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    • From scratch: Microscopic testicular sperm retrieval helps azoospermia patients

    2025-02-27

    As medical technology continues to develop, some people diagnosed with azoospermia now have the opportunity to have their own children without the help of a sperm bank. So how do they get sperm? This involves two common procedures: sperm retrieval by epididymal / testicular puncture and microscopic testicular sperm retrieval. Below, I will explain the difference between these two procedures in detail. Epididymal/testicular sperm aspirationFor patients with non-obstructive azoospermia, we use a simpler procedure called epididymal/testicular sperm aspiration. Specifically, a fine needle is used to puncture the epididymis or testis and remove a small amount of tissue to look for sperm and to determine the spermatogenic function of the testes. This method is relatively easy to perform but has some limitations.Microsperm extractionMicrosperm harvesting is known as microscopic sperm harvesting with an orchiectomy. This is a more delicate and minimally invasive procedure in which a small incision is made in the testicle, and then, with the aid of a microscope, we carefully search for possible spermatogenic vasculature. These selected tubules are then sent under a microscope at 20 times magnification to further search for sperm. This procedure greatly improves the accuracy and efficiency of sperm retrieval. If the sperm is successfully retrieved, it can be used for second generation IVF. Compared to traditional testicular sperm retrieval methods, microsperm retrieval has a relatively high rate of sperm acquisition. Differences in indications for the procedureIndications for epididymal / testicular sperm retrieval: mainly for patients with obstructive azoospermia. These patients have normal testicular spermatogenesis but are unable to expel sperm due to obstruction of the vas deferens. In such cases, sperm can usually be retrieved by epididymal/testicular puncture.Indications for microsperm retrieval: mainly for patients with non-obstructive azoospermia, i.e., those with problems with testicular spermatogenesis. Often, it is difficult to obtain sperm by epididymal/testicular puncture….

    Third Generation IVF Technology and Gender Selection

    2025-02-27

    In clinical practice, many families have good expectation of having two children to make up the word ‘good’, and have also heard that the third generation IVF technology can screen genes and chromosomes, so they often ask if they can ‘customise’ a pair of dragon and phoenix babies with the help of this technology. They often ask if it is possible to ‘customise’ a couple of twins with the help of this technology. Below, I will explain in detail from a professional point of view. Disease, not gender, is the core purpose of IVF screeningTechnically speaking, IVF-3 is indeed able to differentiate the sex of embryos. However, its main purpose is not for gender selection, but for disease screening. Third generation IVF, medically known as Preimplantation Genetic Diagnosis / Screening (PGD/ PGS), is not only suitable for infertile patients with fertility needs, but also of great importance for people with genetic disorders. It allows genetic testing of embryos before implantation to diagnose genetic problems and to screen for embryos that are genetically normal for transfer, thus preventing the acquisition of hereditary diseases in the offspring. Gender Screening in Special CircumstancesSo, under what special circumstances can the gender of the embryo be selected? Sex selection is possible when the patient is suffering from a sex chromosome-linked genetic disorder that is ‘transmitted to males but not to females’ or ‘transmitted to females but not to males’.Human cells contain sex-determining sex chromosomes, XX for females and XY for males, and if the disease-causing gene is located on a sex chromosome, there is a pattern of companion inheritance. If the causative gene is located on the sex chromosomes, the disease is called an X-linked disorder, and if the causative gene is located on the Y chromosome, the disease is called a Y-linked disorder. Most…

    IVF treatment time in detail

    2025-02-27

    During clinical consultations, patients who come for the first time to enquire about IVF techniques often ask two key questions, ‘Approximately how long does it take to do an IVF?’ and ‘How much does IVF cost?’ This is mainly due to the fact that many patients lack in-depth knowledge of IVF technology, and at the same time, having gone through a long journey in search of a child, IVF often becomes their last hope, so they desperately want to conceive quickly and are worried that the treatment will be time-consuming and cumbersome. Next, I will explain in detail how long IVF treatment takes. Understanding the treatment stepsFirstly, we need to be clear about the complete treatment cycle of IVF, which covers the following key steps: initial consultation, pre-operative check-up, documentation, superovulation, ‘night shot’ injection, egg retrieval (with sperm retrieval at the same time for the male partner), embryo transfer, corpus luteum support, and pregnancy test.Examination StageDuring the check-up phase, both the man and the woman are required to complete a full physical examination as well as reproductive health related tests. The woman’s checkup is divided into two parts: non-menstrual and menstrual. There is no strict time sequence for these two parts of the checkup, and it is sufficient to keep an empty stomach. Men usually go to the hospital and complete all the tests in one visit. Results of common tests are usually available on the same day. However, due to differences in testing methods and procedures, the results of individual tests can take anywhere from 2 – 10 days. For special tests such as chromosomal tests, it takes about 2 weeks for the results to be available.After all the test results are available, the patient has to visit the doctor again to check the results. If the results are…

