BioTexCom

Terms

Amenorrhea – suppressed menstruation

Androgen – predominantly male steroid hormone

Andrologist – one of the failures of male’s fertility

Antibody – solvable glycoproteins that are present in blood serum of intercellular lymph; or present in cellular membrane which recognize and bind antigens.

In vitro fertilization – the term refers to fertilization that takes place outside the body, in a lab dish instead of a woman’s fallopian tubes. IVF involves stimulating the ovaries, retrieving released eggs, fertilizing the eggs, growing the embryos in a laboratory, and then implanting the embryos in the woman’s uterus to develop.

Assisted reproduction – artificial insemination.

Biopsy – body tissues withdrawal by resection or puncture using a needle for microscopic, biochemical and microbiological examination.

Blastocyst– a stage of embryonic development that occurs about 5 days after fertilization, when the embryo consists of two different cell types (those that will form the placenta and those that will form the fetus) and a central cavity. Following IVF, the embryos are allowed to reach the Blastocyst stage before being transferred into the uterus, rather than being transferred after the second or third day.

Cervix – The opening into the uterus. The cervix is a ring of tissue at the top of the vagina designed to collect sperm (with a cervical mucus), which are later released into the uterus. Observing changes in your cervical mucus will help you determine signs of fertility.

Chromosome – is an organized structure of DNA and protein found in cells. It is a single piece of coiled DNA containing many genes, regulatory elements and other nucleotide sequences. Chromosomes also contain DNA-bound proteins, which serve to package the DNA and control its functions. As a rule, a person has 23 chromosome pairs.

Chromatism – deviation of normal number of chromosomes or structural changes of certain chromosomes. Frequency rises with parents’ aging (> 35 years to 1-2%,> 43 years to 9%)

Yellow body of ovary – temporary blood gland in the female organism which appears after ovulating and develops progesterone.

DNA – deoxyribonucleic acid is one of two types of a nucleic acid that contains the genetic instructions used in the development and functioning of all known living organisms (with the exception of RNA viruses). The DNA segments that carry this genetic information are called genes, but other DNA sequences have structural purposes, or are involved in regulating the use of this genetic information. Along with RNA and proteins, DNA is one of the three major macromolecules that are essential for all known forms of life.

Ductus deferens – spermoduct

Ovum selection – sucking of follicle liquid with ovum; and artificial insemination before 12 for interference.

Ejaculate – sperm ejection.

Embryo – a term that describes the time from fertilization of the egg until the eighth week of pregnancy.

Embryo period – until 8s week after fertilization and conceiving.

Embryo transfer – placing an egg that has been fertilized outside the womb into a woman’s uterus or into the fallopian tube after IVF.

Embryopathy – failed embryo developing

Endocrinology – one of the youngest and thriving branches of medicine, concerning disease treatment connected to endocrine system abnormalities.

Endometriosis – disease which is characterized by endometrial tissue beside ovum

Endometrium – is the inner membrane of the mammalian uterus.

The epididymis – is part of the male reproductive system and is present in all male amniotes. It is a narrow, tightly-coiled tube connecting the efferent ducts from the rear of each testicle to its vas deferens.

In vitro fertilization- the term refers to fertilization that takes place outside the body, in a lab dish instead of a woman’s fallopian tubes. IVF involves stimulating the ovaries, retrieving released eggs, fertilizing the eggs, growing the embryos in a laboratory, and then implanting the embryos in the woman’s uterus to develop naturally.

Fertility is the natural capability of giving life. As a measure, “fertility rate” is the number of children born per couple, person or population.

Embryo – a term that describes the time from fertilization of the egg until the eighth week of pregnancy.

Follicle – a fluid-filled sac in the ovary that contains the eggs.

FSH/EQQ quality herbal support – herbal Support for Egg Quality Improvement is comprised of a balanced combination of medicinal herbs that help improve egg quality in women of all ages. The treatment increases the blood supply around the ovary, warming it so that it can produce fully ripened high-quality eggs. This herbal support therapy is recommended for enhancing egg quality for natural impregnation, or while undergoing IUI or IVF treatment.

