Pedieos IVF Center offers the full range of Assisted Reproductive Technologies (ART).

[I] STIMULATED CYCLES : -

•  Classical In-vitro fertilization (IVF) method

•  Intracytoplasmic Sperm Injection (ICSI) for male fertility problems.

[II] NATURAL CYCLES (Controlled Ovarian Natural Cycle IVF – CONCIVF

[III] OVUM DONATION with IVF or ICSI

(1) Shared egg program (donation from women undergoing IVF treatment)
(2) Dedicated egg donors (donation of ALL the eggs from one donor to one recipient )

[IV] Embryo Biopsy for Pre-implantation Genetic Diagnosis (PGD)

[V] BLASTOCYST CULTURE (for prolonged culture of embryos up to 5-6 days)

[VI] CRYOPRESERVATION (or FREEZING)

(1) SPERM BANK for the following

----- a. Dedicated donors

----- b. Chemotherapy patients

----- c. Testicular Tissue freezing

(2) CRYOPRESERVATION OF OOCYTES

(3) CRYOPRESERVATION OF EMBRYOS

[VII] TEFNA, TESA and TESE methods for Azoospermia.

[VIII] Diagnostic Andrology Service (DIAS) for diagnostic and treating all male related reproductive and endocrinological problems.

[IX] Sperm washing and concentration facilities for Intra Uterine Insemination treatments (IUI).

[X] In-Vitro Maturation (IVM) for IVF without stimulation

[XI] OTHER TREATMENTS

Therapies Step by Step 

PEDIEOS IVF CENTER offers Assisted Reproductive Techniques (ART) of the following type:

[I] STIMULATED CYCLES

Patient Preparation with stimulation

The woman's ovaries are stimulated to produce eggs with the use of injectable hormones called Gonadotropins (FSH and LH).  Specific treatment protocols individualized for each patient are available:  Long protocol (follicular and luteal varieties), Short protocol and the Ultrashort protocol, all based on how a special medication, the so-called GnRH agonist is used. Newer protocols use the recently produced GnRH antagonists.

Patient monitoring

During ovarian stimulation follicular growth and egg production is monitored with the aid of Ultrasound scanning and blood hormone levels.

Ovum Pick-Up (OPU)

When the eggs are mature, they are collected vaginally with the aid of the Ultrasound Scanner.  The woman is given a very brief anesthesia, therefore she feels no pain during the procedure which lasts only a few minutes.  At the same time the husband produces a semen sample.

Insemination: The eggs are removed from the follicular fluid and transferred in the IVF culture medium until insemination, which is done a few hours after OPU. The semen sample is washed using silica based density gradient medium for separation and purification of highly motile spermatozoa. The sample is incubated up to two hours at 37 o C.

Τhere are basically two methods of In-Vitro Fertilization (IVF).

(1) The Classical IVF : This method is employed when the spermatozoa are normal in concentration, motility and morphology. Approximately 1 million sperm cells (adjusted by their final concentration after wash) per egg are dispersed in a drop of insemination medium and incubated at 37 o C with 5% CO 2, until the next day. The sperm cells are allowed to penetrate the outer membrane of the egg on their own to fertilize the egg. Fertilization [Link] is determined 24 hours after insemination. [photograph]

(2) The ICSI method – micro-insemination :   The method of ICSI is mainly used when the semen analysis is abnormal, i.e. when the sperm cells are below the normal concentration and/or when their motility is poor, or when they have severe morphological defect. This method is also applied in cases of continuous failed fertilization with classical IVF, in the presence of sperm antibodies and occasionally in patients with small number of retrieved oocytes.

In this process, a morphologically good spermatozoon is aspirated in the injecting micro-needle and manually released by piercing the egg membrane with a micro-needle under microscopic control in the centre of the egg, which is held by a holding micro-needle. The inseminated egg is incubated at 37 o C with 5% CO 2 until the next day when fertilization is determined.

Fertlization

Fertilzation either with Classical IVF or ICSI method of insemination is determined 24 hours after OPU by the presence of two pronuclii, one from the sperm (paternal) and the other from the egg itself (maternal).

Culture - Embryo Transfer

The fertilized eggs are cultured in culture medium for 2, 3 or 5 days before transferring them back into the woman's uterus (womb).

Blastocyst culture

Newer developments have led to the successful culture of embryos up to 5-6 days, at which time the embryos become blastocysts.  Blastocyst transfers are successful but they are employed under certain conditions and for certain indications.

Embryo Transfer

Embryo transfer is performed 2-5 days after retrieval, as determined by the physician of the center.

