Services

Preimplantation Genetic Testing (PGT)

• PGD

  Pre-implantation genetic diagnosis (PGD) refers to genetic profiling of embryos created through IVF prior to the transfer into the patient’s uterus. During PGD the embryos are screened for a number of specific genetic disorders, so as to exclude the possibility of selected embryos having these particular abnormalities.

  PGD enables patients with a chronic disease in their family history to avoid passing it on to their children. A specialist may recommend PGD if patients have a family history of severe genetic diseases or previous miscarriages due to genetic disorders.

  PGS

  The term preimplantation genetic screening (PGS) is used to denote procedures that do not look for a specific disease but use PGD techniques to identify embryos at risk. PGS involves checking the embryos chromosomes for common abnormalities. Chromosomal abnormalities are a major cause of miscarriages and the failure of embryos to implant. They can also cause such serious medical conditions as Down’s syndrome.

  PGS is normally recommended for:

  • older patients ( women over 35 years old);
  • patients with a history of recurrent miscarriages;
  • patients with a history of unsuccessful IVF cycles after the embryo transfer stage;
  • patients with a family history of chromosomal diseases.

IVF tests

• For woman

  • Blood type and Rh factor
  • Complete blood count — valid for 1 month
  • Biochemical blood analysis (Protein total, ALT, AST, Bilirubin total, Urea, Creatinine, Glucose) — valid for 1 year
  • Clinical urine analysis — valid for 1 month
  • Coagulogram (prothrombin, thrombin time, aPTT, fibrinogen concentration) — valid for 1 month
  • Smear for flora from urethra, cervix, vagina — valid for 1 month
  • Blood test for detection of HIV, Syphilis, Hepatitis B and C  (must be done only at AltraVita clinic) — valid for 3 months
  • Hormonal screening (AMH, LH, FSH, Prolactin on day 2-3 of menstrual cycle, T4 free, TSH) — valid for 6 months
  • Smear for cytology from endo and exocervix — valid for 1 year
  • Mammary ultrasound (under 35 y.o) — valid for 1 year
  • Mammography (35 y.o. and over) — valid for 1 year
  • Pelvic ultrasound — valid for 1 year
  • Thyroid ultrasound — valid for 1 year
  • Chest X-Ray — valid for 1 year
  • Physician conclusion — valid for 1 year
  • ECG — valid for 1 year

  Medically indicated tests (upon doctor’s request)

  • СА125 before second IVF program
  • Hysteroscopy, endometrial pipelle biopsy are performed for more detailed examination of endometrial tissue
  • Karyotype blood test is done once in life

  For man

  • Blood type and Rh factor
  • Blood test for detection of HIV, Syphilis, Hepatitis B and C  (must be done only at AltraVita clinic) — valid for 6 months
  • Semen analysis (must be done only at AltraVita clinic) — valid for 3 months

  Medically indicated tests (upon doctor’s request)

  • Karyotype blood test is done once in life
  • Depending on the results of medical tests, patients may be asked to visit the following specialists
  • geneticist
  • breast oncologist
  • endocrinologist
  • psychiatrist
  • infectious disease specialist

Assisted Reproduction

• These complex procedures may be an option for people who have already gone through various infertility treatment options but who still have not achieved pregnancy. Those interested in ART should discuss the options with their health care provider and may need to consult a fertility specialist.

  Assisted reproduction is the name given to treatments that can help you get pregnant without you having sexual intercourse. There are varieties of treatments, and what is suitable for you will depend on your own circumstances. The options include:

  • intrauterine insemination (IUI)
  • in vitro fertilisation (IVF)
  • IVF with intracytoplasmic sperm injection (ICSI)
  • the use of donor sperm (donor insemination) or eggs (egg donation).

  Other methods of assisted reproduction called gamete intrafallopian transfer (GIFT) or zygote intrafallopian transfer (ZIFT) are not recommended.

  Certain forms of assisted reproduction (IUI, IVF, ICSI, donor insemination and egg donation) are regulated by law and their use is controlled by the Human Fertilisation and Embryology Authority (HFEA; www.hfea.gov.uk).

Intrauterine Insemination

Hatching

Accommodation for foreign patients

Egg Donation

• Whom is IVF suitable for with egg donation?

  Donor egg IVF is generally with significantly diminished egg quantity and quality (poor ovarian reserve). This includes women with:

  • Premature ovarian failure (early menopause)
  • Very poor egg quality
  • Poor response to ovarian stimulation
  • Very low antral follicle counts on ultrasound
  • Advanced female age, such as over age 40

  Donor egg IVF is recommended to the women who are known to be affected or be the carrier of a genetic disease in order to avoid the risk of passing on genetic disorders to her child.

