Perfect Woman Institute

Preimplantation genetic diagnosis (PGD)

Preimplantation Genetic Diagnosis (PGD) was developed out of a need to provide an alternative to prenatal diagnosis for couples at risk of transmitting a genetic disease to their children.

involves the following steps:

1. Ovulation Induction and Monitoring: The woman is given drugs to produce “Super Ovulation” She normally produces many eggs, which are collected.
2. Egg retrieval: Egg retrieval is accomplished non-surgically using a vaginal ultrasound probe to guide a needle into the ovaries. The procedure does not require general anesthesia and is performed with just simple intravenous sedation. An anesthesiologist administers the sedation to maximize the woman’s comfort and safety. As a result, the experience is not painful and recovery is rapid.
3. Sperm Processing: Freshly ejaculated sperms must undergo biochemical and structural change called capacitation before they can fertilize an egg. Sperms are capacitated in the laboratory and the motile and healthy sperms are isolated prior to inseminating the eggs.
4. In Vitro Fertilization: In-vitro fertilization literally means "fertilization in glass". Follicular fluid removed from the ovaries is examined in our lab for the presence of eggs. These are isolated and placed in culture media where they are allowed to further mature. A few hours later, portions of the processed sperms are placed around each egg. Only 50 to 100 thousand sperms are needed for each egg. The eggs and sperms are left to incubate together in a carefully controlled environment. Approximately 18 to 24 hours following insemination, the eggs are inspected under the microscope to determine how many have been successfully fertilized. These embryos will be cultured in the laboratory as they continue to grow and develop until they reach Blastocyst stage.
5. Blastocyst Biopsy: As each embryo divides to about 120 cell stage, Blastocyst stage, a stage that the cells differentiated into 2 distinct kind of all group: the inner cell mass which becomes the fetal cells which the outer cell mass which are the placental cells, 5-10 cells are removed from the placental part (absolutely not the fetal part) and analyzed for genetic abnormalities. If it contains a genetic defect, then the embryo is destroyed.
6. Embryo Transfer: Typically 2 biopsied embryos which are free of abnormalities are transferred via a thin, soft plastic catheter through the cervix into the uterine cavity. They are then deposited in the upper part of the uterus and the catheter is withdrawn. This is generally a painless procedure and the patient remains in bed for 2 hours, after which she is sent home. As implantation will occur in the following two or three days, the patient is instructed to rest at home during this time after the transfer. Light normal activity is allowed without stress and most sleep well at night.
7. Post-Transfer Management: During the follow-up phase, the woman receives daily vaginal suppository of progesterone with the goal of enhancing implantation. Ten to twelve days after the embryo transfer, blood pregnancy test is performed. Rising blood levels of the pregnancy hormone, hCG, indicates that implantation has occurred. Approximately 10 days after the first hCG level, confirmation of a clinical pregnancy is made by ultrasound by demonstration of the fetal pole and fetal heart beating. The pregnancy has begun.

edit @ 14 Sep 2010 15:51:23 by Perfect Woman

Blastocyst Culture Modern Technology for Infertility

What is Blastocyst ?

Blastocyst is a 5 days old embryo that is formed after the conception of the egg and the sperm. The embryo size before being embedded is 120-150 cells. The embryo cell is divided into 2 types: a group of cells that develop into a fetus and a group of cells that is formed outside the placenta. This is the only cell that is different from the embryo during the cleaving stage (stage: 1-16 cells) that is growing less than 5 days.

Blastocyst Culture is the latest version of fertilization method of conceiving the egg and the sperm outside the body and rearing the embryo until it reaches the blastocyst stage. During the blastocyst, the embryo is implanted into the intrauterine and raised in the fetus. It takes 5 days to rear the embryo outside the body until the blastocyst stage. This method is different from the traditional baby tube fertilization where the embryo is implanted into the intrauterine during the cleaving stage (only 4-8 cells) by rearing the embryo externally for only 2-3 days.

 Today, advanced environmental development has helped to prolong the external embryo rearing to 5-6 days until the embryo reaches the stage where it can be implanted as an infant in the blastocyst stage. This is the stage where the embryo can be immediately implanted into the intrauterine, which results for a better chance of pregnancy, rather than implanting the embryo at other period of the embryo stage.