[II] NATURAL CYCLES (CONCIVF)

This treatment is offered without stimulating the ovaries. Women should be menstruating regularly to undergo this mode of treatment. The egg that women produce naturally every month is collected vaginally under ultrasound guidance and inseminated either by Classical IVF (CONCIVF) or with ICSI as per the quality of sperms to be used.

The benefits of CONCIVF are that (i) women do not have to undergo ovarian stimulation with hormones, so risk of hyperstimulation is avoided (ii) it is inexpensive as compared to stimulated cycles (iii) it can be repeated every month and (iv) has no risk of multiple pregnancy.

[III] OVUM DONATION

There are women who have insufficient egg production or eggs of poor quality.  In these cases the couple may wish to become recipient of eggs donated by another woman.  The couple may find their own donor or our IVF center may find one for them on an ANONYMOUS basis. 

Ovum donation can be done by sharing eggs of the women undergoing IVF treatment or taking all the donated eggs from a dedicated donor.

Only a short time (less than 4 days) is necessary for a recipient from abroad to stay in Cyprus   for this treatment

Our dedicated egg donors are: (i) Fully tested for sexually transmissible diseases and chromosomal disorders.  (ii) Under the age of 34 years. (iii) From healthy family background.  (iv) From various ethnic origins.

[V] CRYOPRESERVATION (FREEZING)

PEDIEOS IVF CENTER offers cryo-technology for human sperm, testicular tissue, oocytes and embryos.

Our SPERM BANK has been operating since 1982, storing frozen semen from male partners undergoing IVF program, dedicated donors and from oncology patients. [photographs…cryo-cans, filling pump, sealing machine]

[A] SPERM BANK :- Our SPERM BANK offers freezing of fresh human semen of :-

•  Dedicated donors: We offer sperm donation from young donors mainly of the Mediterranean origin. Our donors are tested negative for VDRL, HIV, CMV, Hepatitis B & C and Thalassemia. The donor profile can be available on request; however, anonymocity is maintained in all cases.

•  IVF patients: Male partners of patients undergoing IVF who cannot be present to give fresh ejaculates during their partner's day of ovum pick-up can freeze their semen to be thawed and used when required. This technique is also used in patients undergoing ovulation induction.

•  Semen can be frozen from patients prior to their chemotherapy or radiation. We offer a long-term freezing facility for these patients with nominal storage charges payable half yearly. We offer semen analysis for these patients after their therapy and if the quality of the semen is seen to be improving, we advice them to sign a consent form for destroying their frozen straws.

•  Freezing of testicular tissue: Testicular aspirates or tissue biopsies are frozen if motile spermatozoa and or spermatocytes are visible in the patient's samples.

OOCYTE CRYOPRESERVATION is a fairly new method offering an advantage for young patients interested in fertility preservation prior to chemotherapy or radiotherapy from oncology problems.

EMBRYO CRYOPESERVATION is done to avoid the risks of multiple pregnancies or wastage of supernumerary embryos.

OTHER TREATMENTS

1) Treatment of Azoospermia:   TEFNA - TESA - TESE - MESA

When there are no spermatozooa in the ejaculate, attempts can be made to find mature or immature spermatozooa or their precursors in the testes.  When this is successful, fertilization of the egg is attempted with the ICSI method.

2) Diagnostic Andrology Systems (DIAS) offers:

•  Semen Analysis with strict criteria

•  Sperm Vitality Tests : (i) by Dye Exclusion test (EOSIN): to estimate the proportion of ‘dead' v/s ‘alive' spermatozoa. (ii) Hypo-osmotic Swelling Test (HOS): to know the integrity and compliance of the cell membrane of the sperm tail.

•  Mixed Antiglobulin Reaction (MAR) test: test the presence of sperm antibodies.

•  Post-coital test: To evaluate the properties of the cervical mucus and sperm survival and behaviour after coitus.

(e) Sperm washing and concentration facilities for Intra Uterine Insemination (IUI) treatments.

•  Embryo Biopsy for Preimplantation Genetic Diagnosis (PGD):

This technique is used to select healthy embryos that do not carry genetic diseases such as thalassemia, cystic fibrosis, mongolism, etc BEFORE they are transferred back to the uterus. The techniques used at our center for PGD are :-

•  Fluorescent In-situ Hybridization (FISH) for aneuploidy screening, i.e, assessment of chromosomal disorders.

•  Polymerase Chain Reaction (PCR) for assessment of single gene defects.

•  In-vitro Maturation (IVM): This is a new procedure that does not require hormone stimulation of the ovaries. The oocytes are removed before ovulation and matured in vitro. This technique is suitable especially for patients with Polycystic Ovarian Syndrome (PCO) .