Fertility Services

Every couple’s journey to becoming parents is unique. Planning conception is one thing; knowing when one will expect it is quite another.

If you haven’t been able to fall pregnant after trying for 12 months (or if you’re older than 37) it could be time to seek advice. Our fertility specialists will be able to tell you more about the routine tests and procedures as well as our assisted conception treatments.

Surgical procedures

At Wijnland Fertility we offer the full range of fertility surgery, including laparoscopic myomectomy, laparoscopic treatment of all grades of endometriosis, hysteroscopic removal of fibroids/polyps and re-anastomoses of Fallopian tubes after sterilisation.

As part of our general gynaecological surgery we also offer total laparoscopic hysterectomy, as well as endometrial resection/ablation.

  • Endoscopic surgery and advanced endoscopy
  • Laparoscopic diagnosis of endometriosis
  • Gynaecological endocrinology

AI/ IUI

Artificial Insemination/Intra-Uterine Insemination

This procedure is also known as artificial insemination (AI). It consists of a combination of superovulation (i.e. stimulating the growth of more than one egg) with insemination of the prepared sperm sample at the time of ovulation.
Indications for AI:

Female
  • Mild Endometriosis
  • Unexplained Infertility
  • Irregular Menstrual Cycles
  • Failure to Ovulate (Anovulation)
Male
  • Mild Male Factor
  • Sexual Dysfunction (e.g. Premature Ejaculation)
  • Frozen Sperm (e.g. If husband is away at time of insemination or if donor sperm is needed.)

If you are considering the IUI route, a comprehensive consultation with your fertility specialist is recommended, as it is important to first identify the possible cause(s) of infertility. The male partner will also be advised to have a sperm test done. Thereafter, the fertility doctor will discuss your treatment plan with you in detail. Our fertility sister will also discuss the stimulation medication with you.

An IUI treatment cycle includes a few sonar scans with your fertility specialist and specific blood tests may be needed. This is necessary to monitor the growth of the follicles (containing the eggs) and to determine your day of ovulation. The insemination day will then be scheduled accordingly. On the day of the insemination, the male partner should provide the laboratory with his semen sample. Three days of abstinence is preferred. The semen is prepared in the laboratory to allow for an optimal sperm sample with optimised sperm parameters (i.e. concentration and motility) that ultimately will optimise fertilising potential.

The female partner will undergo the insemination of the prepared sperm sample at the doctor’s rooms.

The female partner will undergo the insemination of the prepared sperm sample at the doctor’s rooms. The AI procedure is similar to a routine gynaecological examination for a Pap smear. The pregnancy test is normally performed 12 days after the AI procedure. A blood beta-hCG test is the most accurate. A home pregnancy test is less accurate and can be done 15 days after the AI. We will contact you as soon as we receive your test result. If you have any questions about the testing or interpretation of the results you are more than welcome to contact our fertility clinic.

 

 

IVF

In Vitro Fertilisation

The first baby born as a result of in vitro fertilisation dates back to 1978. Since then, IVF has developed into a treatment accepted for infertility worldwide. It is estimated that five million IVF babies have been born.

In short, IVF is the process of fertilisation that takes place in a laboratory instead of in the fallopian tube. Laboratory techniques play a central role in the success of the fertilisation and embryo development. The body conditions are mimicked, as far as possible, with new scientific developments in the field every year to improve these conditions.

In contrast to popular belief, the fertilisation process itself in IVF is not artificial or ‘conducted via man’. IVF is only the process of bringing the sperm and eggs together. The process must then take its physiological and biological course.

EmbryoScope™ is the world’s most used time-lapse system for observation of embryo development, while maintaining stable embryo culture conditions. It has been used in more than 300.000 patient treatments since 2009.

At the heart of the system is the EmbryoScope™ incubator which ensures stable incubation while automatically taking images of the developing embryos at defined intervals. This information is transferred to the ES server so that the information can be accessed from conveniently accessed computer stations.

In standard IVF the embryos are removed from the incubator every second day so embryologists can make sure they’re growing as they should be. The EmbryoScope™ is an IVF incubator with a built-in camera for automated imaging of the oocytes in a closed incubation environment from fertilization until the time of the embryo transfer.
It is a system that is an incubator, a microscope with an integrated camera and advanced software at the same time. The EmbryoScope™ time-lapse system provides superior image quality, thereby allowing the embryologist to visually follow the development of the embryos. In this way, the embryologist can distinguish and choose between normal developing embryos with good implantation potential and development patterns with a risk of implantation failure.

ICSI

Intra-Cytoplasmic Sperm Injection

ICSI was introduced in the early 1990s and has changed many couples’ chances of successful fertilisation.

ICSI takes IVF a step further and introduces a single selected sperm to the inside of the egg. It therefore crosses a barrier that some sperm or eggs cannot do on their own. ICSI requires highly skilled embryologists to apply the required micromanipulation technique. It uses specialised equipment and micro-needles to handle the sperm and the eggs.

