The Ovulation Cycle

During the time of puberty in females, out of 60,000 to 80,000 available primary oocytes, only 400 of them gets a chance to form a mature oocyte. Only one of the mature oocyte out of the 400 will be released every month which can get fertilized when it comes in contact with the sperm. [2]

How does all this happen?

The hypothalamus produces a hormone called the gonadotropin-releasing hormone or GnRH. GnRH stimulates the anterior lobe of the pituitary to secrete follicle-stimulating hormone (FSH).FSH travels to the ovaries and stimulates a group of follicles to grow, were one of them will  survive and become a mature follicle, the rest die.

FSH triggers the stimulation of the follicles

FSH stimulates estrogen production. The increasing level of estrogen acts on the hypothalamus and the anterior pituitary to increase the level of GnRH and induce the production of another hormone, luteinizing hormone (LH). [3]

FSH triggers the production of estrogen

A surge in LH secretion triggers ovulation – the release of the egg from the follicle and the ovary.

Release of mature oocyte

Fertilization by a spermatozoon, when it occurs, usually takes place in the ampulla, the widest section of the Fallopian tube. The fertilized egg immediately begins the process of development while travelling toward the uterus.

 

 

 

References:

  1. Textbook of medical physiology, 11th edition , Arthur C. Guyton and John E. Hall.
  2. www.youtube.com/watch?v=RFDatCchpus
  3. www.youtube.com/watch?v=pNe43KGZTl8&t=101s

Stimulated Ovulation Cycle

The main steps involved in this cycle are:

  • Super-Ovulation:
    Naturally, in each ovarian cycle one follicle becomes mature and gets ready for fertilization. Now women who have infertility problem and is going to undergo IVF, FSH are given as subcutaneous (under the skin) injection that will regulate ovulation, the growth and development of eggs in the ovaries.[4]
Administration of FSH for Ovarian follicle stimulation
  • Trans-vaginal Ultrasound: 
    After FSH treatment, ultrasound scans are needed to monitor the response of the follicles growth in the ovaries. The growth of the follicles is assessed by observing their increase in size using a trans-vaginal ultrasound.[4]
Trans-vaginal Ultrasound

If the follicles seen on the scan is in the range of 16 mm to 20 mm in size, then the trigger shot is given as mentioned in the next step. This hormone initiates the final maturation and release of the eggs. This mimics the LH surge that stimulates ovulation during normal cycle.

  • Taking a hCG shot:
    The next step in IVF treatment is triggering the oocyte for the last stage of maturation, before retrieval. This last growth is triggered with an injection. This is also called the “hCG (human Chorionic Gonadotrophin) Trigger shot”.[4]
hCG trigger shot

 

The injection is given when the follicles have grown in range of 16 to 20 mm in size. This shot is typically a one-time injection.

 

  • Going for the Gold- Retrieval of Eggs:
    About 34 to 36 hours after the “trigger shot” is received, the egg retrieval or ovum pick up will take place.
Retrieval of the egg

 

 

References:

  1. cimarindia.org/specialities/fertility/ivf-treatment/
  2. www.lifefertility.com.au/ivf-step-by-step/
  3. http://www.fertilitytoday.org/frequent_questions.html
  4. http://www.thebridgeclinic.com/Doctors-on-fertility/entryid/68/steps-to-ivf-treatment-administration-of-drugs

 

Structure of a Human Sperm

Spermatozoa(sperm) is composed of a head and a tail. The head comprises the condensed nucleus of the cell with only a thin cytoplasmic and cell membrane layer around its surface. On the outside of the anterior two thirds of the head is a thick cap called the acrosome that is formed mainly from the Golgi apparatus. This contains a number of enzymes including hyaluronidase (it can digest proteoglycan filaments of tissues) and powerful proteolytic enzymes (it can digest proteins). These enzymes play important roles in allowing the sperm to enter ovum and fertilization to happen.

Structure of a Human Sperm
Structure of a Human Sperm

The tail of the sperm, called the flagellum has three major components: (1) a central skeleton constructed of 11 microtubules, collectively called the axoneme (2) A thin cell membrane covering the axoneme and (3) A collection of mitochondria surrounding the axoneme in the proximal portion of the tail (called the body of tail).
Back and forth movement provided motility for the sperm. The movement results from a rhythmical longitudinal sliding motion between the anterior and posterior tubules that make up the axoneme. The energy for this process is supplied in the form of ATP synthesized by mitochondria in body of tail.
Normal sperm move in fluid medium at a velocity of 1 to 4 mm/min.

References:

  1. Textbook of medical physiology, 11th edition , Arthur C. Guyton and John E. Hall.

Introduction to RoboICSI®

RoboICSI® is an award-winning device to assist the embryologist during IVF towards improving the outcomes, thus helping infertile couples bear a child. Based on a novel design technique, RoboICSI® is a patent-pending device that will help bridge the gap between the demand and supply in the explosively growing infertility industry. It will be a Made-in-India device that will be a pioneer, offering several features for the First time in the World.

It is a smart device, which helps the embryologist to perform ICSI in an enhanced manner. RoboICSI® substitutes the holding pipette that is being used in the conventional ICSI.

