Fertilization can be carried out using "standard ЭКО " or ICSI (in particular, ПИКСИ , IMSI and PIMSI). In standard IVF, eggs are placed in a special medium in a suspension of sperm cells and left in an incubator for several hours. In ICSI, the embryologist selects the sperm himself (assessing its motility and morphology) and inserts it into the egg. Since the egg is very small (about 1/10 mm) and extremely sensitive to external influences, the ICSI procedure requires very high qualifications. PIXIES, IMSI, and PIMSI differ from the "simple" ICSI in a more complex way of selecting sperm.
Next, the embryologist cultivates the embryos in special media, in special cultivation cups, in incubators with constantly controlled temperature, humidity and concentration of gases in the atmosphere. Cultivation takes place within 5-7 days with regular assessment of embryo development and periodic change of media and plates. At the end of cultivation, the embryologist, together with a reproductive specialist, transfers the embryos into the uterine cavity. If necessary, the embryologist performs an auxiliary hatching procedure before the transfer.Also, if necessary, the embryologist freezes embryos, eggs and spermatozoa.
A separate procedure can be performed PGD – preimplantation genetic diagnosis (checking the embryos for genetic abnormalities). To do this, the embryologist performs a biopsy of the embryos — removal of one to several cells from the embryo. This is — the most delicate embryological operation that not all embryologists can perform. The biopsy material is sent to a genetic laboratory for genetic analysis.
Thus, the embryologist:
- evaluates the quality of the obtained biomaterial: spermatozoa and eggs;
- performs fertilization in the laboratory;
- creates and controls optimal cultivation conditions;
- monitors that how embryos develop;
- performs assisted hatching;
- performs embryo biopsy;
- cryopreserves embryos, oocytes, and spermatozoa.
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Questions and answers
Dermoid cyst and pregnancy
An ultrasound revealed a mass in my left ovary during the first pregnancy. I was told that it is a dermoid cyst. Five years have passed since then. I gave birth to a second child. An ultrasound was performed annually. There were differences in size, but not significant. Since I’m going to have the 3rd child, another
ultrasound was done today. The doctor said that the cyst had increased. I am concerned about it. Don't know where to start. What tests are needed? Thank you.
...more Surgical treatment is strictly indicated in your case given the long history of the mass in the ovary and its rapid growth in recent times. In our clinic, we perform such an intervention laparoscopically through 3 small punctures. Patients go home next morning after the surgery and may return to work after 3 days.
This surgery must be as delicate to preserve healthy ovarian tissue (considering your reproductive plans) as radical at the same time to remove the mass together with the capsule. At the preoperative stage an expert level ultrasound with Doppler is required, as well as blood tests for Ca-125 and НЕ-4 tumor markers. The decision concerning the necessity of FEGDS and colonoscopy is taken based on the results of these tests.
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Total knee replacement
My mom suffers from gonarthrosis for the past three years. Despite treatment by injections the pain is still present. MRI revealed a meniscal tear in the posterior horn, the presence of small bony osteophytes on the patella, a small amount of fluid in the joint cavity (signs of exudative synovitis were detected)
joint space is asymmetrically narrowed in the medial segment. The pain is ongoing but the knee remains flexible. Tell me, please, whether the surgery is contraindicated for meniscal tear in case of arthrosis? Is it possible to do an arthroscopic surgery on the meniscus in our case or it should be «major» surgery? And what would you advice concerning knee replacement for the patient in the age of 57? What is the life time of the artificial joint?
...more It is necessary to make an X-ray of the knee in direct projection in standing position. If it turns out that there is no medial cartilage in the medial area, then the knee replacement is the only solution. The age of 57 is normal for the prosthetics. Modern artificial knee joint (when properly placed of course) will
serve for a lifetime. You can make an appointment via phone +7 (495) 933-66-44.
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Kardanov Andrey
07 September 2016
Pain
I am 19 years old, professionally engaged in weightlifting. I did an arthroscopy of both knee joint a year ago, now feel pain in them and it prevents me from training at full capacity. I visited a traumatologist, and «osteoarthritis of 1 degree» was diagnosed. Could you advise me some medicines or anything else to
relief the pain? Thank you very much for the answer!
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First of all you should undergo an MRI and find out what was done at arthroscopy; if it’s really an arthrosis of 1 degree, hyaluronic acid injections are possible and physiotherapy is not required. Anyway, you are always welcome to consultation for thorough examination.
Question to Dr. Yakobashvili
Tell me, please, at which age child's hearing should be checked-up if we were informed at the hospital before discharge that one ear does not hear. At the moment the child’s age is 1.5 months. Thank you.
These tests done in the hospital are often false negative. Hearing can be tested now, it is necessary to make an appointment to the audiologist.
Cought
A child of 11 years old, suffers from cough for more than six months. The cough is dry, sometimes attack-like, mainly begins during the day, and often occurs before sleep. There is no cough at night. CBC is normal, glucose is 4.16, total IgE 111.80, Toxocara, Ascaride are negative, Cytomegalovirus, Mycoplasma are
negative, PPD test is negative as well. A chest x-ray is normal. We have already consulted with a therapist, otolaryngologist, pulmonologist, neurologist, gastroenterologist... the cough is still present. What should we do?
...more First of all, there are no results of whooping cough testing among the results provided above. The disease cannot be ruled out, even if your child was vaccinated. The blood test for antibodies against the whooping cough germ is required (blood test for class M and G antibodies against Bordetella pertussis). Second,
even a slight increase in class E antibodies is a reason to visit an allergist and to perform an evaluation of respiratory function with bronchodilator. This method will detect a latent bronchial spasm in your child. Even if the results of the test will be normal, allergologist mast rule out the allergic nature of the cough even if it's not obstructive syndrome. Third, this cough can be due to gastroesophageal reflux. It is difficult to draw any conclusions having no data of gastroenterologist’s consultation. 24-hour acidity monitoring of the stomach and esophagus is carried out to confirm or exclude the presence of reflux. Fourth, you didn’t mention whether x-ray of nasopharynx and paranasal sinuses was done. Perhaps, after all, the pathology is associated with ENT organs.
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