Gamete – sex cell

GIFT – Gamete Intra Fallopian Transfer, IVF method which is used only in case a woman has healthy tubes.

Gonadotrophic hormones – hormones secreted by the anterior pituitary; stimulate sexual glands and control the reproductive function of the body. The main gonadotrophins are the follicle-stimulating and luteinizing hormones.

Assisted hatching – microsurgical 5PT procedure during which the embryonic chorion is partly destroyed mechanically or chemically, which simplifies the embryo withdrawal from the chorion and its implantation. It increases the chances of getting pregnant with women over 39 years of age.

HCG – human chorionic gonadotrophin.

Testes – male’s genital gland.

Hormone – a chemical substance that travels via the bloodstream and carries a signal from one part of the body to another.

Hormones in female cycle:

• Follicle stimulating hormone (FSH) – a reproductive hormone that stimulates sperm production in a man; in a woman, FSH stimulates the growth of the ovarian follicle and the production of eggs, which is needed in order to ovulate. As the follicle grows, it releases inhibin, which halts the production of FSH.
• LH luteinizing hormone – causes ovulation.
• Estrogen – one of the two principle female sex hormones responsible for triggering growth of the female reproductive system. In the first half of the menstrual cycle, this hormone stimulates the uterine wall to become richly supplied with blood.
• Progesterone – an important ovarian hormone that is normally secreted after ovulation and during pregnancy. Progesterone triggers thickening of the lining of the uterus so it can accept implantation of a fertilized egg.

Hormonotherapy – hormone regulation with the help of medicine.

Intracytoplasmic sperm injection – is an in vitro fertilization procedure in which a single sperm is injected directly into an egg.

Infertility – is defined by World Health Organization (WHO) as the inability to conceive after one year of unprotected, well-timed intercourse, or the inability to carry a pregnancy to term. The Infertility definition is reduced to six months for: Women over 35, Women with a history of painful periods, irregular cycles, pelvic inflammatory disease and miscarriages and couples who know that the male partner has a low sperm count.

Insemination – is the deliberate introduction of sperm into the uterus of a mammal or the oviduct of an oviparous (egg-laying) animal for the objective of impregnating a female for reproduction. Insemination normally takes place during, and as the result of, sexual intercourse between a male and a female, when semen is ejaculated by the male into the female’s reproductive tract, but can take place in ways not involving sexual intercourse.

Analyses required for egg donation program

Analyses And Examinations Required For Women:

1. Rw, HBs, HCV, HIV, syphilis (made no more than 6 months before that)
2. TORCH infections (rubella and toxoplasmosis)
3. Vaginal discharge analysis
4. Karyotype analysis (termless)
5. Blood group and Rhesus factor (termless)
6. Complete Blood Count (CBC) made no more than 1 month before that
7. Biochemical blood count (bilirubin, AST, ALT, kreatinin, complete protein)
8. Koagulogram
9. LH (luteinizing hormone)
10. FSH (follicle-stimulating hormone)
11. Vaginal and cervical canal swab (no more than 6 months before)
12. Microscopic examination of vaginal canal
13. Pelvic organs ultrasound
14. Breast ultrasound
15. Attending physician’s opinion
16. Anti-muller hormone test

Analyses and examinations required for men

1. Rw (Wasserman test)
2. HBs
3. HCV
4. HIV (no more than 3 months before)
5. Blood group and Rhesus factor (termless)
6. Karyotype analysis (termless)
7. Spermogram (no more than 3 months)
8. ICSI screening

Laser assisted hatching

Embryo must break the membrane for the successful pregnancy. There is a special method – laser assisted hatching in order for the embryo to break the membrane and make the process easier. This hole can be made mechanically with the help of pipette, special laser and is created with the biological acid. But there is no full certainty how to make the pregnancy rate higher with the help of this method. Following patient groups can have a successful laser assisted hatching:

• Women aged over 37
• Increased FSH level before treatment
• Terminated embryo quality
• Embryos with thick membrane
• Unsuccessful attempts that were made earlier

How is this method fulfilled?

This method requires corresponding experience, laboratory and mentioned before fact about undefined factor – whether it will help to increase pregnancy rate.

