IVF/ET

It's the therapeutical option with the best results per treatment cycle in reproductive medicine. Therefore its indications have been extended from the first proposed, tubaric sterility, to many other possibilities: repeated unsuccessful insemination, unexplained sterility, infertility secondary to mucus-semen incompatibility, infertility due to immunologic factors, endometriosis, not severe male infertility.
It's based on the induction of growth and maturation of several oocytes by means of gonadotropin administration associated with GnRH analogs, to better control the ovaric response. The different farmacologic inductions of multiple follicular growth are diverse; it is noteworthy that to avoid ovaric hyperstimulation syndrome it is necessary to carry out a detailed endocrine preventive evaluation, besides an accurate monitoring of the multiple follicular growth by ultrasound, performed directly at the Centro Demetra (by means of accurate transvaginal daily ultrasound), and hormonal evaluation (daily measurements of plasma 17-b-Estradiol performed in collaboration with a highly specialized laboratory in that field: Check-up di Palermo -V. E. Parisi n.40; tel. 091/ 321851 - directed by Dr. Gaspare Accardi.) The oocyte sampling is carried out by transvaginal ultrasound with analgesia and eventually local or regional anesthesia (at Centro Demetra's main office) or under general anesthesia (hospitalized at the Day Surgery of Casa di Cura Orestano). During the same procedure, the partner's semen for oocyte insemination, is prepared. After two days the embryos are transfered in utero ; the intrauterine transferring of embryos in general do not require any type of analgesia or anesthesia and is performed under ultrasonographic guidance. Some times embryo transferring is postponed to the third day and even after more days, to seed embryos at a more developed stage (in some cases at the stage of blastocyst) ; furthermore, an important biologic therapeutical option is that of perform on the embryos the Assisted Hatching to increase the possibilities of implantation.

 

ICSI
This technique (Intracytoplasmatic Sperm Injection) differs from the IVF/ET exclusively in the modality of fecundation of the oocyte: in contrast with that of the IVF/ET, where sperm penetrates the oocyte autonomously, in the ICSI a single spermatozoa is injected mechanically inside the oocyte ; the injection is performed by means of micro needles connected with a sophisticated apparatus handled by specifically trained biology personal.
The main indication of this technique is the presence of Severe Dyspermia (male infertility with a very low number of sperm in the semen eventually with associated morphology and motility alterations).