Causes of Infertility
1. Female Causes
Common female infertility causes include irregular ovulation, blocked fallopian tubes, or adhesions preventing the meeting of egg and sperm. Even if fertilization occurs, the embryo might fail to travel to the uterus for implantation. Other causes include polycystic ovary syndrome (PCOS), ovarian cysts, or ovarian decline. Medical testing, such as ultrasounds to check for blockages or fibroids, as well as hormone and ovarian function assessments, can pinpoint these issues. Additionally, high stress and excessive weight can disrupt hormone levels and prevent ovulation.
2. Male Causes
Male infertility may arise from genetic issues that lead to low sperm count or health conditions that impair sperm viability, motility, or quantity. Environmental factors like pollution, exposure to chemotherapy or radiation, underlying diseases (e.g., diabetes, thyroid conditions), and lifestyle choices such as smoking or excessive drinking also contribute to infertility. Injuries affecting the reproductive organs or past testicular surgeries can further reduce fertility.
In Vitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI)
For couples unable to conceive naturally, IVF (in vitro fertilization) or ICSI (intracytoplasmic sperm injection) are viable options.
- IVF (In Vitro Fertilization): In IVF, all collected eggs from the female partner are placed in a culture dish and mixed with the male partner’s sperm. Sperm then compete to fertilize the eggs, with observation over 3-5 hours to confirm successful fertilization.
- ICSI (Intracytoplasmic Sperm Injection): In ICSI, the eggs are stripped of their outer layers, and a single sperm is injected into each egg. This technique is used when sperm count is insufficient for traditional IVF (less than 500,000 sperm per cubic centimeter), or when genetic testing of embryos is necessary.
After 18 hours, fertilization is checked by observing the sperm nucleus within each egg. If fertilization is confirmed, the embryos are placed in an incubator for further development.
Quality Embryos Increase Pregnancy Success
Once fertilized, the embryo is cultured for about five days until it reaches the blastocyst stage (120-150 cells), which is optimal for uterine implantation. The best-quality embryos, determined by their shape, expansion, nucleus size, and cell density, are selected first for implantation. Remaining embryos can be cryopreserved for future use. Research indicates that culturing embryos in incubators equipped with time-lapse imaging systems significantly improves embryo selection, leading to higher pregnancy rates.
Advantages of the Time-Lapse System for Embryo Culture
Time-lapse imaging incubators represent a significant advancement in in vitro fertilization (IVF) by providing continuous monitoring of embryo development. The ASTEC CCM-iBIS incubator, available at Phyathai 2 Hospital, can simultaneously culture up to 9 cases with a capacity of 25 embryos per case. This cutting-edge technology offers numerous advantages, including
- Continuous Imaging:With a built-in GPS system, embryos are monitored every 15 minutes without the need for manual removal from the incubator for microscopic evaluation. This minimizes disturbances to the optimal culture conditions such as light, temperature, humidity, and pH, which can negatively impact embryo development and reduce the risk of stress caused by handling.
- Enhanced Embryo Assessment: Time-Lapse technology allows for better monitoring of cell division and embryo development, aiding doctors in selecting the highest quality embryos for implantation. The system’s precise focus adjustment enhances accuracy in detecting abnormalities.
- Optimal Environment Control: The incubator carefully regulates oxygen (O₂) and carbon dioxide (CO₂) levels to mimic uterine conditions. It also uses nitrogen (N₂) to maintain stable oxygen levels. Alerts are triggered if any environmental parameters deviate, ensuring prompt response from medical staff.
- Data Connectivity: Time-Lapse systems are connected to a Network Attached Storage (NAS), enabling image retrieval and video generation for tracking embryo growth, further enhancing embryo quality assessments.
Couples questioning their fertility status are encouraged to consult a specialist for advice. Lifestyle adjustments, such as weight loss, exercise, stress management, and avoiding harmful environments, may help, along with medical evaluations to diagnose and address specific reproductive issues. Phyathai 2 Hospital offers comprehensive IVF and ICSI services, integrating advanced Time-Lapse systems to improve embryo quality and maximize the likelihood of successful pregnancy.