Laser assisted hatching can be fulfilled with the help of different technologies:

Mechanical paracentesis with the help of micromanipulation and glass needle, embryo is held with the help of pipette. Tender needle does not touch and damage embryo cells. Membrane cautiously rubs between needle and pipette until a whole in the form of cut appears.

Laser cut:

• Laser fiber in direct contact
• Focused laser ray directs membrane with acid through microscope lenses

Preimplantation Genetic Diagnosis

Preimplantation Genetic Diagnosis means cellular – biologic and molecular – genetic examinations with the help of which a decision is taken whether an embryo which is received via artificial insemination is implanted to the alvus or not. PGD is used to determine inheritable diseases and harmful peculiarities of chromosomes and for determination of child’s sex and his inheritable peculiarities.

PGD was used more than 10 000 times. It is used since 90s. PGD causes many ethical and political contradictions because it touches a basic question – germ of life. In many countries, PGD is regulated by law and is allowed only for definite aims. In Germany PGD is used to escape bad inheritable diseases, death or miscarriages.

Preimplantation diagnosis – is a genetic examination of received in the result of artificial fertilization embryo before it is implanted to the woman’s alvus. On the third day after fertilization when an embryo consists of six or ten cells – one or two cells are extracted and examined on genetic mutations. Aneuploidie-Screening is considered to be preimplantation genetic diagnosis, when embryo is checked on additional chromosomes or a lack of them.

In 1990 in England first baby was born using PGD to avoid inheritable diseases and define sex of a baby. A child whose monogenetic inheritable disease was excluded, was born 2 years later. Quantity of children born with the help of PGD is over 10.000 today. PGD is used not only to determine circa 200 diseases but for other aims to, for example to increase success of artificial insemination and to determine baby’s sex.

Sperm donation

When a couple can not conceive a baby due to the husband’s bad sperm quality, they can use donor’s sperm to solve this problem. Reproduction medicine makes sperm transfer. The sperm of a volunteer donor is used. There are sperm banks, where sperm is frozen (cryoconserved) and used by reproductive medicine clinics.

Sperm donation is used many years for the infertility treatment. In England, more than 1000 children are born with the help of sperm donation. In order to escape HIV risk, in some countries it is allowed to use cryoconserved sperm.

When are needed the services of sperm donor?

• When a wife is infertile, husband has sperm cell dyspoiesis
• When a husband has an inheritable disease, which can be inherited by children (muscular dystrophy, haemophilia).
• When wife has progressive rhesus incompatibility and husband has blood type with positive RH.
• When husband is infected with HIV.

Requirements to sperm donor

Potential donor must be full-aged and under 40. He must be healthy. He must not have inheritable diseases, and he must not take long-acting medicaments. Donor and his family members must not have chronic diseases such as diabetes, epilepsy or rheumatism.

Donor examination

Before becoming a sperm donor, a man has to pass sperm semen. Semen is checked for applicability. We also test donor for following illnesses when taking blood sample:

• Hepatitis B
• Hepatitis C
• HIV
• Ghonnerhea
• Chlamydia
• Cytomegaly
• Syphilis

If there is an assumption of infection, further examination will be done, for example herpes or papillomavirus. First, we freeze every sperm sample then we unfreeze it only after 6 months if during all these months no diseases will be found.

Juridical aspects of sperm donation

Sperm donor does not receive any information about the couple that uses his services nor about a child that is born via his sperm donation. Donor can not require anything from parents or child.

Egg cell donation

Egg cell donation is a possibility to have children when it is impossible to get pregnant on own egg cells. We have egg cell bank in our clinic for egg cell donation, and we can offer you many young, attractive and healthy donors that will start the treatment and stimulation simultaneously with you.

Advantages of egg cell donation in our clinic

In our clinic, one client gets one egg cell donor; this means that you receive all egg cells that are produced by a donor over all treatment period. We do not have a so called “egg cells distribution”, the distribution of donor’s egg cells between patients. All our donors are young and are mommies (have 1 child minimum) that is why infertility treatment with the help of egg cells donation has all chances for success. To start an egg donation program you do not have to wait for a long time because we have a big bank of egg cells.

