Micromanipulation

MICROMANIPULATION Birth of the first baby achieved through conception outside the human body 1978 Embryos can be manipulated for cell biopsy to determine their genetic status. It is the technique whereby sperm, eggs and embryos can be handled on an inverted microscope stage, performing minute procedures at the microscope stage, performing minute procedures at the microscopic level via joystick that hydraulically operate glass micro tools

 Male infertility Intracytopasmic Sperm Injection ot ICSI Sperm of any quality and from any level of the male reproductive tract may be used with the only criterian for that the spermis alive even it is non motile. Dead sperm may be able to fertilize , however the DNA from such sperm is too degenerate to form a viable embryo Immature sperm from the testicle or the epididymis can be retrieved for use with ICSI for men who possess no sperm in the ejaculated semen (azoospermia) Azoospermia is due to obstruction in the tract. Necrozoospermia do not survive to the point of ejaculation To overcome this testicular biopsy can be done for a ready source of freshly produced viable sperm.

 ICSI for non male factor infertility To over come the problem cytogenetic screening prformed. The use of ICSI is now routinely applied to a range of clinical situations wherever there is a possiblilty that conventional in vitro fertilization may be suppressed or not occur. Such situations include the following Idiopathic or unexplained fertility Hyper responsive ovarian stimulation cases where egg quality may be reduced Post thaw sperm samples that survive poorly, post thaw egg insemination, Generation of pre implantation genetic screening where embryos clean from extraneous contaminating sperm is needed The conventional problem in fertilization can be overcome by ICSI

Assisted hatching Problems faced by the embryo during implantation -unable to breal free from the surrounding Jelly coat called Zona pelucida This glycoprotein coat acts to protect the egg and to regulate normal fertilization And further continues to protect the embryo until blastocyst stage. During blastocyst stage the embryp fills itself up with fluid like a water filled balloon pumping itself larger and larger until it rupture and hatches from the zona pelucida and implants itself in the endometrium. Due to various reason the Zona pelucida will be thicker and cannot implant, such cases will be assisted by micromanipulation technique A hole is made on the Zona pelucida layer prior to transfer This can be done by mechanical, chemically laser. `

Embryo biopsy Can be done for both eggs and the sperm for pre implantation genetic diagnosis (PGD) and enables both the unfertilized egg by removing the first polar body. In fertilized multi cellular stage (6 to 12 cell stage) or from the trophoectoderm of the blastocyst. To identify any mutations or cross chromosomal errors. Micro insemination Procedure that can be used to increase the chance of fertilization and embry transfer (IV-ET) who may have reduced chance of fertilization through standard egg insemination procedures Active sperms are made to retain in the culture menium.After exposing the mature eggs to an enzyme that removes the cumulus cells which surrounds the cells. Each egg is placed under a microscope and held in place by gentle vaccum with a small glass tube called micropipette. A single sperm is drawn into the hollow glass needle along with small amount of the nutrient liquid medium. The needle is then passed through the Zona pelucida and the cell membrane to inject the sperm into the center of the egg After 18 -18 hrs after ICSI. The eggs are examined for two distinct proneuclei Risks and benefits