Tag Archive: fertility center

Physical Examination and Testing before Fertility Treatment in Dubai

The joy of parenthood is a challenge for many couples. Approximately 10-15% of couples in the U.S. are infertile. Infertility is the inability to become pregnant despite having frequent sexual intercourse for one year. Infertility can be related to a single cause in your partner or yourself, or it can be related to a combination of factors. Fortunately, many effective, safe therapies are available to help couples overcome infertility.

The Female Infertility Evaluation

Most women are advised to try to conceive a full year before beginning fertility testing. However, for women over the age of 35 years, and people who have known medical problems that could affect fertility, earlier testing is appropriate. Experts estimate that around 40% of infertility cases is attributed to a female factor. Fertility Clinic DubaiThe basic evaluation for women with infertility includes a medical history and physical examination. Additional testing is used to further refine the diagnosis. A careful review of each symptom can include:

  • A review of the menstrual cycle pattern to determine if ovulation is occurring, or if other problems exists, such as uterine defects (fibroids or polyps) or a diminished egg reserve (related to aging).
  • Collection of information that could suggest an anatomic problem of the fallopian tubes, including questions regarding history of sexually transmitted diseases, previous abdominal surgery, and /or painful sex or periods.
  • Questions about previous surgery to the uterus or cervix, such as freezing for abnormal Pap tests.
  • A detailed social history to evaluate for environmental exposures or social habits, including alcohol use, smoking, extreme exercise, or drug usage.
  • A general review of systems, which includes questions about symptoms related to endocrine dysfunction.

To evaluate the pelvic structures and assess for possible hormonal problems, the physical examination is done. Additional hormone level testing and ultrasounds are required to assess ovarian age and ovulation. Ovarian reserve testing determines the quantity and quality of the eggs, and hormone tests check levels of ovulatory hormones. A hysterosalpingogram (HSG) is a special x-ray test used to evaluate the uterus and fallopian tubes. When serious damaged to the reproductive organs is suspected, a surgical procedure (hysteroscopy or laparoscopy) can be performed.

The Male Infertility Evaluation

Around 40% of couples have infertility due to a male factor. Evaluate of the male is significant for the development of a comprehensive treatment plan for the infertile couple. The initial male infertility workup includes a medical history, physical examination, semen analysis (one or more), and hormone level testing. The initial evaluation includes:

  • A review of past surgeries, medications used, and health problems.Dubai fertility clinic
  • Inquiry into family history of birth defects, infertility, and problems associated with the reproductive system.
  • A detailed review of occupational hazards, social history, and personal history to evaluate exposure to any substances or toxins that could impact fertility.

The physical examination involves an evaluation and inspection of the penis, testes, scrotum, and prostate. Laboratory tests are conducted, including a urinalysis to assess for infection. The semen analysis is done to assess sperm movement (motility), number of sperm (sperm count), shape of sperm, and if or not the sperm are mature.

Hormone testing evaluates levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, and testosterone to determine if a problem exists that could affect sperm production. A transrectal ultrasound and scrotal ultrasound are done to help the doctor check for ejaculatory duct obstruction and retrograde ejaculation. In addition, a testicular biopsy could be done to see if sperm production is normal.

PRC Fertility Center in Dubai is a first rate clinic for comprehensive workup and treatments to help women achieve their fertility goals. Patients are treated by Board Certified fertility specialists in the Middle East with compassion, expertise and diligence. Call now!

Detecting Chromosomal Disorders through Pre-Genetic Diagnosis

Pre-genetic diagnosis (PGD) is the use of genetic testing technology to assess and evaluate embryos for abnormalities. Also called preimplantation genetic diagnosis, PGD can be performed using many techniques available. In the in vitro fertilization (IVF) process, an egg is fertilized with sperm in the laboratory setting. After a few days, the resulting embryo is biopsied for genetic analysis. This allows the embryologist to evaluate if or not the embryos are genetically normal or if chromosomal abnormalities exist.

Why are embryos analyzed?