We choose donors in such a way, so that your characteristics would match donors’. In our clinic you receive fresh, not frozen embryos. Embryos develop to blastocysts (5 days), than 3 selected embryos are implanted. It is possible to freeze embryos that are left to use them next time if needed.

Criteria for egg cells donor in our clinic.

All our egg cells donors are under 30, average age is 26 years. All of them have at least one child (all children are healthy). All egg cells donors are attractive, intelligent and healthy. All of them pass general medical, gynecological, and psychiatric examination, during three months are tested for HIV, Hepatitis B and C.

What is egg cell donation?

For egg cell donation egg cell donor and client are needed. Egg cell donor undergoes IVF treatment to produce egg cells. Then egg cells are fertilized in the laboratory with the husband’s sperm or patient’s partner (or donor’s sperm). Donor egg cells are developed in embryos, among which one or two/three are transferred to the patient’s alvus. Frozen embryos that are left are the property of patient or her husband. After successful pregnancy patient delivers a child and becomes a mother.

IVF/ICSI

ICSI > Intra Cytoplasmic Sperm Injection – it is generally performed in addition to an in vitro fertilisation procedure to extract often several oocytes from a woman.

IVF/ICSI is the procedure that is fulfilled naturally. Women are inserted hormones to raise the quantity of maturating eggs. Egg cells are observed with the help of ultrasound. When they reach the size from 18mm to 20mm, chorion gonadotropic hormone is injected to fasten the maturation that results in 36 hours. By this time, patients are prepared for the operation and under anesthesia egg cells are retrieved by follicular injection via ultrasound.

In between the man gives his semen. Semen is estimated, and then the most mobile and normal will be picked up and used in the procedure.

For a normal IVF procedure, egg cells are placed into Petri dish, and take root in the ratio 100.000 semen for an egg cell. Mixture is put into an incubator and next day, after egg cells are diagnosed in normal conditions and if semen is of good quantity from 70 to 80% off cells are fertilized. Egg cells continue to separate and in 2 days after recovery they reach 4^th cellular. On the third day embryos reach 8^th cellular.  The same day, 3 healthiest embryos are taken and placed into the woman with the help of plastic catheter. In our center embryo transfer is fulfilled, which is carried out under careful ultrasound observation. Embryos are placed 2 centimeters below alvus.  It results in more success for pregnancy. In 12 days pregnancy tests are done.

ICSI procedure

During IVF procedure semen and egg cells are put into the same membrane and wait until semen fertilizes an egg cell. Fertilization will not happen if the quantity of semen is not enough. Even if the semen is normal there is a variety that fertilization will not happen due to unknown reasons. During ICSI procedure, separated semen is taken and micro injected into the egg cell, this results in guaranteed fertilization.

ICSI procedures become more and more popular because they expel the probability of unsuccessful fertilization of egg cell by semen. With the help of the usual ICSI procedure the quantity of pregnancies rose. Unlike western clinics we do not take additional ICSI expenses. Sometimes semen can not be found due to absence of tube between testicle and penis. In this case semen can become active with the help of testicle biopsy. This is called TESE procedure (testicular semen). Semen that is received this way also can be used.

Rising pregnancy rate

In order to raise success ratio, a couple of processes need to be done. For example, some embryos have thick outer shell that prevents embryo replanting. That is why laser is used to make this outer shell thinner. In some cases in order to get better embryos, eggs are transferred not in 3 but in 5 days. 5 days embryos are called blastocysts, consequently the process is called blastocyst transfer.

In case of failed IVF/ICSI attempts, chromosomes may cause embryo abnormalities. In this case PGD procedure is done (Preimplantation Genetic Diagnosis). With the help of this technology one cell is cautiously retrieved from 4-cell embryo and is researched to analyze chromosomes. Then embryos with normal chromosomes are chosen and are transferred to a woman on the next day.

In several IVF/ICSI cycles several embryos are transferred. After 3 of them are used, other high quality embryos are frozen to be used in the future. Today, embryo freezing is a widespread technology that gives women a chance for pregnancy. Embryo transfer is not as expensive as regular cycle because nor medical treatment nor anesthesia is needed. In case couple wants one more child and if the cycle fails to be successful, it is possible to freeze embryos for several years.

