Medication is given to the patient which temporarily switches off the messages going from the brain to the ovaries telling them to produce an egg on a monthly basis. In addition, down regulation prevents premature release of the egg. Thus, down-regulation primarily serves to ensure correct    timing of ovulation prior to egg collection. Our unit uses oral contraceptive (OCP) down regulation protocol which is also called long agonist protocol it’s been in use for a long time and it offers the best result.

Gonadotropins (e.g. hMG, fostimon, follicullin, gonalF) are given to stimulate the ovaries into producing the follicles, which contain the eggs. Treatment with follicle stimulation hormone (FSH) lasts 1 to 2 weeks starting on the second day of the cycle and involves a once-daily subcutaneous or intramuscular injection. Our nurse will teach you how to give the injections yourself. The length of  the treatment will depend on how your ovaries respond; ovarian response will be monitored by the use of ultrasound and a blood test that measure your oestrogen levels. Once ultrasound shows that the lead follicle has matured in size,  human Chorionic Gonadotropin (HCG)  will be injected to trigger the release of the egg.

Please contact our embryologist Tinei Makurumure (+263 773 422 234). He will provide bottles   for the semen collection, answer any questions you may have in this regard and personally collect the specimen from your husband. The semen will be processed in the laboratory in the Avenues Clinic and your husband will be asked to deliver the sample directly to Tinei (and only to Tinei) at the theatre door entrance on the fourth floor of the Avenues Clinic this is to ensure that no mistakes of identity occur.  Different arrangements may be made for IUI and IVF.

Thirty-six hours after the trigger shot, retrieval of the eggs is undertaken. The procedure  is performed at the Avenues Clinic most often by a transvaginal route. A needle, guided by ultrasound imaging, is inserted through the vaginal wall into the ovaries, where the follicles containing the eggs are punctured and the follicular fluid is withdrawn. Anaesthesia/ analgesia may be used for this procedure but different options are available please discuss this with the gynaecologist. The procedure takes about 10-30 minutes, and you can return home a few hours after wards. The eggs are transferred in the follicular fluid to the laboratory where their developmental stage is assessed under the microscope. A sperm specimen is then washed and prepared for insemination. Each egg is placed in a dish and a defined number of sperm cells are added. Each dish is placed in an incubator. The embryos are then observed for a few days for evidence of fertilisation.

If fertilisation is successful, the embryos can then be transferred to the uterus. The transfer technique is accomplished by placing the embryos (usually two of them) inside a narrow plastic tube (transfer catheter) which is then inserted into the uterus through the cervix. Ultrasound may be used to guide the catheter insertion. The procedure lasts only a few minutes. You may then rest for an hour or two and then return home where you should not strain yourself for 1 or 2 days.     

 ICSI is a type of assisted microsurgical fertilisation that involves the injection of a single sperm directly into an egg. Over the last few years, various methods of assisted microsurgical fertilisation (micro-manipulation procedures) have been developed for use when a male partner exhibits poor sperm motility and/or low sperm count. ICSI allows a much higher fertilisation rate for   these patients with ‘normal’ fertilisation in over 50% of the eggs. Eggs for ICSI are obtained in exactly the same way as   those for IVF. Following egg retrieval, the cells surrounding each egg are carefully removed. The eggs are then examined under   a microscope and only those that are judged as mature are suitable for injection. Typically, 70% of the eggs that are   obtained are suitable for ICSI.  The sperm are washed and prepared. The egg and the   sperm are then   placed under a special microscope that   has micro manipulators attached to it. One micro-manipulator holds the egg in   place, while the other is used to inject the sperm into the egg. The remainder of the procedure is similar to standard IVF with regard to incubation of   the eggs and transfer of the resulting embryos.

The sperm freezing procedure which can also be called cryopreservation is carried out in various stages. Firstly the patient will be screened for infectious diseases which includes HIV, HTLV, Hepatitis B and Hepatitis C. Written consent for your sperm to be stored will be required and you are asked to produce the sperm sample at the clinic. It is then frozen and stored in liquid nitrogen. Each vial of a patient’s semen sample is labelled with the patient’s name, date and a unique number recorded. The treatment with frozen sperm is just as successful as treatment using fresh sperm.

