Premature ovarian insufficiency (POI) also known as premature ovarian failure. It is the ovarian dysfunction or the condition that the ovaries stop functioning earlier than they should.

POI is caused by low estrogen levels and follicle-stimulating hormone (FSH) abnormalities. It mostly occurs in menopausal women.

But young women can have POI as well! They may recognize something went wrong with their body, such as irregular periods, irritability, mood swing. These are similar to the symptoms of menopause.

Congenital diseases, chemotherapy, radiotherapy, genetic disorders, and unhealthy activities or habits may lead to this condition.

The diseases that are associated with POI, e.g., diabetes, hypertension, hyperthyroidism, chocolate cyst.

If you are at risks of premature ovarian insufficiency, it is recommended to consult with the doctor in order to find out the treatment that is suitable for each patient.

Reference: Prime Fertility Center Co., Ltd.

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ICSI (Intracytoplasmic Sperm Injection)

ICSI (Intracytoplasmic Sperm Injection) is an in vitro fertilization procedure with the laboratory technology. Both IVF and ICSI are comprising of similar procedures. But the difference is how sperm will fertilize an egg. In ICSI program, only one best sperm cell will be selected then injected directly into a fully matured egg. Patients will be prescribed some hormonal medications. Stimulating ovaries to produce several eggs. ICSI can make a pleasant fertilization rate. As well as reduces some fertilization problems or abnormalities caused from egg and sperm. For examples: multiple sperm fertilize an egg, sperm cannot penetrate the egg. The combined egg will transform to be an embryo after fertilization. Next, the embryo will be raised and will grow up among the appropriate environment inside a laboratory. Finally, the embryo will be transferred to the uterine cavity in order to implant then develop to be the fetus later on.

Couples who should receive the infertility treatment with ICSI program:

1. Female’s age more than 35 years
2. Stenosis for both sides of the fallopian tube
3. Severe Endometriosis
4. Ovarian hormone dysfunction for examples: Chronic Anovulation, PCOS (Polycystic Ovary Syndrome)
5. Severe sperm abnormalities including sperm morphology, sperm count, sperm motility
6. Male who is sterile or had a vasectomy but the body can still produce sperm. To extract sperm under this limitation, a surgical procedure will be performed such as PESA, TESA, TESE.
7. Couples who have failed from previous IVF cycle
8. Couples who prefer to screen the embryo’s genetic diseases

Frozen Embryo Transfer (FET)

Frozen Embryo Transfer (FET) is the process of embryo transplantation into the uterus after thawing frozen embryo. The patient can choose the FET date by convenient time e.g., 1-2 months after the fertilization process. The evidence supports FET in women more than 35 years of age are providing more pregnancy rates than FRESH embryo transfer.

Due to the inducing medication that the female takes to develop multiple of healthy ovum, the huge amount of hormones generated will weaken endometrium, consequently lessening the success rate of the transfer regardless of the perfect condition of embryos. Given the circumstance, the embryo transfer right away after ovum retrieval (FRESH transfer) may not be an effective protocol. 

Moreover, a number of studies from various institutes found that FET offers better and higher chance of pregnancy than the FRESH transfer because endometrial tissue is in more proper state for embryos. Therefore, the doctor will consider which protocol fits best for each couple individually.