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Medically assisted procreation (MAP) techniques are used to overcome any obstacles to natural conception. We use several different medically assisted reproduction techniques, with increasing levels of complexity (levels I, II and III), to achieve our goal. The simplest techniques, such as intrauterine insemination, favour the meeting of the male gametes with the oocyte, inside the female reproductive system. The more complex techniques involve the use of special laboratory instruments that ensure physiological conditions similar to those in the uterus. As a result it is possible to develop the embryos formed and transfer the most suitable embryo to the uterus, optimising the chances of success. Our MAP centre is a level III centre, which means it is authorised to perform all types of treatment, even the most complex (ICSI with TESE).
With regards to specific, personal situations of total sterility of one or both partners, the solution to achieve our goal is the use of gamete donation. Donation is altruistic, voluntary and completely anonymous.
In Italy it is possible to donate eggs, sperm or both gametes.
Our Clinic collaborates with international centres of excellence in the selection of donors and gametes that are ideal for all levels of MAP techniques, allowing couples to obtain outstanding results without the need to travel abroad.
Sperm freezing and oocyte vitrification are well-established technologies with very high success rates, which have made fertility preservation possible. There are several reasons to undergo gamete cryopreservation; medical reasons– for example, patients who must undergo therapies that are harmful to oocytes or spermatozoa, social reasons- those potentially seeking pregnancy at an advanced age. Age is a known risk factor for infertility, and cryopreservation of oocytes at a younger age is a preventive strategy to preserve one’s fertility. It is no coincidence that for some years now, Silicon Valley technology giants such as Facebook and Google have been offering their employees fertility preservation campaigns.
Intrauterine insemination is a first-level technique, whereby the male gametes meet the oocyte inside the female reproductive system. Follicular growth is monitored during the weeks preceding ovulation using ultrasound. On the day of insemination the spermatozoa are prepared in the laboratory and, through the aid of a thin catheter, are released into the patient’s uterus to allow the physiological rise of faster spermatozoa towards the ovulated oocyte. This technique can be performed with the partner’s gametes, or, in cases of total male sterility with no female infertility factors, can be performed with donated male gametes.
Level II techniques involve ovarian stimulation to recover a greater number of egg cells, used for fertilisation in the laboratory. The embryos resulting from fertilisation are cultured in special incubators, which mimic the physiological conditions of the maternal uterus, to very high quality standards. During this process, all crucial parameters are carefully controlled, including temperature, pH and microenvironmental quality.
This can last between 5-7 days, until the Blastocyst stage, when an embryo is formed by many cells and organised in a more complex structure. There are two main types of fertilisation: IVF and ICSI.
In IVF (In Vitro Fertilisation and Embryo Transfer), oocytes taken from the ovaries are brought into contact with the partner’s spermatozoa, or with donated spermatozoa, if necessary, and spontaneous fertilisation is expected.
With ICSI (intracytoplasmic sperm injection), a single, mature oocyte is inseminated with a single sperm which is selected at high magnification using a micromanipulator microscope, and inserted using a micro-needle into the cytoplasm of the oocyte. ICSI is particularly useful when the basic parameters of the seminal fluid do not reach a sufficient degree to allow spontaneous fertilisation, or after unsuccessful IVF treatments.
Level III techniques involve gamete retrieval or embryo transfer under general anaesthesia with intubation. These are special conditions, such as surgical sperm retrieval using the TESE or MicroTESE technique, oocyte retrieval by laparoscopy, or intratubaric transfer of male and female gametes (GIFT) by laparoscopy.