Investigation

semen Investigation

Standard Semen Analysis

  • Concentration, Motility, Morphology

  • Anti-Sperm Antibodies

  • Semen Culture and Sensitivity

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Advanced Sperm Diagnostics

  • DNA Fragmentation

  • Sperm Survival Assay

oocyte (egg) and uterine investigation

Initial Assessment

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  • Ovarian Ultrasound

  • Baseline Hormone Panel

  • Sonohystogram with 3D Imaging

    • Uterine structure

    • Tubal Patency

  • Anti-Mullarian Hormone

  • Vitamin D

  • Endometrial Biopsy 

Advanced diagnostics

  • Endometrial Receptivity Assay


Treatment

CONTROLLED ovarian stimulation

Oral medications or injections are given to produce more eggs (oocytes) and/or induce ovulation. Specific drug therapy will depend on the type of diagnosis and other factors contributing to infertility. 

Timed Intercourse

Often used for idiopathic (unknown) infertility, the menstrual cycle is monitored carefully and ovulation induction may be performed. Patients are prescribed intercourse on the specific day of ovulation for the greatest likelihood of success.

IntraUterine insemination (IUI)

This technique is used when there is a mild to moderate degree of sperm impairment. A sperm wash is performed, this isolates the motile sperm from the seminal fluid. This sample is loaded in a catheter that is placed through the cervix, allowing sperm to be injected directly into the uterine cavity. The result is a higher concentration of motile sperm in the uterus than can be achieved by intercourse.

Therapeutic DOnor insemination (TDI)

Performed in the same manner as an IUI, but using a donor sperm sample. To ensure that samples are safe and of the highest quality, donor sperm is purchased from sperm banks that meet Health Canada requirements (one of the strictest jurisdictions in the world for compulsory testing of donor sperm). 

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Assisted Reproductive Technologies

In Vitro Fertilization (IVF)

The oocytes (eggs) are fertilized in the laboratory. Resulting embryos are grown to the blastocyst stage before either transferring back into the uterus or being cryopreserved for future transfers.

Intra-Cytoplasmic Sperm Injection (ICSI)

The embryologist isolates the highest quality sperm and injects it directly into the oocyte to induce fertilization. The embryos are then grown in the same manner as IVF.

FERTILITY Preservation

In the cases of medical conditions or treatments that can impair fertility (e.g. cancer therapy or some surgeries), oocytes or sperm can be collected and cryopreserved for future use and are then protected from potential damage.

Assisted Hatching

Hatching involves creating a small hole in the zona pellucida (the shell of an embryo) using a high frequency laser. This is done after cryopreservation because the freezing hardens the shell and the embryo may have difficulty breaking through and implanting into the uterus.

Pre-Implantation Genetic testing for anueploidy (PGt-a)

Genetic testing of embryos following IVF+ICSI to screen for abnormal numbers of chromosomes or missing/added genetic material on chromosomes. Approximately 20% of IVF embryos will have some chromosomal abnormality.

Pre-Implantation Genetic testing for Single gene mutatioN (PGt-m)

Genetic testing of the embryos created following IVF+ICSI to determine if they are carriers of specific disorders of which the patient has a personal or familial history that can be linked to a single gene (e.g. Cystic Fibrosis).

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Third Party Reproduction

Egg Donation

KARMA partners with many oocyte donation services to assist patients with low ovarian reserve, advanced maternal age, or same-sex male couples. Known egg donation can also be performed at our clinic.

Gestational Carriers (Surrogacy)

Surrogacy is used when someone is unable to carry a pregnancy due to medical reasons (e.g. absent or malformed uterus), a history of unexplained recurrent pregnancy loss, or for same-sex male couples. Surrogacy may be done via an agency or with a surrogate known to the intended parents.


 
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