Reproductive medicine is our business. So, whether it is fertility treatment, pre-implantation genetic diagnosis, or gender-selection, we provide it, and to the highest international standards, medically, scientifically and ethically. After the initial consultation and the necessary tests, we will discuss with you in detail what treatment is necessary and what are your chances of success.
- Intra-uterine insemination
- IVF
- ICSI
- Embryo freezing
- Sperm and Egg freezing
- Pre-implantation genetic Diagnosis (PGD)
- Gender Selection
- LASER Assisted Hatching
- Transmyometrial Embryo Transfer
- Treatment of azoospermia
- Recurrent IVF Implantation Failure
- Reproductive Surgery
In some couples the delay in pregnancy may be unexplained, meaning that no cause is found after doi ng all the necessary tests. In this condition one treatment option is super-ovulation and IUI. It involves giving the woman medications to produce more than one egg and, at the right time in the menstrual cycle when the eggs are ready, inserting the husband’s specially prepared sperm into the womb.This brings more sperm closer to more eggs and increases the chances of pregnancy.
For pregnancy to occur, sperm and egg must meet to form an embryo. This may not happen naturally for various reasons, such as blocked Fallopian tubes or scar tissue in the pelvis. The treatment in such cases is IVF. It involves giving the woman medications to increase egg production from the ovaries. The eggs are then collected and mixed with the husband’s sperm in a test tube in the laboratory to form an embryo. This is why it is called test-tube baby. The embryo is transferred to the womb 2-5 days later.
Some men have very low sperm count or very slow sperm that are not even suitable for IVF. Others do not produce sperm at all in the ejaculate (azoospermia) so sperm need to be obtained from the testis through a minor procedure. For these men the best treatment is test-tube baby using the ICSI technique, where an individual sperm is injected directly into each egg using very precise equipment under high magnification in the laboratory.-
Many couples produce more embryos than are transferred during IVF. We have the facility to freeze those ‘surplus’ embryos if they are of good quality, and then replace them back at a later stage, perhaps if the initial treatment cycle was not successful or even if it was and the couple would like another baby.
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A frozen embryo transfer cycle is much easier and less costly than a fresh cycle. In addition, the woman avoids the inconvenience and potential side effects of the ovarian stimulation drugs and the egg collection procedure.
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In our center, the results of frozen embryo transfer are almost as good as the fresh IVF cycles.
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We have an active sperm freezing programme, which is very useful in many cases. These include men
who are about to undergo chemotherapy treatment that might affect their ability to produce sperm in the future, men who produce variable number of sperm and when the husband might be away during his wife's treatment. -
We also offer egg freezing, which is useful in women who are about to undergo chemotherapy treatment.
- PGD refers to the genetic tests performed on the embryo before it is transferred to thewomb.
- This is a highly advanced technique available at our center for the avoidance of certaingenetic conditions, such as Down's syndrome, in families known to be carriers of thesegenes. Also couples with recurrent pregnancy loss due to chromosomal translocations(when the genetic material is arranged differently in one of the parents) benefit from thistechnique.
- Some couples carry genes for certain serious diseases that may appear in some of theirchildren and not in others, depending on which genes they inherit. The reproductiveoptions for these couples are one of 3 options.
The first is to get pregnant naturally and then see what comes out, whether it is anaffected baby or not. Some accept this option, but many prefer not to go ahead withit, particularly if the disease is severely disabling for the child.
The second option is to get pregnant naturally but have a test done during pregnancy(such as taking a sample from the placenta or the fluid around the baby) to look forthe disease. If the baby is affected then there is the option of terminating thepregnancy. Although this option avoids the birth of an affected child, it involvestermination of pregnancy or the risk of losing a normal pregnancy as a result of thetests done.
The third option is PGD, when embryos are formed in the laboratory through IVF (seeabove) and one cell is taken from each embryo when it is 3 days old, through a verydelicate technique called embryo biopsy. That cell is then analysed for the diseasegene in question. Only embryos found to be free from the disease are transferred tothe womb, thus avoiding the risks of both termination of pregnancy and the birth of anaffected child.
