Fertility evaluation includes assessment of the sexual health for both the partners. For men this include semen analysis for sperm count, shape, and movement.

For women, it includes tests on ovulation through blood tests for hormonal level and ultrasound. The doctors may also assess the ovarian reserves through Laparoscopy surgery.

Additional tests may be required to check how the sperm and egg interact and if the male partner is having antibodies against the sperm.

IUI is a method of artificial insemination. Male sperms are concentrated and placed inside the womb at the time of ovulation to give the eggs a direct chance of fertilisation.

This technique is suitable for couple who have:

• Unexplained infertility
• Endometriosis related infertility
• Mild male factor infertility
• Cervical factor infertility
• Ovulatory factor infertility

IVF is an Assisted Reproductive Technology (ART) done by extracting eggs from female ovaries and fertilising it with the sperm. The fertilised egg (embryo) is then transferred and implanted inside the woman’s womb.

IVF is a good choice in cases include:

• Women have reduced fertility age of 40
• Reduced production of egg by the ovaries
• Fallopian tube anomalies
• Endometriosis
• Uterine fibroids
• Unexplained infertility
• Male infertility

This technique is an advanced stage technology for IVF. While conventional IVF includes transferring a fertilised embryo in the uterus, this technique allows the embryo to be incubated for 5 days in order to let them develop to the blastocyst stage and increase the chances of implantation. The blastocyst is then deposited in the uterus around the 6th day.

Various reasons may sometimes make it harder for the sperm to penetrate the outer layer of the egg. The sperm itself may have movement or structural issues, or the outer layer of the egg could be too hard.

In such cases, ICSI is adopted to help the sperm to fertilise the egg. In this procedure, a single sperm is injected inside the cytoplasmic of the egg.

Ovulation induction is a fertility treatment that utilises medication (oral or injectable) to help stimulate ovulation. A woman’s cycle is monitored for a month or two and medication is given right at the beginning of the menstrual cycle. The body’s response is then monitored through ultrasound.

The clinician may suggest the best time for intercourse or insemination when you are about to ovulate.

Also called embryo banking, this technique involves freezing one or more embryos for future use. They can later be thawed and placed within a woman’s uterus.

This technique is useful for women who want to give birth at a later stage in life or have some medical conditions or are on medications that may cause infertility.

FET includes freezing the embryos post IVF, thawing, and transferring them to the womb at a later stage.

Egg freezing technique harvests eggs from ovaries and freeze them in the unfertilised state to store and use later when the woman is ready for pregnancy.

This technique is helpful for:

• Women undergoing treatments for diseases like cancer
• Women who wish to preserve eggs and use them when they are ready for pregnancy

The process is carried out by andrologists who use a special freezing solution and store the sperms in small vials. Sperms need to stay frozen at a constant temperature of -196 degree centigrade.

Sperms can be frozen for as long as one desires and used when needed. After thawing the frozen sperms, they are analysed to ensure motility and activity before being used for IVF.

Semen analysis is a test to check a man’s sperm for the number, shape, and movement. This test helps to identify problem in the sperms that may leads to male infertility.

This procedure is similar to an X-ray and is used to view the insides of the fallopian tubes and the uterus to check for any anomalies.

Hysteroscopy is done using a Hysteroscope which is a thin lighted tube inserted within vagina to examine cervix and the uterus to check for the cause of vaginal bleeding, or even remove polyps and fibroids.

Laparoscopy is essentially similar, but the instrument is inserted though the abdominal wall.

This technique is useful in men who have an obstruction that prevent the sperm release, congenital condition (like absence of vas deferens), have had vasectomy, or have non-obstructive azoospermia.

Sperms may be removed through PESA (Percutaneous Epididymal Sperm Aspiration) where sperms are collected using a needle from epididymis. It may also be conducted through TESE (Testicular Sperm Extraction) where sperms are collected from testicular tissue through an incision in the scrotum.

Pantai Hospitals provide services in transferring frozen embryos, eggs, and sperms from other facilities and centres.

This technique helps select embryos that provide the best chance for implantation. Embryos are cultured and inspected for assessment on morphology and other aspects. An embryoscope is set up within the incubator to take images of embryos at set intervals, analyse and select the best ones for transfer to the womb.

This IVF technique helps the embryo to hatch by breaking the outer shell and creating an opening. Easy hatching increases the chances of the embryo to implant on the wall of the uterus.

This is a prenatal genetic diagnosis technique to identify abnormal embryos and select only genetically normal ones for implantation.