Assisted hatching with laser

What does the technique consist of?

Assisted hatching is a laboratory technique that involves creating a small hole in the zona pellucida of the embryo using a laser, thereby facilitating its implantation into the uterus.

The zona pellucida protects the embryo during its development; however, for a blastocyst to implant in the uterus, it needs to break out of the zona pellucida. Blastocysts naturally hatch (a blastocyst in expansion stage 5 is a hatching blastocyst; a blastocyst in expansion stage 6 is a fully hatched blastocyst, as it is outside the zona pellucida). This technique assists the embryo during hatching and consequently helps its implantation.

When is assisted hatching recommended?

• Embryos with thick zona pellucida
• Repeated implantation failures
• Preimplantation Genetic Testing (PGT-A)

ICSI (Intracytoplasmic Sperm Injection)

ICSI is an assisted reproduction technique that involves the microinjection of a sperm into the cytoplasm of an egg using a micropipette. The ICSI technique involves injecting the sperm directly into the egg's cytoplasm, overcoming natural barriers that may prevent the egg and sperm from merging.

When is the ICSI technique recommended?

• Long-term infertility
• Poor sperm quality
• Fertilization failure with conventional IVF

PICSI or Physiological ICSI

The PICSI (Physiological Intracytoplasmic Sperm Injection) technique is a variation of ICSI that allows for sperm selection based on their maturity level.

The PICSI technique provides a higher degree of sperm selection than ICSI. In ICSI, the embryologist selects the sperm to inject based on its morphology and motility. The PICSI technique allows for the selection of mature sperm. Mature sperm have completed spermatogenesis, including the processes of membrane remodeling, cytoplasmic extrusion, and nuclear maturation.

What does the technique consist of?

The maturity of sperm is directly related to its ability to bind to hyaluronic acid (HA), as mature sperm have a specific receptor for this molecule on their head.

The PICSI technique is performed on a special plate containing synthetic drops similar to hyaluronic acid. This allows the differentiation of mature sperm (those that bind to the HA medium) from immature sperm (those that do not adhere to the HA medium).

When is the PICSI technique recommended?

• Patients with previous failed cycles
• Patients with low fertilization rates and/or poor embryo quality
• Patients with male factor infertility

EndomTRIO (EMMA, ERA, ALICE)

The EndomTRIO package, consisting of EMMA, ERA, and ALICE tests, provides a thorough assessment of the endometrial environment. With these tests, doctors can recommend a tailored treatment plan to enhance the chances of a successful and healthy pregnancy.

What is the EMMA technique?

EMMA (Endometrial Microbiome Metagenomic Analysis) examines the microbiome of the endometrium, analyzing bacterial balance and identifying beneficial bacteria that support a successful pregnancy.

What is the ERA technique?

ERA (Endometrial Receptivity Analysis) determines the optimal timing for embryo implantation by assessing endometrial receptivity. Based on the results, we can schedule the embryo transfer for the time with the highest likelihood of pregnancy.

What is the ALICE technique?

ALICE (Analysis of Infectious Chronic Endometriosis) detects chronic endometrial inflammation and pathogenic bacteria often linked to chronic endometriosis. This condition can contribute to implantation failure or recurrent miscarriages.

Who is the EndomTRIO method suitable for?

The EndomTRIO method is recommended for:

• Couples who have experienced repeated implantation failure
• Patients with a history of recurrent miscarriages
• Individuals seeking a comprehensive assessment of endometrial health to enhance their chances of a successful pregnancy