. Somatic and psychological diseases which has contraindications for pregnancy;

2. Innate development abnormality or acquired deformations of the uterine cavity, which makes it impossible to implant embryos;

3. Ovary tumors;

4. Hyper-plastic processes in the endometrium,

5. Benign uterine tumors requiring operative treatment

6. Sever inflammatory diseases of any localization,

7. Malignant neoplasms in any localization, including anamnesis.

Availability of the severe male infertility factor doesn’t exclude the use of donor oocytes. Aspiration of spermatozoa from the epididymis (PESA, MESA, TESA) and injection of a single spermatozoon into the oocyte cytoplasm (ICSI) are the two modern methods of the treatment of male infertility and can be applied together with donor oocytes. Previously married couples with serious pathologies of oocytes or sperm had only two options: adoption or childlessness. Today the oocyte donorship, TESA and ICSI provide the third option – opportunity for the married couple to jointly experience the pregnancy and the birth of a child. Oocyte donors face certain risk of complications and difficulties conditioned with the necessity to combine their job with donorship cycle and therefore they receive appropriate material compensation for their participation in the donor’s program. The use of donor’s oocytes is a quite expensive treatment method but the efficiency is high as well. The pregnancy rate of IVF with donor eggs is 60-65%. Today medicine has succeeded in egg vitrification (quick freezing). These method will allow to frozen and store donor eggs, which in first place will simplify their use and allow to pass the half year quarantine for follow up of syphilis, AIDS and Hepatitis.

Reproductive medicine center Vitromed has own donor base, which will meet requirements of the married couples. For consultation, information about the procedure cost, admission registration call +(374) 10 65-34-34 or +(374) 10 65-43-43