Who can become a donor?

In the frames of egg donation program, in our clinic you can choose a donor who matches your personal requirements. Our selection method is based on the client’s needs and we continue to make other steps if you like our proposition. You choose which donor’s characteristics are the most important for you. We respect your decision.

Selection method in our clinic

In the process of potential donor selection, their medical and psychological states are carefully studied. Whenever which donor we choose – he will meet your requirements and expectations.

Our credo: donor must be selected personally for you. For this reason we meet on the first consultation to get to know each other better (in case if you choose a program that we offer) before we select donor for you. It is important for us to find out what donor qualifications you are interested in first of all. For the majority of women who plan an egg donation procedure, it is important that the donor looks like him. We always meet with our donors personally to select the best one for you.

When we choose donor, we consider following criteria: ethical background, height, body type, eye color, hair and skin color, hair and skin color; we make our best to find the most attractive donor for your profile requirements. We also consider blood type and Rh. We also can make a characteristic about school and professional education. Many of our donors have eastern European appearance, blond or dark hair with blue, grey or brown eyes. This is why it is necessary to choose a blond or dark hair woman with the same eye color as yours.

After you tell us what you wish, we search in our egg donor data bank to find the best match with all the parameters that you provide us. We meet our donors personally to guarantee you the best match. We inform you about age, height, weight, eye and hair color, school education and profession of donor, we also give you information about age of the donor’s child or children and then you take a decision. If you are not satisfied with our offer we can again start the search and selection of donor for you again. We understand how difficult a decision is on egg donation and start next procedures if you are satisfied with the choice.

Female infertility

Almost one third of women have problems with reproduction function. Infertility can be influenced by deregulations or severe illness. If endocrine profile is defective, chances to conceive decrease; this means that egg cells do not mature and ovulation does not happen, or a fertilized egg cell can not attach.

Hormonal causes

There are many deregulations of female menstrual cycle that cause poor maturation of ovum or problems with implantation. Following deregulations are the most widespread:

• Congenital absence of the vas deferens (CBAVD) – ovarium cystis. Meaning not only the genuine cystis, but also big quantity of small eggs, follicles which can not mature and fade. This fading egg cells can be screened and they will look like a small cystis. There are two causes of CBAVD: increased outcome of androsterone and insulin resistance.
• Insulin resistance: overweight intensifies not only CBAVD, but also insulin resistance (often occurs together with CBAVD). Insulin resistance causes an increased production of insulin.
• Increased androsterone: circa one third of women with irregular menstruation have an increased androsterone. This can lead to defective fertilization of egg cells or to a complete absence of ovulation. Alike symptoms as CBAVD can be observed.
• Increased lactation hormone: Hyperprolactinemia is a hypophisis failure (pituitary gland). For many women it is a cause of problematic ovulation or absence of menstruation. Increased level of lactation hormone negatively influences hypothalamus and obstructs ovulation hormone and egg cells fertilization.
• Insufficient functioning of thyroid gland: Insufficient functioning of thyroid gland can be the reason of the above described lactation hormone and can cause described effects for ovulation. Hyper function – is a sub function of thyroid gland.
• Hypophisis: pituitary gland failure can take place in 10% of women, whose menstruation was hormone assisted. Women who suffer anorexia, go info elite sport, often have stress, can suffer such a disease.
• Premature menopause: in 1% of all women, functional loss of ovarian occurs before 40. It is referred to premature menopause period. There are many diverse causes of this problem, but there are not completely explained.
• Deficiency of yellow body: it is one of the most widespread reasons for female infertility. When ovulation starts, and then starts the forming of yellow body. After ovulation yellow body hormone controls the preparation of endometrium to the embryo implantation.