Egg freezing is also known as mature oocyte cryopreservation. Before the beginning of egg freezing screening blood tests are done which includes the ovarian reserve testing.  It determines the quantity and quality of your eggs. On day 3 of your menstrual cycle the doctor might test the concentration of follicle-stimulating hormone (FSH) and AMH in your blood.  Blood tests and an ultrasound of the ovaries may be recommended in order to get a more complete assessment of ovarian function. The screening of infectious diseases such as HIV is carried out. HIV potentially infectious eggs are stored differently as compared to other eggs. The patient is given hormone injections to make the ovaries release more eggs than usual (ovarian stimulation). Collecting as many eggs as possible improves the success rates for this procedure. The actual egg collection is carried out with a needle guided to follicles with an ultrasound probe. The procedure takes around 15-20 minutes and is performed under sedation. The majority of the fluid is removed from the eggs to reduce chances of damage during the freezing process. The eggs are then stored in liquid nitrogen.

Embryo freezing is a routine part of the IVF process. It is a method of preserving the viability of embryo transfer.

Embryos are removed from the 37 degrees celcius incubator and placed in a weak solution of CPA’s at room temperature. Embryos spend 8 minutes in this solution, which is enough time for the water and CPA’s to equilibrate. When first in the CPA solution, embryos initially shrink (as water leaves the embryo) and then re-expand as the CPA’s enter the cells.

Embryos   are placed in a stronger CPA solution and allowed to equilibrate for just 1 minute.

Each embryo is loaded up into a fine straw which has been pre-labelled with identifying and tracking information. The label has information on the individual(s) that created the embryo (full names and date of birth), tracking information for any sperm and/or oocyte donor used, and the date of the freezing procedure and the status of the embryo at the time of freezing.

The straw is sealed at both ends and plunged into liquid nitrogen at a temperature of -196 Degrees Celcius. It will remain at this deep sub-zero temperature until the individual(s) that created the embryo request for it to be warmed.

Sperm banks collect and store sperm. As part of this process, a sperm bank laboratory analyses semen samples, offers frozen sperm donor samples and provides long-term storage of semen. Some of the sperm stored in these banks are donations made to help infertile couples or single parents to have a child. All semen samples are collected in a dry, sterile container. Before sperm samples are frozen, they are prepared with a solution that reduces damage to the sperm from freezing and thawing. These samples are placed in small tubes and frozen slowly. The frozen samples are stored in liquid nitrogen at very low temperatures. This is known as cryopreservation.

This programme facilitates donation of eggs to women who are menopausal or with premature ovarian failure, who still have a desire to have a family.

In order to import embryos you will need to find a licensed fertility clinic (if you don’t already have one) to ensure your eggs, sperm or embryos are moved safely. There are strict requirement for importing and your clinic will need to be happy those requirements have been met before they allow your eggs, sperm or embryos to be moved to our centre. For one to be able to import an embryo they need to be frozen (cryopreserved) in a tube first and then shipped in a container that is designed for the transport of biological materials and that maintains the safety and quality of the eggs, sperm or embryos.

Clinics will often work with specialist courier companies to ensure that all material is kept safe during transit but if you have any concerns you should talk to your clinic about their transportation process. Our centre is in partnership with Pam Matthews a specialist IVF courier who can transport your embryos from anywhere in the world to our centre her website www.embryosafecryotransport.com.

Our centre offers keyhole surgery that involves inserting a small telescope through the abdominal wall so that the pelvic organs can be visualised. Laparoscopy enables the gynaecologist to evaluate the pelvis and is the gold standard for diagnosis of blocked fallopian tubes. Hysteroscopy allows the gynaecologist to evaluate endometrial cavity and diagnose conditions like endometrial polyps and submucosal fibroids.