ICSI, Preimplantation Genetic Diagnosis (PGD) Testing, and Assisted Hatching
Micromanipulation refers to the procedures which are performed using microscopic instruments to manipulate oocytes (eggs), sperm, and embryos. These microscopic techniques are designed to increase the chances of a successful in vitro fertilization (IVF) cycle. At the Center for Reproductive Medicine, serving Orlando and Central Florida, these procedures — ICSI, preimplantation genetic diagnosis (PGD) testing, and assisted hatching — are performed in our state-of-the-art laboratory facilities by a highly qualified team of embryologists.
Intracytoplasmic Sperm Injection (ICSI)
Since early 1995, intracytoplasmic sperm injection (ICSI) has been a standard practice at our Orlando, Florida-area fertility center for couples with severe male factor infertility. This type of infertility may result from a number of sperm problems, including the absence of sperm in the ejaculate (azoospermia), low sperm count (oligospermia), poor sperm motility (asthenospermia) or morphology (teratozoospermia). ICSI may also be performed when there are antisperm antibodies present - sperm-attacking proteins which may be found the blood, seminal or in vaginal fluids.
The ICSI procedure is extremely delicate and must be performed by an experienced embryologist. It involves the use of a microinjection pipette (glass needle), though which an individual sperm is injected into a mature egg. Several days after the procedure, the fertilized embryos are placed into the uterine cavity, via a procedure known as embryo transfer.
Couples who are interested in learning more about ICSI and our IVF program are invited to schedule an appointment with one of our infertility experts.
Preimplantation Genetic Diagnosis (PGD)
For patients of our Florida fertility center who carry certain genetic conditions, preimplantation genetic diagnosis (PGD), also known as embryo screening or genetic testing, can improve a couple's chances for a successful IVF cycle, pregnancy, and birth of a healthy child. PGD may also be suitable for couples who have had multiple failed IVF attempts and those who have suffered recurrent miscarriages on the basis of chromosomal anomalies.
Preimplantation genetic diagnosis involves the removal of one or two cells from an embryo prior to embryo transfer. These cells are then tested to determine the genetic status of the embryo. Embryos that do not possess disease-causing genes or chromosomal abnormalities may be deemed suitable for transfer to the uterus. By selecting only the embryos that appear to have the best chance for development, the likelihood of implantation may be increased and the potential for miscarriage reduced. Genetic diseases for which PGD may screen include cystic fibrosis, Down syndrome, Huntington disease, sickle cell anemia, Tay Sachs disease, and many others.
Comparative Genomic Hybridization (CGH)
CGH is a technique provides the detection of losses and gains in DNA copy number across the entire genome without prior knowledge of specific chromosomal abnormalities. The standard preimplantation genetics testing methods, using PGD techniques, have only provided the evaluation of 9 to 12 chromosomes out of a total of 23 chromosome pairs in the human embryo cell. CGH solves this problem by evaluating all 23 chromosome pairs, allowing completely screened normal embryos to be identified and transferred or frozen. When CGH is performed on a Blastocyst biopsy, it is effective in screening out mosaicism (mixed cell lines in the same organism).
Patients that may benefit from the CGH technique:
- Patients with repeat miscarriages.
- Older patients who naturally have a higher percentage of genetically abnormal embryos.
- Patients who have experienced repeat implantation failure can be screened for genetically abnormal embryos.
Since 1991, the use of the micromanipulation technique known as assisted hatching has been used in our embryology laboratory to increase our patients' chances of successful pregnancy. During the assisted hatching procedure, there is thinning of the protective outer membrane that surrounds the embryo, known as the zona pellucida. An embryo must “hatch” through this membrane in order to implant itself in the lining of the uterus. Because the use of certain fertility medications and the normal aging process of a woman's eggs can cause the zona pellucida to harden or thicken, the assisted hatching procedure may increase the likelihood of implantation.
Learn More about Micromanipulation
At our fertility laboratories, sophisticated micromanipulation techniques are used to help improve our patients' chances of becoming pregnant. Please contact our fertility center in the Orlando, Florida area to learn more about ICSI, preimplantation genetic diagnosis (PGD) testing, and assisted hatching.