Fertility Clinic DubaiEmbryos are analyzed for one or more reasons. These include:

  • Gender selection – For family balancing, the embryologist can assess the embryo’s gender.
  • Aneuploidy – With this condition, there is an extra chromosome or a missing one. Down Syndrome is an example of aneuploidy, which is more common as a woman ages.
  • Translocations – This refers to a change in chromosome structure, where chromosomes are attached to each other, or where pieces of two different chromosomes are interchanged.
  • Recurrent pregnancy loss – Certain genetic defects can cause repeated pregnancy losses.
  • Single gene disorders – Diseases or conditions caused by an inherited single mutated gene. Examples include Sickle Cell Anemia, Cystic Fibrosis, and Tay Sachs.

The PGD Process

The pre-genetic diagnosis can be done using different approaches. These are:

  • Microarray method – This form of preimplantation genetic screening requires a blood test from the parents to create a DNA fingerprint. This can be used to compare the DNA from the assorted embryos to make sure there is one chromosome from each parent for every 23 pairs of chromosomes. This technique has the ability to test all chromosomes in less than two days. In addition, this test can be used to calculate the estimated accuracy of the result, which avoids errors.
  • Fluorescent in situ hybridization (FISH) – With this method, a single cell is analyzed under the microscope. Fragments of DNA are specified to each chromosome being tested using microscopic markers and fluorescent single detection.
  • Comparative genomic hybridization (CGH) – Also called a blastocyst biopsy, CGH tests the chromosomes expelled by the eggs during cells division after fertilization. This involves using cells of a day-5 embryo.

How accurate is PGD?

The accuracy of preimplantation genetic testing varies from couple to couple. There is a chance that PGD will not be 100% reliable. However, accuracy rates are 98% for most couples.

After the ResultsIVF treatment photo

Once PGD testing results are available, the fertility specialist discusses them with the clients, and only normal embryos will be used for IVF cycles. One or two embryos are placed in the woman’s uterus, and extra embryos are frozen for later cycles. PGD allows the doctor to use genetically normal embryos for transfer, increasing the chances of IVF success. When all chromosomes are evaluated, and assessed as normal, the chances of pregnancy is around 85-90%.

PGD for Failed IVF Treatment

When a couple experiences a failed IVF cycle, PGD is recommended. One of the most common reasons IVF fails is genetic abnormalities of the embryos. Women may have factors that cause their ovaries to produce genetically abnormal eggs, which produce problems with the embryos. This will lead to unsuccessful IVF treatment. Egg donors can be an option when this is found. If the male’s sperm contributes the abnormal genetic material, donor sperm may be used.

PRC Fertility Center is a top Dubai fertility clinic with over 25 successful years in America. Now open in Dubai Healthcare City, PRC has Board Certified providers with exceptional live birth success rates for IVF, ICSI, tubal reversal, and all aspects of Assisted Reproductive Techniques. Call us today!

Hormonal Therapy to Prevent Ovarian Failure

Premature ovarian failure (POF) is loss of ovary function before the age of 40 years. Failing ovaries do not produce adequate hormones, so eggs are not released regularly and infertility occurs. Premature ovarian failure is different from premature menopause. Women with early menopause stop having periods altogether, and the woman cannot become pregnant. With premature ovarian failure, pregnancy is possible. Between 5-10% of women with premature ovarian failure go on to get pregnant without medical intervention, but others require treatment.

What are the symptoms of premature ovarian failure?

A woman experiencing premature ovarian failure will experience certain symptoms. These include:

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  • Night sweats
  • Irregular or missed periods
  • Hot flashes
  • Vaginal dryness
  • Decreased sexual desire
  • Difficulty concentrating
  • Irritability

What causes premature ovarian failure?

Premature ovarian failure is the result of either follicle dysfunction or follicle depletion. With normal fertilization, the pituitary gland releases hormones that cause the ovaries’ egg-containing follicles to mature. When one follicle reaches maturity, it bursts open and releases an egg into the fallopian tube. With follicle depletion, the number of follicles in the ovary that may mature are less than should be, due to toxins or chromosomal defects. Follicle dysfunction occurs when the follicle does not mature due to an autoimmune disease or other factors.

How is premature ovarian failure treated?

