Egg quantity and quality gradually diminish with age. This is especially the case in women over 35, leading to infertility, more miscarriages and the risk of having children with a chromosomal abnormality. Egg freezing is thus an alternative for women who are not ready to be pregnant and patients who need an ovarian surgery, chemotherapy, or radiation. With vitrification, using antifreeze collants called cryoprotectants and avoiding ice crystal formation, the eggs are placed in glasslike state. The survival rate of the frozen eggs stands at 80-90%.
Kept under ultra-low temperature conditions in a liquid nitrogen tank at -196 C, sperms can be preserved for a long time. Sperm freezing is advisable for men looking for vasectomy while also keeping some sperm, those who want to have children in the future, or patients who need chemotherapy and radiation that affects the reproductive system. Sperm freezing is also an alternative for those who are not available on the day scheduled for sperm injection or egg retrieval. In addition, sperm freezing can help with fertility treatments such as intrauterine insemination (IUI) or in vitro fertilization (IVF) in the future.
Cancer treatment with chemotherapy and radiation can affect reproductive function, decrease ovarian function, and may cause patients to go into menopause after chemotherapy. Chemotherapy can also temporarily or permanently affect spermatogenesis.
Collaborating with the oncology team,
Bumrungrad Hospital's multidisciplinary team provides holistic care for patients.
Fertility and genetics specialists can help the patients to have children in the future after cancer treatment ends with the use of in-vitro fertilization, where sperm, eggs or even embryos are kept frozen prior to chemotherapy or radiotherapy treatment.
Bumrungrad Fertility Center can help patients with HIV to get pregnant safely, reducing the risk of passing it to their partners and babies as well as adverse pregnancy outcomes and complications with the use of Assisted Reproductive Technology. Before treatment, our multidisciplinary team consisting of infectious disease specialists, obstetricians, pediatricians and psychiatrists, will assess the patients’ fertility, HIV treatment, the need for antiretroviral drugs, and sperm quality in men with HIV especially those with AIDS, who often have sperm anomalies. As for the female spouse with HIV, infectious disease specialists will suppress the HIV viral load to undetectable levels in order to reduce the perinatal transmission of HIV.
CASA or Computer Assisted Sperm Analysis is a highly effective computerized tool that provides accurate data regarding sperm count, motility and morphology.
These procedures involve surgical retrieval of sperm directly from the testicles or the vas deferens, either for treatment or diagnosis purposes. The sperm retrieved are then frozen for further use to fertilize the eggs from the woman in the IVF process. After the embryo is developed, it is then transferred, implanted in the uterus, possibly leading to pregnancy. The surgical procedure of sperm retrieval are as follows:
- PESA (Percutaneous Epididymal Sperm Aspiration) is the method of puncturing the skin of the testicles with a needle into the epididymis and extracting sperm.
- MESA (Microsurgical Epididymal Sperm Aspiration) uses an operating microscopy to locate the tubules of the epididymis precisely and then extract sperm with a needle.
- TESE (Testicular Epididymal Sperm Extraction) is surgery performed to obtain a small piece of testicular tissue and separating the sperm in the testicular tissue.
This involves diagnostic laparoscopy and laparoscopic surgery, allowing patients to undergo treatment with assisted reproductive technology to receive appropriate care prior to treatment. It is a modern treatment method for patients with infertility, frequent miscarriages, or unsuccessful embryo implantation due to gynecological problems such as polyps, uterine fibroids, uterine fibrosis, pelvic fascia, and narrow or blocked fallopian tubes. Hysterosalpingography (HSG) is performed to examine the fallopian tubes, polyps, uterine fibroids, and uterine fibrosis.
Platelet-rich plasma (PRP) is produced by spinning blood in a centrifuge so that it separates. PRP is a fraction of venous blood with a concentrated platelet count, generally greater than 4-5 times normal baseline. Studies have found that PRP injections into the uterus before progesterone insertion are beneficial for those with unexplained thin endometrium or uterine lining. They help improve the lining thickness and increase blood flow in the uterus, thereby significantly boosting the chances of pregnancy.