Counseling

Counseling regarding obstetric and gynecological problems including the infertility issue for couples planning to have children is provided by a specialized medical team. Specialists may advise fertility planning by relying on natural approaches or by seeking medical technology to help. This depends on the causes of infertility and the physical conditions of the couple.

Fertility wellness

Specialists make assessment of individual clients’ fertility wellness to prepare them for pregnancy and then give advice on how to  strengthen their reproductive health to improve the quality of germ cells, eggs and sperm before starting the treatment process appropriate for each individual client.

Genetic testing for couples in preparation for pregnancy

Couples either with or without a family history of genetic diseases are advised to undergo genetic testing before pregnancy in order to prevent certain serious diseases that may be passed on to their offspring. A specialist in medical genetics can provide screening and give diagnosis of more than 100 genetic diseases that can cause abnormalities in children.
 

Intra Uterine Insemination: IUI

It is a primary treatment of infertility caused by various factors including low sperm count and motility, sexual dysfunction due to disability, injury or other problems such as premature ejaculation or endometriosis in women. In IUI, sperm is placed directly in the uterus. The success rate of this approach depends on the woman’s age and the causes of the couples’ infertility. If a pregnancy has not been achieved after 2-6 rounds of IUI, the client may be advised to consider the in vitro fertilization (IVF) treatment.

In Vitro Fertilization (IVF)

IVF is a form of external fertilization, close to the natural process. It is an alternative suitable for those unsuccessful with IUI, which can be due to various causes including the man’s low sperm count and motility, thus sperm being unable to reach the eggs, or the woman’s  endometriosis, damaged fallopian tubes, uterine abnormalities, fibrosis, IUI failures, and increasing age.

Intracytoplasmic Sperm Injection (ICSI)

A form of external fertilization, ICSI involves injecting a healthy sperm into the center of the egg to promote fertilization. It is helpful for couples with male infertility issues of poor sperm count, motility, and morphology. With ICSI, the rate of the fertilized egg developing into an embryo is close to that of couples with normal sperm analysis in the male partner.

Embryo culture using Embryoscope™

An Embryoscope™ is a special type of incubator equipped with a built-in microscope and camera and the Timelapse system (TLS), allowing the embryologist to monitor embryo cell divisions or development at any time. time. The embryo quality can be evaluated through a visual display with the software that helps select most promising embryos for implantation without any impact on the embryos.

Assisted Hatching, AH

This is an advanced laboratory procedure, using lasers or enzymes to gently thin the outer shell of the egg, called the zona, or to create a small crack to help the embryo “hatch” from its “shell,” without harming the embryo while increasing the chances of pregnancy.

Preimplantation Genetic Testing

It is a screening and diagnosis testing of genetic diseases in the embryo along with in vitro fertilization IVF treatment. Fertilized embryo cells are randomly extracted and tested for genetic abnormalities before being transferred into the uterus.

• Preimplantation Genetic Screening (PGS) aims to select embryos with normal chromosome numbers (Euploid) to transfer into the uterus to increase the chances of pregnancy.
• Preimplantation Geneticdiagnosis (PGD) aims to select embryos without genetic diseases for the transfer into the uterus so that the children born are prevented from having their parents’ genetic diseases.

Egg Freezing

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%.

Sperm Freezing

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.

Fertility treatment in cancer patients (Oncofertility)

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.

Fertility Treatment for HIV Couples

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.

Computer Assisted Sperm Analysis (CASA)

CASA or Computer Assisted Sperm Analysis is a highly effective computerized tool that provides accurate data regarding sperm count, motility and morphology.

PESA, MESA & TESE

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.

Reproductive surgery: Minimal Invasive Surgery (Hysteroscopy, Laparoscopy)

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.

PRP (Platelet Rich Plasma) injections to improve uterine lining thickness

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.
 

Bumrungrad Hospital features a team of  specialists in all related fields of infertility, providing continuous care from pre-IVF to post-IVF periods to ensure the outcomes and the mother and the newborn’s safety.

 

 

Our multidisciplinary team consists of the following:

• embryologists
• infectious disease specialists
• obstetricians and gynecologists
• psychiatrists
• infertility nurse practitioners
• nurse navigators - IVF
• pharmacists

In pursuant to the Protection of a Child Born by Medically Assisted Reproductive Technology  Act B.E. 2558 (2015), Bumrungrad Hospital would like to ask that you be informed of the requirements and present the following before receiving treatment with assisted reproductive technology:

1. Marriage certificate as evidence of legitimacy of the couple’s relationship as required by law.
2. Certification of the documents with Thai or English translations. In case of marriage registration made abroad, it is required that the marriage registration be certified by the embassy situated in Thailand of the country of the marriage registration.