Other Services

Cryopreservation

What is it?

During cryopreservation, the sperm or embryos are frozen and then stored in liquid nitrogen at very low temperatures.

Embryo Cryopreservation

During an In Vitro Fertilization (IVF) cycle, often more embryos are produced than are actually transferred. Couples can elect to cryopreserve the remaining high quality embryos for future use.

One advantage of freezing embryos is that should a couple elect to undergo a subsequent fertility treatment, it will not be necessary to undergo the follicle stimulation, egg retrieval and additional laboratory procedures and costs associated with it.

Embryos can be frozen indefinitely with more than half remaining viable after thawing.

For cancer patients, embryo freezing can be one means of preserving their fertility in the event they may wish to become a parent once they are cancer-free.

Sperm Cryopreservation

Sperm cryopreservation is available for men who wish to bank sperm for possible future use. Frozen sperm remain viable indefinitely and can be thawed for use in fertility treatments such as Intra Uterine Insemination (IUI) or In Vitro Fertilization (IVF).

Many cancer treatments can have a damaging effect on sperm quality. Young male cancer patients who someday wish to become fathers may consider freezing sperm prior to undergoing treatment as a means of preserving their fertility for the future.

Men with certain conditions in which the sperm have to be extracted through surgical means, such as TESE, may also consider sperm cryopreservation for future use.

Time Lapse Imaging

What is it?

Time-lapse imaging is an incubator that maintains the necessary physiological conditions required by a living embryo while they are in the IVF laboratory. It has an incorporated time lapse system that has a camera that continuously captures images and records them as a video of the embryonic development.

This system allows the embryologist to monitor embryo cell divisions while the embryos are still in the incubator and we can carry out a study of the development of the embryos.

Who it's for?

Although in theory this technology can be applied to any type of patient undergoing IVF treatment, the chances of an improvement in the results are greatest among patients who generate more embryos because there is a better potential for selection. Time-lapse imaging is an embryo-selection tool that helps us more when we have a lot of embryos to choose from.

It can be used in cases where more information about the embryo is desired in situations where there is repeated implantation failure, advanced maternal age and history of recurrent miscarriage. It will help couples and women to make an informed decision about future treatment plan or closure as appropriate.

Time-lapse imaging will not be suitable for all patient groups. Please discuss this with your consultant if this technology can be useful to you. Until good quality RCT evidence is available, this technology is offered only in certain circumstances such as repeated implantation failure, after counseling as to its cost effectiveness.

How it works?

Based on recent studies, the cell division pattern of the embryos is becoming a valid alternative for selecting the embryos which have the best potential for implantation. There is growing evidence suggesting that certain cell time points and events are especially important for predicting further development potential, and pregnancy potential of embryos. Using these time points we can choose the best embryos among all the embryos of the patient and also give a lot of information regarding the viability of those embryos. These time points can only be recorded fully if it is done under a time lapse camera and routine observations under the microscope does not allow us to capture all of these time points since they can vary between embryos.

Some retrospective studies have shown that embryos with specific division times and certain development patterns can have up to 15 – 20% better chance of pregnancy. The optimum times for cell division can be checked more easily and the chances of implantation improved in cases in which selection using time-lapse imaging technology is possible.

Sperm, Eggs & Embryo Freezing

What is it?

Cryopreservation is a term used to indicate the freezing of embryos, eggs or sperm, in order to preserve them for future use.

For men with low sperm counts or for those who need surgical sperm retrieval, sperm can be frozen prior to IVF treatment. Similarly, sperm freezing is also available for patients undergoing chemotherapy or surgeries that involve the pelvic area.

For those undergoing IVF, we offer the preservation of additional embryos using a vitrification protocol. Vitrification is specially indicated for preserving embryos and eggs. For patients, this means an extra opportunity to return for additional treatment without having to undergo ovarian stimulation.

For single women or women seeking fertility preservation following a diagnosis of cancer, we can vitrify eggs to allow the possibility of having a baby using those eggs in the future.

Ovarian Tissue Cryopreservation

What is it?

Many medical conditions, like cancer, require treatment that can impact long term fertility and reproductive health. Ovarian tissue cryopreservation is a procedure that may allow girls and young women the opportunity to have children later in life by removing and freezing ovarian tissue before these treatments start.

Cryopreserving, or freezing, ovarian tissue requires a surgical procedure in which an ovary or part of an ovary is removed. The tissue containing immature eggs is frozen, and stored at a third party storage facility, for use later in life. This tissue may be re-implanted inside the body, or potentially, the eggs could be matured outside of the body and used later through in vitro fertilization. Although current research is promising, maturing the eggs outside of the body has not yet been done successfully in humans.

