CRGW has been set up to provide treatments which the NHS does not currently provide and also to provide conventional treatments for couples to whom NHS treatment is denied.
We provide all aspects of reproductive medicine treatment.
- IVF (In Vitro Fertilisation)
- ICSI (Intracytoplasmic Sperm Injection)
- IUI (Intrauterine Insemination)
- Ovulation Induction and Intrauterine Insemination (OI/IUI)
- Egg Donation (See Egg Share and Donation Program)
- Egg Sharing (See Egg Share and Donation Program)
- Blastocyst Culture
- Assisted Hatching
- Embryo Freezing
- EmbryoScope Time-Lapse Imaging
- Sperm Freezing
- Surgical Sperm Retrieval
In Vitro Fertilisation (IVF)
IVF was developed for women where there is a Fallopian tube problem. It involves the woman having daily injections of follicle stimulating hormone (FSH or human menopausal gonadotrophins, HMG) for around 12 days, which stimulates eggs to grow. Most women give themselves the injections or get their partner to do it.
The response to these injections is monitored, and at the appropriate time, the eggs (oocytes) are collected from the ovaries with a needle, in a procedure that usually takes around half an hour, during which you are sedated. The eggs are then mixed with your partner’s sperm, fertilsation occurs and embryos are produced. Usually one or two embryos are put back in the womb, two or three or five days later
Intracytoplasmic Sperm Injection (ICSI)
ICSI was developed for couples where there is a problem with the numbers of sperm. The woman goes through the same process as for IVF but a single sperm is injected directly into the egg (rather than allowing them to try and fuse naturally). In these circumstances, ICSI improves the chances of fertilisation, and hence increases the chances of having embryos to put back in the womb.
Surgical Sperm Retrieval (SSR)
If the tube which connects each testicle to the penis (the vas deferens) is blocked, sperm cannot get out with the ejaculate. However, sperm can be recovered directly from the testicle using techniques called MESA (micro-surgical sperm aspiration), TESA ( testicular sperm aspiration) or PESA (percutaneous epididymal sperm aspiration).
Intrauterine Insemination (IUI)
In cases of unexplained infertility, where the woman has been shown to be ovulating normally or where a couple might have difficulty having intercourse, the partner’s sperm is prepared and inseminated in to the womb at the time of ovulation without the need for stimulatory drugs.
Ovulation Induction and Intrauterine Insemination (OI/IUI)
The woman goes through the same injections as for IVF (but uses lower doses of FSH or HMG) and at the appropriate time her partner’s sperm is prepared and inseminated into the womb. Cycle for cycle, OI/IUI is not as successful as IVF but it is considerably less expensive and in cases of unexplained infertility, OI/IUI might be appropriate.
Relatively recent advances in blastocyst culture and transfer have resulted in improved IVF pregnancy rates and reduced multiple pregnancy rates. Traditionally, embryos are transferred to the uterus on day three (called Day 3 transfer) after fertilisation and it is not uncommon to transfer two or three embryos. However, it is now possible to grow embryos in the laboratory to the blastocyst stage of development, which occurs on day five after fertilisation when the embryo has 50-200 cells. Typically, the strongest, healthiest embryos make it to blastocyst stage as they have survived key growth and division processes and have a better chance of implanting once transferred. The selection of potentially more viable embryos allows the embryologist to transfer fewer embryos, often one or two, lowering the risk of high order multiples while maintaining high pregnancy rates
The success of IVF is dependent on a whole series of events, one of the final steps being implantation. For implantation to occur, the embryo must escape from its outer coat (the zona pellucida) - this is known as "hatching". Once the embryo has hatched through its zona it can make physical contact with the lining of the womb (the endometrium) and implantation then begins.
Failure of implantation may result from an inability of the embryo to hatch and in some women this may be why they aren’t getting pregnant, even with IVF. Assisted hatching is a physical or chemical treatment of the zona pellucida to try and improve implantation. See Assisted Hatching patient information leaflet for further details.
Embryo freezing is now a well established procedure. It allows us to freeze any good quality embryos that remain after embryo transfer. At CRGW embryos may be frozen at various stages of development; just after fertilisation (pronucleate stage), day two, three or Blastocyst. The decision to freeze and at what stage will very much depend on which day the embryo transfer takes place and the number and quality of the embryos available.
Under certain circumstances a decision may be taken to freeze all embryos at the pronucleate stage. This is normally done to help prevent Ovarian Hyperstimulation Syndrome (OHSS, see IVF and ICSI Patient Information leaflet).
The cost of IVF or ICSI treatment at the CRGW is fully inclusive of Embryo freezing and the first years storage.
EmbryoScope Time-Lapse Imaging
Time lapse videos of your embryos will enable our embryologists to enhance embryo selection for transfer by studying timelines of cell division. This novel and unique application has shown to have a vast improvement in pregnancy rates as patterns of embryo development can be monitored to select the most viable embryos from a group. CRGW were the first in Wales and the South West and amongst the first in the UK to offer this treatment option.
Sperm freezing like embryo freezing, sperm freezing is well established. There are a variety of reasons why sperm may need to be stored.