The process of freezing spermatozoa in order for a man to preserve his fertility and use the frozen sample whenever is needed. It is mostly recommended in your fertility treatment to freeze a sperm vial as a safety deposit and further use.

The process of freezing unfertilised oocytes in order for a woman to preserve her fertility and use them in the future to create a family.

Artificial insemination (IUI) is an assisted reproduction technique and fertility treatment that involves the injection inside the uterine cavity of sperm that has been prepared in the laboratory to improve its count and motility. This is done via a thin catheter the doctor passes through the vagina and the cervix of the uterus. The timing of the procedure is critical as it must be synchronised with ovulation. IUI can be generally performed either during a natural menstrual cycle or a medicated/stimulated one.

The idea behind IUI is that women who experience difficulty getting pregnant can benefit from the exact timing and placement of a more potent sperm inside the endometrial cavity. IUI can be of particular benefit in cases where there is a cervical factor such as cervical scarring, cervical stenosis or thick cervical mucus, or mild male factor of reduced sperm count and motility, as well as in cases where there is a problem achieving or synchronising intercourse with ovulation. This method is also used for single women using donated sperm.

For some women, a stimulated IVF cycle is inappropriate for a number of different reasons. This could be due to:

• A health condition that is a contraindication to controlled ovarian stimulation (history of DVT or Oestrogen receptor positive breast Ca)
• Advanced maternal age or poor ovarian reserve, which is often associated with low egg quality, can often become worse with aggressive stimulation protocols.
• Some women cannot tolerate the stimulation medication or simply want to avoid it for other reasons.

For these women, fertility treatment without stimulation or with minimal stimulation may be the best option. The patient’s natural hormonal cycle is used to mature the eggs and egg collection is carried out to retrieve 1-3 eggs that would otherwise ovulate spontaneously. IVF/ICSI fertilisation and subsequent embryo transfer is carried out in the same way as in conventional IVF.

Stimulated In Vitro Fertilisation

In vitro fertilisation (IVF) is the most complex of the assisted reproduction techniques that are used to treat infertility and assist conception. During an IVF treatment, a number of different protocols can be used for the stimulation of the ovaries and the creation of multiple follicles instead of just one that occurs during a natural menstrual cycle. Following follicle tracking via regular ultrasounds and when the number and size of follicles permits it, a trigger injection is given, and the mature eggs are collected from the ovaries 36 hours later during a procedure called oocyte retrieval (egg collection). The oocytes are then fertilised by the sperm in the embryology laboratory. Subsequently, the fertilised eggs (embryos) are allowed to grow in the lab and are transferred in the uterus 2,3 or 5 days later. A cycle of IVF treatment takes about two weeks and is the most effective form of assisted reproduction. The procedure can be achieved by using the female partner’s own eggs and male partner’s own sperm or may involve eggs, sperm, or embryos from an anonymous donor.

IVF is often offered as a primary treatment for infertility in women around or past the age of 40 with no other infertility factors, due to the higher success rates compared to other assisted reproduction techniques.

However, IVF treatment is also appropriate when there are certain medical conditions. It may be the only or optimal option in cases of:

* Fallopian tube damage or blockage or previous tubal sterilisation
* Anovulation or various hormonal and ovulation disorders
* Premature ovarian failure
* Endometriosis
* Impaired sperm production or function associated with male partner infertility
* Unexplained infertility
* Genetic disorders
* Fertility preservation for cancer or other health conditions

For some women, egg production and/or egg quality is too weak for normal fertilisation and development. This can be caused by various reasons such as advanced maternal age, endometriosis, premature menopause, chemotherapy, or congenital chromosome anomalies.

The above problems can be solved using donor eggs as a fertility treatment. At Serum, we offer a large pool of carefully selected egg donors. We take pride in our donation programme, as all our donors are young, beautiful, and aged 18-30.

In some cases, male infertility cannot be treated. In these cases, (azoospermia, severe oligo-teratospermia, etc.) sperm donation can be a solution. In addition, single women can proceed with sperm donation as fertility treatment and create their own family. At Serum, we have the first and largest Sperm Bank established in Greece since 1991. We provide a wide variety of proven top-quality sperm donor options for our patients and their IVF treatment.

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ICSI is an in vitro fertilisation technique, in which a single spermatozoon is injected directly into an oocyte. This procedure is most commonly used to overcome male infertility problems, although it may also be used where an oocyte cannot be easily penetrated by a spermatozoon.

We are one of the few clinics globally that don’t charge extra for this procedure. We believe every couple, regardless of their infertility problem, deserves the most suitable treatment and our embryologists will use all their expertise and knowledge to determine whether ICSI is likely to be a suitable option for you.