This system allows the embryologist to monitor embryo cell divisions while the embryos are still in the incubator and we can carry out a study of the development of the embryos.

Who it's for?
  • Ovarian tissue cryopreservation (OTC) is the only available fertility preservation option for girls who have not yet started their menstrual periods.
  • OTC may be the only feasible option for young women who have gone through puberty and need to start their treatment urgently.
  • OTC is only available at a limited number of adult and pediatric institutions in the United States.
How it works?
A Fertility Preservation Patient Navigator meets with patient, family, and treatment team to determine fertility risk, identify available preservation options, and coordinate team efforts throughout the treatment process. A surgical team meets with the patient & family to discuss OTC, performs the procedure, and provides follow up care after surgery. Some retrospective studies have shown that embryos with specific division times and certain development patterns can have up to 15 – 20% better chance of pregnancy. The optimum times for cell division can be checked more easily and the chances of implantation improved in cases in which selection using time-lapse imaging technology is possible.

Laparoscopic Surgery

What is it?

Laparoscopy may be used to diagnosis infertility or to treat a fertility problem. Laparoscopy is a surgical procedure that involves making one, two, or three very small cuts in the abdomen, through which the doctor inserts a laparoscope and specialized surgical instruments. A laparoscope is a thin, fiber-optic tube, fitted with a light and camera.

Laparoscopy allows your doctor to see the abdominal organs and sometimes make repairs, without making a larger incision that can require a longer recovery time and hospital stay.

Whether or not diagnostic laparoscopy should be done in women with infertility is controversial. If a woman is experiencing pelvic pain, then the consensus is that surgery may be recommended.

However, in cases of unexplained infertility, or situations where pelvic pain is not a factor, whether the benefits of the surgery outweigh the risks is a matter of debate.

Who it's for?
Your doctor may suggest laparoscopic surgery to help diagnosis a cause for infertility. Usually, it’s performed only after other infertility testing has been completed, or if symptoms warrant testing. Laparoscopy should not be done routinely, however. Possible reasons your doctor may recommend diagnostic laparoscopy include:
  • You experience pain during sexual intercourse
  • You have severe menstrual cramps or pelvic pain at other times in your cycle
  • Moderate to severe endometriosis is suspected
  • Pelvic inflammatory disease or severe pelvic adhesions are suspected
  • Your doctor suspects an ectopic pregnancy (which can be life-threatening if left untreated)
Often (but not always), if a diagnostic laparoscopy finds problems, the reproductive surgeon will repair, remove, or otherwise treat the issue right away. Laparoscopic surgery may be used to surgically treat some causes of female infertility. Your doctor may recommend surgery if:
  • Hydrosalpinx is suspected. This is a specific kind of blocked fallopian tube. Removing the affected tube can improve IVF success rates.
  • Endometrial deposits are suspected of reducing your fertility. This is rather controversial, with some doctors saying removal is only warranted if you’re in pain, and others saying it can improve pregnancy success rates and is worth doing even if pelvic pain isn’t a problem.
  • Surgery may be able to unblock or repair a fallopian tube. Success rates vary greatly when it comes to tubal repair. If IVF is going to be required even after surgery, then going straight to IVF is a better choice. If the woman is young and all other fertility factors look good, surgical repair may be worth trying first.
  • An ovarian cyst is suspected of causing pain or blocking the fallopian tubes. Sometimes, drainage of the cyst with an ultrasound-guided needle is better. Removal of a large endometrial ovarian cyst may reduce. Your doctor should discuss this with you.
  • A fibroid is causing pain, distorting the uterine cavity, or blocking your fallopian tubes.
  • You have PCOS and your doctor recommends ovarian drilling. Laparoscopic ovarian drilling involves making three to eight tiny punctures into the ovaries. In women with PCOS who have not ovulated on fertility drugs, this procedure may enable them to ovulate on their own. However, the risks may not outweigh the benefits, and its use is controversial.
How it works?
Laparoscopy is performed in a hospital under general anesthesia. While it is sometimes possible to conduct a diagnostic laparoscopy in a fertility clinic office, this is not recommended. In the office setting, if something is found during the procedure, you will need to have the procedure again in a hospital setting for the repair. Your doctor will give you instructions on how to prepare for surgery beforehand. You will probably be told not to eat or drink for 8 or more hours before your scheduled surgery, and you may be instructed to take antibiotics. When you get to the hospital, you’ll receive an IV, through which fluids and medication to help you relax will be delivered. The anesthesiologist will place a mask over your face, and after breathing a sweet-smelling gas for a few minutes, you’ll fall asleep. Once the anesthesia has taken effect, the doctor will make a small cut around your belly button. Through this cut, a needle will be used to fill your abdomen with carbon dioxide gas. This provides room for your doctor to see the organs and move the surgical instruments. Once your abdomen is filled with gas, the surgeon will then place the laparoscope through the cut to look around at your pelvic organs. The surgeon may also biopsy tissue for testing. Sometimes two or three more small cuts are made so that other thin surgical instruments can be used to make repairs or move the organs around for a better view. The surgeon will visually evaluate the pelvic organs and the surrounding abdominal organs. He or she will look for the presence of cysts, fibroids, scar tissue or adhesions, and endometrial growths. He or she will also look at the shape, color, and size of the reproductive organs. A dye may be injected through the cervix, so the surgeon can evaluate if the fallopian tubes are open. Even if no signs of endometriosis or other problems are found, the surgeon may remove a sample of tissue to be tested. Sometimes, very mild endometriosis is microscopic and cannot be seen by the naked eye with the laparoscopic camera. If ectopic pregnancy is suspected, the surgeon will evaluate the fallopian tubes for an abnormal pregnancy.