Here is a quick overview about RoboICSI

 

Benefits of RoboICSI®

  • Novel micro-manipulation

RoboICSI® offers a novel way to grasp cells using bio compatible material, which offer several advantages compared to the traditional micro-pipette aspiration-based immobilization

  • Gentle handling of cells

RoboICSI® ’s intelligent passive force-limiting technology ensures that the oocyte that is grasped is not damaged even if the embryologist makes a mistake

  • Quick and hassle-free installation

RoboICSI® is designed and developed keeping in mind the current devices that are used in ICSI workbenches. RoboICSI®’s plug-and-play system allows the user to quickly plug the system, perform and the auto-calibration and get started in about a day

  • Easy onboarding and seamless integration

RoboICSI® is easy to learn, which allows clinics to add it into their workflow without much hassle

  • Eliminates subjectivity while handling oocytes

Performs routine tasks and reduces fatigue.Augments the embryologists and maximizes their potentials

  • Enables the IVF clinics to handle more volumes

Advantages of RoboICSI® over conventional ICSI

  • Easy-to-handle

RoboICSI® is a robust device. It replaces the use of pneumatic pump, making it easier to handle with an easy-to-use and intuitive control.

  • Not-fragile

The conventional ICSI holding pipette is made of glass and has a tendency to break while handling the oocytes. RoboICSI® replaces the glass pipette with a Holder made up of silicone elastomer, which is not fragile.

  • Automated

Data is collected automatically throughout the process.

  • Gentle manipulation of oocytes

The Holder which is designed to be soft, ensures no oocytes are harmed during the ICSI procedure (even inadvertently).

Pain Markers

Respect the hormones


Mom-To-Be:

There is a lot of procedure that has to be followed before the ICSI process. In the initial stage female are given drugs to boost the egg supply by taking fertility hormone called as gonadotrophin. This increases the number of eggs produced. Some women experience ovarian hyper-stimulation syndrome (OHSS) because of the hormone stimulating drug.

If the eggs are produced in an increased amount this will lead to low ovarian reserve. RoboICSI can predict the egg state and stability at the oocyte retrieval stage. This will reduce the dosage of the hormones given to female for increasing the egg count. Eggs collected can also be reduced as we will know the properties of eggs way before the ICSI process.

Quicker way to ace ICSI


Novice embryologists:

The conventional ICSI needs a lot of patience and dexterity. A novice embryologists find it challenging to fix and align the holding pipette. They may tend to break the holding pipette which is made up of glass if it is got closer to the ICSI plate. The precise plane should be achieved without breaking the holding pipette. The broken pieces will be hazardous if found in the ICSI plate. The entire plate has to be then disposed which will also contain the eggs.

 

The amount of pressure given to hold the egg is also a very important parameter. If too much pressure is given then the eggs might get damaged or ICSI will fail if there is no enough pressure applied.

 

RoboICSI is made up of a soft and bio compatible material that will be in contact with the eggs during the ICSI process. It is a not fragile which will not break even if it touches the ICSI plate which makes the embryologist to on-board easily with RoboICSI.

Say Bye to the suction pump which controls the pressure in conventional ICSI because RoboICSI works on a NO-PRESSURE method. Even if more actuation than required is given to grip the eggs there will be no damage caused to the eggs which has been proven by RoboICSI.

Spend Less, Earn More


IVF Clinics:

RoboICSI will be replacing the entire left manipulator with more efficient and compatible setup for a much lower cost compared to the present manipulators in clinics. Thus, will reduce the money spent by the clinics on purchasing the manipulators.

RoboICSI can handle more samples in fewer time which means more cases for a day.

 

What is ICSI

Intracytoplasmic sperm injection (ICSI) is an ART involving the injection of a single sperm into the cytoplasm of an oocyte to achieve fertilization. It is mainly performed for the treatment of couples with male factor infertility and those with poor fertilization with conventional IVF.

ICSI is the only treatment option for couples with severe male factor infertility. It can be performed with ejaculated or surgically retrieved sperm.

Intracytoplasmic Sperm Injection

Infertility Treatments

Assisted Reproductive Technology (ART), according to WHO, refers to infertility treatments where both eggs (oocytes) and sperm are handled ex-vivo to achieve pregnancy. In conventional ART procedures, the oocytes and sperms are combined in a laboratory ex vivo (i.e. outside the human body) and the resulting embryo (mature and fertilized oocyte) is implanted back into a woman.

ART’s includes techniques such as In-vitro fertilization (IVF), Intracytoplasmic Sperm Injection (ICSI), Gamete Intra-Fallopian Transfer (GIFT) or Zygote Intra-Fallopian Transfer (ZIFT) .

What is Infertility

Infertility is a disease of the reproductive system caused due to the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse [1]. In simpler words, it is the state of not being able to produce offspring. In female, it is the inability to conceive, and in male it is the inability to impregnate.

The four major causes for infertility can be classified into:

    1. male factor
    2. female factor
    3. combined male and female factor
    4. unexplained

Approximately 40% of infertility cases are due to female factor, 40% due to male factor, and 20% due to a combination of both.

According to the 2017 statistical analysis, in India there are about 30 million couples with infertility as shown in the following Figure.

Figure 1. IVF Scenario in India

References:

  1. F. Zegers-Hochschild et al. http://roboicsi.com/blog/wp-admin/post.php?post=5&action=edit