Indications of ICSI
  • Failed IVF Fertilisation
  • Poor Sperm Parameters
  • Sperm Extracted from the Testis
  • Low Oocyte Count
  • Spinal Injury in Men
  • Women Older than 38

The expected fertilisation rate of eggs is about 60 – 70%, the same as standard IVF.

The expected fertilisation rate of eggs is about 60 to 70%, the same as standard IVF. This is because the success of ICSI fertilisation is biologically shared equally by the eggs and the sperm, as both must function optimally to result in good-quality embryos.

The quality of the eggs is determined mainly by the woman’s age and therefore correlates the strongest with fertility treatment outcome success, because women’s egg quality declines over time. That is also why success rates are grouped into female age categories.

Sperm are selected on their appearance, called morphology.

This parameter is usually assessed in a sperm test, but when the count is too low or the sperm were extracted from the testis it cannot be estimated. The normal morphology of the sperm correlates with its ability to fertilise an egg, and therefore normal sperm are good candidates to choose for ICSI. If the percentage of normal sperm is very low and normal ICSI results in poor fertilisation rates, IMSI is chosen for the next ICSI cycle.

Lifestyle factors and medication are the main factors that can be changed to improve, in part, the quality of sperm or eggs.

 

icsi

 

IMSI

IMSI is an advanced method over ICSI to improve embryo quality. When sperm morphology is very poor, and the resulting embryos from previous ICSIs have been poor and not resulted in a pregnancy, IMSI is the next option to consider. IMSI, which entails the selection of sperm at 200 to 400 times larger magnification than standard ICSI, enables the embryologist to closely scrutinise the sperm morphology in more detail.

IMSI has been shown to improve embryo quality, reduce miscarriages rate and increase chances of an ongoing pregnancy.

 

imsi

 

 

IMSI

Intracytoplasmic Morphologically-selected Sperm Injection

The development of a highly successful freezing method, namely vitrification, has increased the survival rates of embryos to 90%. A frozen embryo has the same chances of resulting in a pregnancy than a fresh embryo transfer. This success is also related to the endometrium. When a frozen embryo transfer is done, the uterus lining is in a natural state, it is not as heavily stimulated as during a fresh IVF cycle. Thus, the receptivity of the uterus lining is normalised and even better when compared with IVF.

If surplus, good-quality embryos could be frozen in an IVF cycle, it could mean that a second or third embryo transfer could be done without going through the whole IVF process again. In some cases it can even mean that a family can be completed with two or more children in one IVF cycle.

Embryo freezing is also a way of fertility preservation for a couple in which one partner is diagnosed with cancer and needs healing treatment that cannot wait. When a person is single, either egg freezing or sperm freezing may be a better option. These options heavily rely on the diagnosis and many other factors involved. In these situations we will give guidance and support in making such difficult choices.

Egg Freezing

Find out more about Egg Freezing (also known as Social Freezing or Oocyte Cryopreservation), a smart solution that’s highly recommended for women looking to postpone starting a family, for whatever reason.

Egg Freezing Explained

Many modern women postpone childbearing in order to complete their education, get their career on a solid footing, or find the right partner with whom they want to share their life.
 

  • As a result, increasing numbers of women find themselves over the age 35 and confronted by fertility challenges.
  • Egg freezing offers women the possibility of greater control over their reproductive future by potentially extending their fertility.
  • By age 35, a woman has lost ± 95% of her eggs and the rest are ageing rapidly (Mathews & Hamilton, 2002, 2009).
  • Should women have to freeze their eggs and delay motherhood until their 40s just so they can compete in a professional environment designed by and for men? – This is a social-political question.
  • Procedure starts out just like the technique to harvest eggs for IVF.
  • When a woman is ready to use her eggs, they need to be thawed and fertilised.
  • Not all the eggs may survive the cryopreservation and thawing process.
  • To freeze eggs, a technique like verification can be used.
  • To freeze eggs: For the best chance of success, a woman should be 35 years old or younger.
  • One probably needs to freeze around 20 eggs to have a chance for pregnancy; with vitrified eggs, 85% have a chance of survival.
  • Eggs probably can be stored indefinitely.
  • Approximately 1 500 babies have been born worldwide form cryopreserved eggs, but the data is limited.
  • A woman needs 8 to 12 frozen eggs for successful pregnancy.

Please contact us for more information.

Assisted Hatching

The oocyte is surrounded by a gel-like protein layer (zona pellucida), which functions as a sperm-binding and selection matrix and stops more than one sperm from entering the egg during fertilisation. This layer also protects the embryo until about day 5 or 6 of development, when it needs to be shed to enable the blastocyst to implant into the uterus lining.

In older women (> 38 years), or when embryos are frozen, this protein may have changed slightly and may cause the embryo to become trapped inside. In some cases the zona layer is thickened, which we can pick up by-micro measurements on the ICSI microscope and EmbryoScope™.

Assisted hatching or thinning is a technique applied very carefully to the embryo by the embryologist with specialised equipment or mediums. It helps the embryo escape from the zona more readily. It may increase the chances of having identical twins slightly, but chances are still very low. We apply a very gentle zona-thinning technique to ensure that the embryo is not affected.