- Our laboratory staff are highly experienced in PGD, which is a technique that requiresextra skills, equipment and genetic expertise not available in most IVF centres in theworld.
- To view a short film of embryo biopsy being performed in our laboratory, pleaseclickhere.
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Some couples who have all boys or all girls children may wish their next baby to be of the opposite gender. This is called ʻfamily balancingʼ, and is a legitimate request for an increasing number of couples all over the world. Other reasons for wanting to choose the gender of the baby is in cases where there is a disabling genetic disease that occurs in one sex only.
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Although many methods are purported to do so, the only technique that accurately determines the gender of the baby before conception is IVF and PGD (see above), looking for the X and Y chromosomes. Embryos with XX are girls and those with XY are boys. The embryos of the desired gender are then transferred to the womb.
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Because of our expertise in both IVF and PGD, we achieve very high success rate with gender selection patients, who come to us from many countries all over the world.
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For the embryo to implant into the womb and form a pregnancy, it has to 'hatch' from its outer shell. This may not happen in some women who have thicker than usual outer shell in their eggs. To overcome that, we perform an advanced technique called LAH (Laser assisted hatching), where an extremely minute hole is made in the outer shell of the embryo using computer-guided laser energy. This technique has been proven not to harm the embryos and to increase the chances of success in cases where there has been previously repeated unexplained failure of IVF.
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To view a short film of LAH being performed in our laboratory, please click here.
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The usual route of transferring embryos to the womb in IVF is through the cervix (neck of womb), and the easier the transfer, the higher the chances of pregnancy. However, in some women embryo transfer through the cervix is either very difficult or impossible. In such cases the treatment is to transfer the embryos through the wall of the womb using a special needle under ultrasound guidance.
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This is a highly successful technique which has been developed by Dr Khaldoun Sharif in collaboration with Japanese colleagues, and is used in our center in cases that need it.
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To download copies of our published papers on the transmyometrial embryo transfer, please click here.
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About 8% of men who present to our center suffer from a condition called 'azoospermia', where there are no sperm whatsoever in the ejaculate. This represents the most severe form of male infertility.
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These men require careful and expert assessment. A few of them have reduced hormones and will respond well to hormonal treatment. Most, however, will require a minor surgical procedure to obtain sperm from the testis and then use them for ICSI.
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We have wide experience and special expertise in managing these cases, and have published in international medical journals teaching other doctors of how to manage
• To download a copy of our published papers on azoospermia and its treatment, please click here.
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Many couples who have had repeated unsuccessful IVF attempts elsewhere are referred to us, because we have special expertise and very good results in dealing with these cases.
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Before embarking on another IVF cycle in these couples we do a number of tests to try and find out the reason (or reasons) behind the previous failures. There could be problems in the womb (such as a uterine septum), the tubes (such as hydrosalpinx), or the blood clotting tendency. Most of these problems have solutions, and not surprisingly once the problem is solved the chance of successful IVF become much higher.
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Even in couples who have had repeated unsuccessful attempts in the past and nothing wrong is found on testing, there are certain techniques that we use (such as Laser assisted hatching) and are proven to increase the chances of success.
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For some couples with reproductive problems, surgery may be necessary and in some cases may be the only thing needed. For example, women with large ovarian cysts or large uterine fibroid require those removed before starting their fertility treatment. Others with uterine septum and repeated miscarriages need just a simple scope operation to remove the septum.
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Most of the reproductive surgery we perform is done through what is called 'minimal access surgery'; without the need for large abdominal cut. It is done through laparoscopy (a scope for the abdomen) and hysteroscopy (a scope for the womb), which have many advantages, including less cost, less tine in hospital, and faster recuperation period.
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Dr Khaldoun Sharif is a UK-accredited minimal access reproductive surgeon, and uses the latest surgical technology and up-to-date equipment. So we have both the expertise and the tools to give you the best outcome from your reproductive surgery.