The main treatment for premature ovarian failure is estrogen replacement therapy. Estrogen is prescribed along with progesterone, which protects the uterus lining. The combination of these hormones may restore ovarian function.Fertility Clinic Dubai

  • Estrogens – These are available in pill form, as a gel or patch applied to the skin, or as a vaginal ring that can be replaced every 3 months. The doses is 100-150 mcg daily for transdermal (topical), and estradiol 2-4 mg daily for oral form.
  • Progestins – These are administered only 10-14 days each month, with recommended dose of medroxyprogesterone 10 mg orally.
  • Androgens – Many women also have low levels of free testosterone, which can cause low libido and fatigue. Methyltestosterone is given in 1.25-2.5 mg each day orally.
  • LHRHa – Luteinizing hormone-release hormone analogue can be used during chemotherapy to protect the ovaries. LHRHa reduces the risk of ovarian failure and is associated with a higher pregnancy rate for cancer patients who take it. The rates of premature ovarian failure are reduced two-thirds in patients who take LHRHa, according to clinical studies.
  • DHEA – Supplementation with DHEA has shown positive results in some studies of women with ovarian insufficiency. However, it is less effective for women with outright ovarian failure.

Can premature ovarian failure be predicted?

With new technology and scientific research, there are now ways the Dubai fertility doctor can detect if you are at risk for developing POF. The FMR1 genotype tests for a gene that predicts whether or not a woman will have POF. Women diagnosed with high risk for future POF can managed their reproductive life by freezing eggs.

At PRC Fertility Center in Dubai, comprehensive fertility treatments are offered. This includes first rate Dubai IVF treatments, egg freezing, ICSI and additional options to help women reach their fertility goals. Call us today!

Preimplantation Genetic Testing in Dubai

Preimplantation genetic testing, also called preimplantation genetic diagnosis (PGD), is a process of removing a cell from an embryo for genetic testing. This is done at PRC Dubai fertility center to assess for diseases and conditions that could interfere with the embryo’s survival once it is introduced into the uterus. PGD is used in the in vitro fertilization (IVF) process.

History of PGD

The first IVF procedure was completed in 1978. Years later, scientists began testing the embryo for potential health problems as well as chromosomal abnormalities. PGD was used in humans in 1990, and many improvements have occurred with PGD in the last 25 years. Genetic technologies used on cells removed from embryos and embryo biopsy have improved drastically over the last couple of decades.

Stages of Egg and Embryo Development

Three basic stages exist at which embryos or eggs may be biopsied to remove cells for testing. These include:

  • Polar body – This is an early stage where the polar body of the egg is removed and tested. A mature human oocyte (egg) has one polar body, and a fertilized egg has two polar bodies. This technique does not alter the egg or embryo so that it cannot implant into the uterus or develop into a fetus. However, there is the chance of damage to the developing embryo with polar body biopsy.
  • Cleavage stage – Day three of the embryo’s development is stage three. At this point, the embryo has 6-10 cells. Removal of the outer shell (zona pellucida) is performed so 1-2 cells can be removed for testing. Stage three development is important for the embryo’s development, so many IVF programs are not performing this technique.
  • Blastocyst stage – The trophectoderm biopsy is the technique performed during the blastocyst stage of embryo development. After the embryo is formed into a multi-cell mass (trophectoderm), it has a fluid-filled cavity. This biopsy involves making a small hole in the shell of the embryo so several cells can be removed for testing.

PGD Clinics

The best fertility clinics for PGD are the ones with the best IVF success rates. The clinic should have an excellent culture system in order to obtain the maximum number of quality cells for biopsy. The clinic should also be skilled in embryo biopsy and blastocyst freezing, as well as successful in thawing frozen eggs and embryos.

Candidates for PGD

The most common reason for preimplantation genetic testing is advanced age. Women of advancing age have increased rates of chromosomally abnormal eggs, which develop into abnormal embryos. Five main types of clients should use PGD. These include clients who:

  • Are having IVF with female age of 38 years or older
  • Have repeated IVF failure, defined as three or more failed attempts
  • Have a family history of inherited genetic diseases
  • Are carriers of chromosomal translocations
  • Have had recurrent miscarriages

Rates of Chromosomal Abnormality

The percentage of eggs with some type of chromosomal abnormality does increase as the woman ages. Approximately 45% of human embryos have some form of chromosomal abnormality. By testing the embryos available for transfer, we can avoid use of ones with abnormalities and choose healthy, high-quality embryos for transfer the woman’s uterus. PGD testing of early embryos will increase the chances of a successful pregnancy.

