Andrology
Andrology service encompasses,
- Semen analysis to screen for male fertility problems
- Sperm DNA fragmentation testing, an advanced sperm test for men with unexplained infertility, recurrent pregnancy loss, recurrent IUI or IVF failures, varicocele and for men with lifestyle and occupational risk factors
- Sperm washing for intrauterine insemination (IUI)
- Advanced sperm selection techniques such as microfluidics (ZyMot) for IVF/ ICSI in men with abnormal sperm motility and morphology and a high sperm DNA Fragmentation Index.
- Sperm banking/ freezing for Fertility Preservation before treatment for a cancer diagnosis if treatment that reduces sperm count and quality will be used; in men undergoing vasectomy that may want future fertility; in men that want to combat effects of aging on sperm; and for men who want their partner to undergo fertility treatment when they are away for occupational or other reasons.
- The Andrologist and the Reproductive Endocrinologist perform indicated examination and hormone tests and recommend appropriate treatment which may include lifestyle modification, medication and surgery. They work hand in hand with specialist Urological surgeons when required
- Epididymal and Testicular Sperm Extraction (TESE) for assisted reproduction in men with azoospermia or severe sperm defects.
Intrauterine insemination (IUI)
IUI is a procedure in which sperm is washed/ processed then deposited inside the uterus around the time of ovulation to increase sperm density at the site of fertilisation. IUI is suitable for people with the following conditions,
- physical or psychosexual problems that prevent natural deposition of semen in the female genital tract such as erectile dysfunction, ejaculatory dysfunction, spinal or musculoskeletal deformity, vaginismus
- donor insemination in those with severe male factor infertility and those who wish to avoid a known severe heritable genetic disease that is present in the male partner
- sperm washing to prevent transmission of viral infections such as HIV and hepatitis B to the female partner and child
- mild to moderate abnormalities in sperm count, motility and morphology
- suspected cervical problem affecting sperm transport
- unexplained infertility, minimal to mild endometriosis
In vitro fertilization (IVF)/ Intracytoplasmic Sperm Injection (ICSI)
IVF is a procedure in which a woman is given medication to stimulate her ovaries to develop many mature eggs which are then harvested and fertilized with washed sperm inside a laboratory dish. The resulting embryo is then placed into her uterus (womb). A pregnancy results when the embryo implants inside the uterus. Intracytoplasmic sperm injection (ICSI), a process during which the sperm is injected directly into the egg, is performed when there are severe sperm abnormalities, testicular or epidydimal sperm is used, previous fertilization failure, or if PGT will be performed.
IVF/ ICSI is suitable for people with some of the following conditions,
- Blocked or damaged fallopian tubes
- Low sperm count
- Unexplained infertility
- Endometriosis
- Failed previous treatments with ovulation induction or intrauterine insemination
- Advanced maternal age
Preimplantation genetic testing (PGT)
PGT is an embryo selection method in which a few cells are biopsied from a day 5 embryo and screened for the presence of a genetic disorder. PGT is suitable for people with some of the following conditions,
- recurrent pregnancy loss
- recurrent IVF treatment failure
- a known genetic disorder in the family and wish to have a child who is unaffected
- older maternal age >35years to reduce the chance of giving birth to a child with a genetic disorder such as Down’s Syndrome
- allows single embryo transfer and reduces risks of multiple pregnancy
Fertility Preservation
through egg or embryo freezing (cryopreservation). Egg or embryo cryopreservation is suitable for,
- women undergoing treatments that are toxic to the ovary such as pelvic radiotherapy or chemotherapy for a cancer diagnosis, or autoimmune disease.
- Women undergoing extensive surgery on the ovaries that involves removing a whole ovary or large portions of the ovary such as those with large ovarian cysts or borderline tumors, endometriosis or risk-reducing oophorectomy for BRCA mutations
- Women who wish to delay childbearing for social reasons
- Females at genetic risk of premature ovarian insufficiency (eg-Turner’s Syndrome)