Cryopreservation refers to the process of preservation of oocytes, blastocysts, sperms and embryos in frozen state to make them available in future. Patients with hyperstimulation syndrome, excess oocytes or embryos, etc find this technique very useful to get their oocytes, sperms, embryos preserved by freezing and later retrieved in the hour of need. Males with anticipated collection problem can use this to pool their sample to be used later.

Cryopreservation is helpful for the patients with any one or more of the following conditions-

1.       Cycle cancellation leading to the danger of ovarian hyperstimulation

2.       Bad health conditions post oocyte aspiration

3.       Donor oocyte arrangements

4.       High progesterone level at the time of HCG injection

5.       Unfavorable implantation site

Although this sounds simple but is a very complicated procedure requiring sophisticated, advance and costly equipments, liquid nitrogen jars and other computerized machinery. First of all the collected oocytes, embryos and sperms that needs to be preserved are exposed to cryoprotective agents which dehydrate them. Then the resultants are put into the straws specially meant for the purpose in ehich they are allowed to be cooled slowly upto the temperature as low as -196 degree celcius. Straws are preserved into liquid nitrogen which allows them to be safe for eternity. Ideally embryos, sperms or oocytes should be freezed in the pre-nuclear stage.

Cryopreservation also claims great precaution so that cell’s structural integrity is not disturbed. Much of the efforts of cryopreservation is dedicated to keep the damage due to intra-cellular ice formation minimum. This is done by proper dehydration of the cells before freezing otherwise intra cellular crystals may be dangerous to the cells.

Dr Akash Sharma, the senior embryologist at Adam and Eve test tube bay and research centre is an expert of cryopreservation.

Male infertility- Dr Akash Sharma

Male infertility is the inability of the male to make the female pregnant who is fertile. 40-50 percent of human infertility is caused by this.

There are different types of causes for male infertility such as pre-testicular causes, testicular causes, post-testicular causes, tobacco consumption, damaged DNA, etc.

Pre-testicular factors are the impending conditions to the adequate testes support which also include poor hormonal and general health situations. These can be obesity, drugs, alcohol, strenuous cycling, severe medications like chemotherapy and other relevant factors.

Tobacco consumers are at 30 percent more risk of infertility than others. Its been evident through researches that tobacco kills sperms.

Damaged DNA is inherited factors of genes resulting in infertility.

Testicular factors means low quantity and poor quality sperm production despite having proper hormonal support. This can owe to age, genetic defect, chromosomal abnormalities, hydrocele, testicular cancer, etc.

Post-testicular causes refers to the conditions of after sperm production that leads to male infertility and also includes the defects and problems of genital tract and ejaculation.

To diagnose the infertility the practitioner will need to check relevant medical history, do physical examination of penis, scrotum, testes, anus, rectum, etc. Semen analysis must be done to check semen quantity, sperm percentage, motility or forward rate. Blood tests should also be conducted to reveal any genetic defect. Ultrasonography or Doppler of scrotum can be useful if the doctor has doubt about some hidden diseases like hydocele, vericocele, etc.

Patient with male infertility should avoid smoking tobacco, marijuana, use alcohol, avoid excessive heating of testes, using supporters while engaging in sports or excercises.

Infertility due to different causes requires different treatments. Pre-testicular and ejaculation based infertility issues can mostly be addressed with medicinal means whereas testicular infertility problem is not responsive to medication. Normal treatments for testicular and post testicular (other than ejaculation problem) infertility problems includes using sperms for IUI, IVF, ICSI or surgeries.

Being a male infertility expert Dr Akash possess a great deal of experience in ruling out the cause and best course of treatment for the males suffering with infertility issues.

Dr Akash Sharma- Embryo Culture

Embryo culture is a part of IVF treatment which involves culture or development of resultant embryos for some time (normally ranges from 2-6 days) before being implanted into female uterine cavity.

Normally embryos are cultured by the embryologists from two to six days. This duration varies because of different stages of embrogenesis and embryo transfer. The first one and main stage is cleavage stage which remains from 2 to 4 days after co-incubation. Second is the blastocyst stage which comes at 5^th or 6^th day after co-incubation.

Blastocyst stage of embryo culture sigficantly increase the chances of conception but at the same times decreases the number of embryos available by then for the purpose of embryo cryopreservation and embryo transfer. Thus one can understand that cleavage stage has increased cumulative clinical pregnancy rates.

Embryo culture is performed in two ways- artificial culture medium or the autologous endometrial coculture. This autologous endometrical coculture means culture to be performed on the top layer of cells from the woman’s own uterine lining. Embryo can be cultured completely via a single medium or sequentially with the above two mediums.

Although no significant perversion or disorder is reported in humans yet studies with animal have detected some epigenetic abnormalities in the embryos that have undergone embryo culture.

Dr Akash Sharma, the senior embryologist of The adam and eve test tube baby centre and research institute, noida has great expertise and rich experience in the field of embryology and embryo culture.

IUI Dr Akash Sharma

When sperms are unable to reach the female generative cavity, then sperm are established there through a medical process known as Intra Uterine Insemination or IUI. In an attempt to achieve pregnancy, washed and ready semen of the husband or the donor is placed into the feminine internal reproductive organ. An IUI expert simply completes the last step of intercourse through the equipments where ejaculated semen reaches the uterine tract and lets copulation of sperm and egg take place.

Even before pre-IUI evaluation several symptoms of both the male and female partner such as Ejaculation failure [because of diabetes, multiple sclerosis, spinal cord injury and retrograde ejaculation, psychological], Low sperm count, Poor sperm quality, etc in males whereas Mild endometriosis, Cervical mucus hostility, etc in females or combined unidentified factors needs to be taken into account by the IUI expert.

As an integral part of the pre-IUI analysis, patient needs to go through some routine blood tests, hormone analysis, HIV/Hepatitis tests, semen analysis, anti-sperm anti-bodies, ultrasound, etc.

Although IUI is a fairly simple and short process of insemination, still it requires the suitable environment for fertilization, which is the presence of right quantity of healthy eggs. Sperms must be introduced into female reproductive tract at an opportune time when maximum eggs are evolving. But before we do that, little preparation is required for both the partners. IUI expert shall guide the male partner about various things such as sex abstinence, diet, sleep and other thing, which should be duly followed by him. After that sperms should be collected properly and hygienically. Oral drugs and injectibles are administered as a part of Ovulation induction, which ought to be undertaken by the feminine partner to make sure right amount and quality of eggs. The IUI professional ought to see that the precautions and directions concerning this preliminary stage is communicated to the couple and is properly followed.

Both the partners need to keep a watch for any symptoms because pregnancy may take place anywhere between 6-12 weeks after insemination to conceive.

Dr Akash Sharma is the notable IUI professional of Delhi and has a great experience of IUI procedure. http://www.drakashsharma.com