Treatment Procedures
• Stimulate the egg to produce as much ovaries as possible by using injection. One injection is continuously injected daily for 7-10 days. Normally, 8-10 ovaries are required. Currently, more purified stimulant is commonly used to produce ovaries, reducing the amount of injection and medicine
• Once the egg is stimulated, the doctor would follow-up the status of the egg growth by using ultrasound. When the egg is fully developed, the doctor would perforate the egg by absorbing the egg cell externally from the body
• Egg perforation is done through the vagina by using the ultrasound to indicate the position of the fetus. A small needle is used to perforate the egg. It takes 5-10 minutes only. The doctor uses suppressant during the perforation. The patient can go home after the treatment
• The semen is stored in a container. A special equipment and pure sperm liquid are used to select the efficient, germ-free and strongest sperm before conceiving with the egg
• The egg and sperm are conceived. The egg is incubated in the testing room for 5 days
• During the blastocyst stage, the embryo is implanted into the intrauterine by inserting a small, plastic tube into the vagina. The patient is fully aware of the insertion process without feeling any pain. The patient is required to rest for at least 2 hours before returning home
• A periodic appointment is required to track the level of hormone balance and to test is the embryo implantation is suitable for the intrauterine membrane
• After 14 days of the embryo implantation, the doctor would test he pregnancy by perforating for hCG hormone or the placenta hormone

Advantages of Blastocyst Culture
• The pregnancy tendency rate is high
• Selection of good quality embryo is used for the best growth in the intrauterine
• Blastocyst is a method where the embryo that can be naturally implanted in the intrauterine
• Reduce the risk of having more than 2 twins since the ratio of pregnancy is higher than any other methods used, even though 1-2 embryos are implanted
• Ability to diagnose the embryo abnormality before implanting the embryo into the intrauterine (PGD)
• No pain, no operation or no stomach perforation is required
• No hospital admission is required

Testicular Sperm Extraction (TESE)

A method where the semen is extracted from the testicles for cases where the male is unable to produce sperm from the semen excreted. The semen tube may be clogged or partially cut off (sterile). TESE is a minor and uncomplicated operation. A part of the tissue is cut off from the testicles by using a needle to absorb the sperm for identification. Anesthetic or anti-suppressant are used for the restricted operation area. The tested sperm is injected into the egg by ICSI process.

Intra Cytoplasmic Sperm Injection (ICSI)

This technique is a direct injection of a single sperm into each egg. This is one way of conception for patients who have a few sperm or no sperm to penetrate into the egg by itself.

What is Ultrasound?
Ultrasound is a type of sound wave which has a frequency higher than 20,000 Hz. At present the ultrasound wave is used to develop medical equipment to detect various diseases including the infant’s health in the womb.

How dos the 4D-Ultrasound functions?
Today, the ultrasound machine is more complex and superior to the traditional 2D-ultrasound machine where the length and width of the picture can be depicted or the graphic is blocked by the level of wave transmission each time. Although the picture is useful, it does not clearly display the infant’s picture. The new ultrasound machine digitally collects the quantity of reflecting sound and display the picture in 3D format in a more realistic manner. The 4D-ultrasound can capture each of the 3D pictures with realistic animations at real time via the 4D technology in order to clearly identify the infant’s behaviors.

Advantages of 4D-Ultrasoun

What does the 4D-Ultrasound detects?
The cutting edge of the 4D-ultrasound, not only brings joy to the parents and members of the family for entertainment purposes, but attention is paid to the infant’s health as the first priority. The physician’s careful evaluation of the infant’s growth and development is carefully emphasized on:

A Fully Integrated 4D-Ultradound Check-up at The Perfect Woman Institute offers:

• 3D pictures of the infant in the womb
• 4D-ultrasound DVD (can be opened only by DVD player and computer)
• Infant’s growth report
• Perfect Mom file with pictures and DVD
• Booklet about the womb’s development and duty of being a mother during pregnancy

Suitable Period for Pregnancy Check-up by
4D-Ultrasound
                Patients can undergo 4D-ultrasound check-up at any stage of their pregnancy. The body of the infant can be viewed at the pre-natal stage while more details of the infant’s body are displayed at a later stage. The best accurate picture of the infant can be captured during week 26-33 for single pregnancy and during week 24-28 for twins.

edit @ 14 Sep 2010 15:39:35 by Perfect Woman