Technology used to Assess Chromosomes

There are three technologies currently being used for assessment of chromosomal abnormalities. These are:

  • Array Comparative Genomic Hybridizaiton (aCGH)
  • Quantitative Real-Time Polymerase Chain Reaction (qPCR)
  • Single Nucleotide Polymorphism Microarrays (SNP)

PRC Dubai is the top fertility center in Dubai. After two successful decades of treatment at several metro Los Angeles fertility centers, PRC is now open in Dubai Healthcare City! Call us today at 800-4544.

Here is a video on PGD Testing:

 

The Basics of Egg Freezing in Dubai

Egg Freezing in Dubai Healthcare City

Women often delay childbearing due to personal circumstances. Because egg quality declines with age, women now have the option of egg freezing so the eggs can be fertilized and implanted at a later date. This form of assisted reproductive technology enables women to cryopreserve (freeze) eggs when they are at their healthiest.

The Natural Egg Reserve

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On average, a woman has around 600,000 eggs, which are present at birth. This supply diminishes at a rate of 1,000 per month throughout the lifespan. This egg reserve decline is often referred to as a woman’s biological clock. The loss of eggs continues, regardless of pregnancy, absence of menses, or if the woman is taking oral contraceptives. The rate of egg loss accelerates when a woman is in her late 30s and early 40s. By midlife (43-47 years of age), a woman usually loses her natural ability to have children. What is more important, egg quality diminishes with time, and chromosome defects and miscarriages are more common with a later age of pregnancy.

Preparing for Egg Freezing

Women interested in freezing eggs will first undergo a series of fertility tests to assess reproductive potential and readiness for IVF. This involves:

  • Initial evaluation of ovarian reserve – The consultation with the fertility specialist involves taking a medical history, conducting a physical examination, and assessing the rate of future success. Testing include assessing follicle-stimulating hormone (FSH) levels, estrogen levels, antral follicle count, and anti-Mullerian hormone (AMH) levels.
  • Egg retrieval process – This process involves taking fertility medications to stimulate follicle growth so multiple eggs are produced. Ultrasound and blood levels are used to monitor progress, and eggs are retrieved during a simple office procedure.
  • Egg preservation – The retrieved eggs are then processed through a rapid freezing process called vitrification. The frozen eggs are cryopreserved until they are needed. It is important for the client to maintain contact with the fertility clinic so the eggs will not be abandoned.

Creating Embryos using Frozen Eggs

The process of using frozen eggs involves:

  • Thawing – When the client decides to have a child, the eggs can be thawed in the laboratory. Thawing occurs on the day the eggs are to be fertilized and should be synchronized with the woman’s cycle. Around 90% of the frozen eggs survive the freeze-to-thaw process.xxxAccordion2

 

  • Fertilization – Thawed eggs are then fertilized in our laboratory using intracytoplasmic sperm injection (ICSI), where a single sperm is strategically placed into each egg. ICSI is required for fertilization because the protein coat around the egg becomes hardened through the freezing process. Around 70% of the injected eggs are expected to become fertilized.

 

  • Embryo culture – After fertilization, the eggs remain in the laboratory for three to five days to develop into embryos. While not all develop into embryos, the number of eggs that survive and progress is related to the woman’s age at the time of egg freezing.

 

  • Embryo transfer – The number of embryos transferred to the client’s uterus depends on her age at the time of egg freezing. Younger women have greater likelihood of implantation, so fewer embryos are transferred. The transfer is done using a tiny insertion catheter and ultrasound guidance.

PRC Dubai offers first rate fertility treatment in Dubai Healthcare City. After 25 years of success in the US, PRC is now offering state-of-the-art options in the Middle East! Here’s a video on Egg Freezing:

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