Organic causes:

Ovulation and successful fertilization can prevent not only the violation of female hormonal balance. Also such reasons as cystis fusion and tumor can be the cause of:

• Damage of Fallopian tubes: in two third of cases, this is a reason for female infertility. If Fallopian tubes are discontinuous, bond or narrowed, then semen can not get into the egg cell, so that the fertilized egg cell can not get into alvus.
• Cicatrization of vesical cervix because of inflammation or operation leads to the fact that semen can not get into fallopian tube and can not fertilize an egg cell.
• Myoma: Myomas (benign muscular tumors) depending on their size can cause infertility and result in miscarriages and problems during pregnancy.
• Endometriosis: chronic, benign proliferation of mucous coat. Endometriosis is very painful and can result in fusion and bonding of fallopian tubes.

Age and lifestyle

Lifestyle influences hormonal balance greatly. If a woman leads unhealthy living, often has stress and is in years, it all will have an impact on hormonal balance.

• Age: egg cells grow older together with an organism. Egg cells’ aging can result in chromosome changes, which can cause absence fertilization and increase a variety of miscarriages and child’s chromosome defectiveness.
• Overweight also negatively influences the possibility of conceiving a child. Overweight can be connected with following hormonal misbalance: insulin resistance, increased androsterone, lactation hormone, CBAVD syndrome, insufficient functioning of thyroid gland.
• Underweight can also negatively affect an ability to conceive a child. If a woman is underweight, body classifies it as hunger and pregnancy can harm the mom’s health. Brain receives a signal that reproduction processes should decrease.
• Stress. Physical activities also have their effect on hormonal balance of a woman. If a woman often has stress it is necessary to measure prolactin level. This effect is also connected with hormonal reasons.
• Medication taking also influences hormonal balance. It is necessary to discuss medication treatment with a doctor before having a child.

• Immune system. In some cases there is a variety that woman’s immune system will consider egg cells to be a foreign matter.

Venereal diseases

Some contagions that are sexually transmitted can restrict fertility. Among these are chlamydia and blennurethria. Women and men who had such venereal diseases can become infertile in future.

• Chlamydia: Chlamydia infection is a common cause of women’s sterility and miscarriages. Venereal diseases can bring to alvus fusion and fallopian tube sticking. In this case a woman can not conceive naturally. Unfortunately, it is hard to identify this infection in a body and it can appear again and again. A pregnant woman can transmit them to a child.
• Blennurethria: very often such disease ad blennurethria is hard to defect, as it hardly has any symptoms. It is a most common genital disease. Blennurethria that did not undergo treatment can have consequences for many organs, including genitals. It can also lead to organic damaging, then – sterility of a woman. Pregnant women can transmit this disease to a new born. If this problem is not discovered timely, it can lead to loss of vision of a new born.

Heritable diseases:

Heritable diseases can change chromosomes and lead to the disruption of body’s reproductive processes; also there is a possibility of miscarriage.

Heritable diseases have numerous distinguishing features. Detailed genetic tests give copious information about the causes.

Male infertility

Women infertility is not always the reason for the sterile marriage. Circa in 30-40% childlessness is caused by women infertility, in other 30-40% of cases biological cause of infertility lies in a man. In 15-20% both partners are infertile, in other 5-10% it impossible to define the infertility cause.

The most widespread cause of male infertility is a low quality of semen. There are also many other reasons. Opposite to female infertility, problems with male’s fertility decrease with age. As a rule, bad quality of semen is a consequence of the following reasons. Male’s infertility can also be genetic.

Among low quality semen there are: azoospermia, asthenozoospermia, oligospermia, and teratozoospermia.

Azoospermia – absence of semen in the semen fluid. Azoospermia can be connected with the blockade of seminiferous ways. Both can be caused by birth defects.

Asthenozoospermia – the decrease of active sperm. Only active sperm can fertilize an egg cell, when there is minority of such sperm – chance for pregnancy decreases.

The decrease of sperm in ejaculate is called oligospermia. Normal quantity of semen/ml – is more than 20 mln.

Decrease of this index below norm is called teratozoospermia.

Here are the reasons for insufficient quantity of semen:

• Mumps disease in childhood;
• Cryptorchism;
• Diabetes;
• Operated tumors;
• Genetic causes;
• Stress;
• Infections;
• Factors determined by environment;
• Drugs and alcohol abuse.

There are also genetic factors of male infertility:

• Chromosome mutation;
• Micro division in Y chromosome;
• Congenital absence of the vas deferens (CBAVD)