Assisted Reproduction

Assisted reproduction is not a single technique but a set of options that step up from simple to advanced. The right one depends on the cause of infertility, the woman's age, the test results and the number of previous attempts.

The techniques

Intrauterine insemination (IUI)

The semen sample is washed and concentrated in the lab, then placed inside the uterus with a thin catheter at the time of ovulation. It suits mild male factor, cervical problems and some cases of unexplained infertility. At least one fallopian tube must be open.

IVF and ICSI

Eggs are fertilized outside the body and the embryos are transferred to the uterus. This is the right step for blocked tubes, severe male factor, or when IUI has not worked.

Surgical sperm retrieval

When there is no sperm in the ejaculate, sperm can sometimes be retrieved directly from the testis with techniques such as microsurgical extraction (Micro-TESE), then used for ICSI.

Frozen embryo transfer

Frozen embryos are transferred in a later cycle, once the uterine lining has been prepared, either naturally or with hormones. This gives the body time to recover from stimulation and allows the best timing for implantation.

Modern lab techniques

• Blastocyst culture (day 5) to choose the strongest embryos.
• Vitrification (fast freezing) of eggs and embryos, with high survival rates after warming.
• Preimplantation genetic testing (PGT) in the cases that need it.

Science first

In recent years many add-ons have been offered to patients, but not all of them are proven to help. International bodies such as ESHRE and the UK fertility regulator (HFEA) review these add-ons continuously. It is best to rely on what has been shown to improve the chances of pregnancy for each case.