IMSI is a technique that involves the selection of a spermatozoon which has external as well as internal normal morphology. This is feasible by using an inverted microscope that provides a magnifying power around 6000 times more compared to ICSI. The above fact allows the detailed observation of the inner content of the spermatozoon. After the selection, the most suitable spermatozoon is used for ICSI.

PICSI is a technique which allows the embryologist to imitate nature in selecting a spermatozoon capable of fertilisation. This is based on the hyaluronan, a biopolymer found in the gel layer around the oocyte. In PICSI, an “ideal” spermatozoon binds to the hyaluronan hydrogel contained in the dish and is selected and used for ICSI. .

Aspiration of testis fluid and tissue by applying negative pressure with a fine needle.

Tissue aspiration from epididymis (a sperm storage tube) using gentle needle suction.

Short surgical procedure to expose a man’s vas deferens (sperm transportation ducts) and aspirate the content by using a fine cannula.

For couples or single women who need both donor eggs and donor sperm, we offer fresh double donation, or frozen embryos made with donor eggs and donor sperm as a fertility treatment.

Once the oocytes are fertilised, they are placed in a special culture medium where they can grow. Monitoring the embryos’ progression, symmetry, and fragmentation, allows the embryologist to assess their quality (and hence the chance of a successful pregnancy). Culturing blastocysts (day 5 of embryo growth) enables the embryologists to select the embryos which are more likely to be euploid (have the right number of chromosomes) and hence have a higher chance of a clinical pregnancy and live birth, compared to a day 3 embryo.

Embryo cryopreservation involves freezing embryos for later use. This is most often realised with excess embryos remaining after the transfer of fresh embryos or if a lady cannot have a fresh transfer during her fertility treatment.

Some patients may have a family history of an inheritable genetic disorder, such as cystic fibrosis. In these cases, in order to reduce the risk of having a child with such a disease, the patients might opt for pre-implantation genetic testing of embryos. Recurrent miscarriages, more than 3 unsuccessful IVF treatments and the 4th decade of a woman’s life when an own egg cycle is followed, are some extra cases in which PGD/PGS could be advised. In this way, only embryos with normal genetic layout would be transferred. PGD and PGS refer to all the genetic testing conducted after an embryologist performs Embryo Biopsy and therefore provides the genetic lab with some embryonic cells suitable for analysis. Biopsy technique can be divided into two categories: cleavage stage/day 3 biopsy and trophectoderm (TE)/day 5 or day 6 biopsy during the blastocyst stage.

However, it should be noted that in some cases, such as recurrent pregnancy losses, there is much controversial evidence on whether the method provides a clear advantage of improving implantation and live birth rates. You can thoroughly discuss and decide on the above by having a consultation with our IVF consultants, embryologists, and genetic lab prior to your fertility treatment.

This is the technique our lab uses in order for the patients to have their embryos tested with Pre-Implantation Genetic Diagnosis or Screening. Trophectoderm (TE) Biopsy is performed on day 5 or day 6, when an embryo reaches blastocyst stage. By using specific microtools, the embryologist removes 5 to 10 cells from the outer part of the embryo which is called Trophectoderm and will give placenta and other membranes on a later embryo development. In this way, an adequate number of cells is provided to the geneticists for suitable testing and no harm is caused to the Inner cell mass (ICM) which will develop to become the foetus. The removed cells are then transferred into appropriate media and moved to the genetic lab.

Assisted hatching may improve pregnancy rates in some women undergoing IVF treatment. In assisted hatching, an opening is formed on the shell (Zona Pellucida) surrounding the embryo before the embryo is transferred to the uterus.

Sometimes a woman cannot carry a pregnancy. There are many reasons for that, such as lack of uterus (previous Hysterectomy or Rokitansky syndrome), severe endometrial adhesions, multiple fibroid uterus, significant medical problems (i.e., aortic stenosis, severe renal disease, etc.). In these cases, she may choose to have another woman to carry the pregnancy and deliver the baby for her as an alternative fertility treatment option.

The process is allowed in Greece following an application to the courts. Based on the current legislation, the baby is born under the name of the intended parents, making Greece a very attractive destination for surrogacy. For more detailed information about the legal and medical part of this treatment, you can be easily advised by our consultants.

The platelet rich plasma (PRP) method is an autologous invasive method, in which platelets, rich in growth factors, are isolated from the blood plasma of the female patient, and after centrifugation in the lab, are injected into the ovaries transvaginally aiming to ovarian rejuvenation. This is something mostly recommended to ladies with premature ovarian failure or advanced reproductive age in order to improve their egg quality and/ or ovarian activity. There is also the option of endometrial PRP where the blood plasma is injected on the endometrium when a woman faces issues with her lining thickness or after repeated implantation failures.