Antenatal Check up

What is it?

Prenatal care, also known as antenatal care, is a type of preventive healthcare. Its goal is to provide regular check-ups that allow doctors or midwives to treat and prevent potential health problems throughout the course of the pregnancy and to promote healthy lifestyles that benefit both mother and child. During check-ups, pregnant women receive medical information over maternal physiological changes in pregnancy, biological changes, and prenatal nutrition including prenatal vitamins. Recommendations on management and healthy lifestyle changes are also made during regular check-ups. The availability of routine prenatal care, including prenatal screening and diagnosis, has played a part in reducing the frequency of maternal death, miscarriages, birth defects, low birth weight, neonatal infections and other preventable health problems.

Cesarean Section

What is it?

Cesarean delivery (C-section) is a surgical procedure used to deliver a baby through incisions in the abdomen and uterus.

A C-section might be planned ahead of time if you develop pregnancy complications or you’ve had a previous C-section and aren’t considering a vaginal birth after cesarean (VBAC). Often, however, the need for a first-time C-section doesn’t become obvious until labor is underway.

If you’re pregnant, knowing what to expect during a C-section — both during the procedure and afterward — can help you prepare.

Why it's done?
Sometimes a C-section is safer for you or your baby than is a vaginal delivery. Your health care provider might recommend a C-section if:
  • Your labor isn’t progressing. Stalled labor is one of the most common reasons for a C-section. Stalled labor might occur if your cervix isn’t opening enough despite strong contractions over several hours.
  • Your baby is in distress. If your health care provider is concerned about changes in your baby’s heartbeat, a C-section might be the best option.
  • Your baby or babies are in an abnormal position. A C-section might be the safest way to deliver the baby if his or her feet or buttocks enter the birth canal first (breech) or the baby is positioned side or shoulder first (transverse).
  • You’re carrying multiples. A C-section might be needed if you’re carrying twins and the leading baby is in an abnormal position or if you have triplets or more babies.
  • There’s a problem with your placenta. If the placenta covers the opening of your cervix (placenta previa), a C-section is recommended for delivery.
  • Prolapsed umbilical cord. A C-section might be recommended if a loop of umbilical cord slips through your cervix ahead of your baby.
  • You have a health concern. A C-section might be recommended if you have a severe health problem, such as a heart or brain condition. A C-section is also recommended if you have an active genital herpes infection at the time of labor.
  • Mechanical obstruction. You might need a C-section if you have a large fibroid obstructing the birth canal, a severely displaced pelvic fracture or your baby has a condition that can cause the head to be unusually large (severe hydrocephalus).
  • You’ve had a previous C-section. Depending on the type of uterine incision and other factors, it’s often possible to attempt a VBAC. In some cases, however, your health care provider might recommend a repeat C-section.
Some women request C-sections with their first babies — to avoid labor or the possible complications of vaginal birth or to take advantage of the convenience of a planned delivery. However, this is discouraged if you plan on having several children. Women who have multiple C-sections are at increased risk of placental problems as well as heavy bleeding, which might require surgical removal of the uterus (hysterectomy). If you’re considering a planned C-section for your first delivery, work with your health care provider to make the best decision for you and your baby.
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Location

Dr Surinder Singh Fertility Specialist


2nd Floor, Room F1, Thomson Hospital Kota Damansara
Petaling Jaya, Malaysia.

Contact Us

Tel: 016-211 1357

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Monday: 9 AM–6 PM Tuesday: 9 AM–5 PM Wednesday: 9 AM–6 PM Thursday: 9 AM–6 PM Friday: 9 AM–5 PM Saturday: 9 AM–1 PM

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