  Our donors

  Altravita IVF clinic has a well-developed egg donation program corresponding to the highest standards and criteria set by the American Society for Reproductive Medicine (ASRM). We only accept egg cells from young (18-32), good-looking, healthy donors.

  We have a large database of active egg donors who underwent a thorough medical and psychological screening. Besides providing a detailed medical history about herself and close blood relatives, the donor undergoes the following examinations:

  • general medical examination (including blood tests, ultrasound scan)
  • ovarian reserve testing  
  • infectious disease screening for a variety of infections
  • genetic screening and karyotyping
  • drug test
  • medical examination by gynecologist, geneticist and psychiatrist.

  Fresh and frozen egg donation programs  

  Both programs are offered at Altravita.

  Fresh egg donation IVF cycles is the way the majority of egg donation is done around the world:

  • The donors are chosen by a recipient couple and stimulated to produce multiple eggs.
  • The eggs are retrieved and fertilized by patient’s partner sperm (or donor sperm) with the resulting fresh embryos transferred to the patient.
  • Remaining embryos would be frozen for future frozen embryo transfer procedures (if needed).

  All the eggs from the donor are available to you for fertilization. This cycle maximizes the pregnancy rates and typically results in additional embryos for cryopreservation.

  Egg freezing has improved significantly over the past several years due to fine-tuning of freezing and thawing protocols. Thawed egg survival and viability is much better than it was previously. A new technology of ultrafast freezing (vitrification) of oocytes was invented. The embryologists at our clinic were early leaders in the field of egg and embryo vitrification. Altravita has a record of successful IVF programs with frozen donor eggs.

  Frozen egg donation does not require synchronization of the cycle between the donor and the patient. Treatment cycles are quicker and treatment cost is lower compared to fresh egg donation.

  Legal aspects of egg donation program

  According to the legislation of the Russian Federation a woman, who gave birth to a child, is considered the mother (except for surrogacy cases). The donor has no legal relations to the child conceived from her egg.
  The law does not set the age limit for this treatment program.

  IVF with egg donation treatment steps

  • Consultation with reproductive endocrinologist; selection of the individual stimulation protocol: preparing the uterine lining for embryo transfer and synchronization of the donor and patient cycles in case of fresh egg donation.
  • Monitoring of the hormonal stimulation under ultrasound.
  • Collection of donor eggs under general anesthesia/thawing of vitrified donor eggs.
  • Sperm collection, analysis and preparation. Semen is prepared for fertilization by removing inactive cells and seminal fluid by so-called sperm washing.
  • Fertilization using ICSI or IMSI methods.
  • Cultivation of embryos. The produced embryos are being cultivated in special incubators for 5-6 days. Their development is closely monitored by experienced embryologists. If necessary, PGS or PGD can be performed to select the embryos free from genetic diseases.  
  • Embryo transfer is a painless transfer of the best embryo into the woman’s uterus. Spare embryos will be cryopreserved by vitrification method.

IVF: minimal stimulation protocol

• Included services

  • Ovarian stimulation
  • Medication for stimulation of ovulation:  Clostilbegyt 50 mg – 1 box, gonadotropins (Puregon, Gonal, Menopour) 600 IU, Diphereline 0.1 – 2 ampules, Cetrotide – 1 ampule.
  • Folliculometry
  • Hormonal monitoring of stimulation
  • Consultations of reproductive endocrinologist
  • Transvaginal ovarian puncture
  • General anesthesia
  • 2-3 hours stay in day hospital with medical monitoring
  • Identification and evaluation of oocytes’ maturity
  • Preparation of sperm for fertilization using two samples of ejaculate
  • Cultivation of embryos until 5-6 day of development
  • Freezing of embryos

  Excluded services

  • Additional medicaments
  • Emergency care in case of complications 
  • Assisted hatching
  • Biopsy of embryo
  • Any type of PGD/PGS
  • ICSI/IMSI fertilization
  • Additional consultations of specialists
  • Embryo transfer
  • Storage of frozen embryos
  • Usage and thawing of donor gametes 

TESE/TESA

• TESA can be used as a diagnostic procedure to detect causes of male infertility, or as a procedure to recover sperm from the testicles from men with obstructions or ejaculatory problems that cannot be treated by any other methods.

  In the TESA procedure, a very fine needle is passed into the testicles under anaesthetic, and a tiny amount of tubules is removed from the seminiferous tubules (network of tiny tubes inside the testicles, where sperm are produced). These tubules are then processed in the laboratory and checked for the presence of sperm, which can be used to fertilize eggs.

  Sperm retrieved from the seminiferous tubules in a TESA procedure are less mature and less motile than sperm found in ejaculated seminal fluid. As such, ICSI or IMSI are required to achieve fertilization with TESA sperm.

Female infertility diagnosis