    Why Women of Advanced Age Should Consider Three-Generat

    2025-02-27

    　　As women age, many wonder why conceiving becomes more challenging and why miscarriages are more common. The answer lies in our reproductive system, which functions like a clock that only moves forward. As we get older, our reproductive capabilities decline, resulting in fewer eggs and sperm, while their quality also diminishes. With a higher proportion of “bad seeds,” the chances of successful conception and pregnancy are reduced. To address these concerns, we can assess the quality of our “seeds” through in vitro fertilization (IVF). The third generation of IVF builds on the earlier practices by incorporating pre-implantation genetic testing (PGT). This involves testing the cells of embryos at the blastocyst stage, which is categorized into three types: PGT-A (aneuploidy screening), PGT-M (diagnosis of single-gene disorders), and PGT-SR (diagnosis of chromosomal structural abnormalities).Let’s focus on PGT-A (aneuploidy screening).What is PGT-A and Why is it Important for Older Women?PGT-A is a pre-implantation test that screens embryos for chromosomal abnormalities, known as aneuploidy. A prominent example of this is trisomy 21, commonly referred to as Down syndrome. Typically, humans have 23 pairs of chromosomes; aneuploidy occurs when there is a missing chromosome, an extra chromosome, or even multiple excess chromosomes. Traditionally, embryo selection during IVF is based on morphological assessment, which can carry significant risks. Just because an embryo appears healthy does not guarantee that it has the correct chromosomal makeup. Most embryos with chromosomal abnormalities result in miscarriages or terminate pregnancies. A small number that do survive may lead to births with severe health issues. However, through PGT-A, the risk of these complications can be significantly reduced. In summary, the aim of PGT-A is to prevent miscarriages related to chromosomal abnormalities, enhance the likelihood of successful pregnancies, and ultimately increase the rate of live births.

    IVF Treatment Process and Considerations

    2025-02-27

    Recently, a number of patients have inquired about the specific steps, potential risks, and precautions involved in IVF treatment. A full understanding of these is crucial for a woman to successfully prepare for IVF egg retrieval and improve her treatment success rate, as detailed below. Steps of IVF treatmentOvulation stimulation: The use of drugs such as follicle stimulating hormone (FSH) and luteinising hormone (LH) stimulates the development of follicles in the woman’s ovaries, encouraging them to release more eggs at one time in order to increase the number of eggs retrieved. The procedure usually lasts for 8 – 12 days, during which time the follicle development is closely monitored.Egg retrieval: Under ultrasound guidance, the ovaries are punctured vaginally with a special fine needle to retrieve mature eggs. The procedure takes about 15 – 30 minutes and requires strict asepsis to minimise the risk of infection.Cultivation of fertilised eggs: The retrieved eggs are placed in a specific environment in the laboratory and fertilised in vitro with sperm, either by conventional fertilisation or by intracytoplasmic sperm injection (ICSI). The fertilisation process is usually completed within a few hours.Embryonic development: The fertilised egg divides and develops in a suitable incubator with precisely regulated temperature, humidity and the necessary nutrients to mimic the in vivo environment. The zona pellucida usually hatches around the 3rd day after egg retrieval.Embryo Transfer: The well-developed embryos are selected and gently transferred into the woman’s uterine cavity with the help of a transfer catheter on day 3 – 5 after egg retrieval. The procedure takes about 10 – 15 minutes and requires precision and gentleness. Risks of IVF egg retrievalPain: Some patients may experience mild to moderate pain during egg retrieval. Depending on the level of pain, pain medication will be given after the procedure to relieve symptoms.Infection: Although…

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