Directed by our PhD embryologist, Diamond Institute’s laboratories for assessment and treatment of male and female reproductive issues adhere to the highest clinical standards and are certified by the American College of Pathology. For patient convenience and optimum timing, we pride ourselves on providing the most technologically advanced procedures onsite.

ANDROLOGY PROCEDURES
Dedicated to the male partner, the andrology laboratory tests sperm manually and also uses computer-assisted analysis to ensure the highest degree of accuracy. Initial semen studies indicate which additional investigative steps and treatment procedures are necessary.

Semen Analysis
We analyze semen for viscosity, agglutination, pH, count, motility (movement), and we observe the percentage of sperm with normal morphology (shape and other characteristics).

Hypo-osmotic Swelling Test (HOS)
By challenging the ability of sperm to swell in a fluid condition, we can obtain information that shows the quality of the sperm membrane and may indicate the sperm’s ability to complete fertilization of an egg.

Human Sperm Cryoperservation
At a temperature of -180o, we cryopreserve sperm, a method Diamond Institute, as one of the cryopreservation pioneers, started over 16 years ago. This is especially helpful in treating male partners with poor quality sperm or low counts, concentrating and freezing more of the most viable sperm.

Determination of Direct and Indirect Sperm Antibodies
Direct (male partner to his own sperm) or indirect (female partner to male sperm) antibodies strongly reduce fertilization chances. When semen samples show excessive agglutination or reduced progressive motility or when the couple encounters an unexplained low fertilization rate (<50%) during an IVF cycle, we check for antibodies that fight sperm. In the presence of antibodies – male or female, Diamond then can opt for fertilization procedures to overcome the issue.

Semen Culture
Culturing seminal plasma can detect the presence of both aerobic and anaerobic organisms, possibly pointing to a diagnosis of male accessory gland infection, particularly of the prostate.

Sperm Preparation for IUI/ IVF
To select the best sperm, motile spermatozoa are separated from the seminal plasma, immotile spermatozoa, and other cells before being used for intrauterine insemination (IUl) or in vitro fertilization (IVF). Our laboratory primarily uses Swim-up and Percoll gradient centrifugation for sperm preparation techniques.

EMBRYOLOGY PROCEDURES
Once we have ruled out or identified male partner issues and formulated treatment plans if warranted, we are able to proceed with fertilization methods tailored to each couple we see. Using today’s most current technology, Diamond Institute enjoys consistent success rates for patients.

Oocyte Retrieval
Thirty-six hours after administering hCG to mature preovulatory oocytes, we retrieve these oocytes from follicular fluid, wash them to eliminate red blood cells, and place them into the incubator with the fertilization medium where, after a minimum of three hours, they will be inseminated with the male partner’s prepared sperm suspension.

Oocyte Insemination
Following egg retrieval, the three to five-hour separate incubation of egg and sperm allows oocytes to undergo the final stage of maturation which usually occurs in nature after ovulation. The waiting period allows sperm to undergo capacitation whereby they acquire the ability to fertilize the awaiting oocytes.

Intracytoplasmic Sperm Injection (ICSI)
Diamond Institute was one of the first North American treatment centers to perform ICSI where the single sperm is fused with an egg to achieve fertilization. We expertly bypass barriers – including severe male factor infertility and inability of sperm to interact with and penetrate eggs. ICSI can be performed with sperm from ejaculate or using testicular sperm aspiration (TESA). Click here to see video

Embryo Cleavage Check
We grade embryos by cell number, fragmentation, and blastomere symmetry, a great guide for Diamond physicians and patients in deciding how many and which embryos to transfer. Generally Grade I embryos display more implantation success.

Embryo Freezing/Blastocyst Vitrification
Although we can freeze an embryo at the fertilized egg stage one day after oocyte retrieval, the most successful stage is Day 5 freezing at the blastocyst stage. Diamond Institute is the leading center for blastocyst vitrification (ultra-rapid freezing without ice crystal formation) and hosts visiting worldwide infertility experts in onsite education about the method.

Laser Assisted Hatching Using the ZILOS Laser
Diamond recommends assisted hatching to increase implantation and conception. When patients present issues including advanced maternal age, hormonal imbalance, and previous implantation failure, there is a concern that the embryo may fail to hatch and implant. Using a laser beam and computerized targeting, we create the most precise and controlled opening in the embryo capsule in preparation for intrauterine implantation soon afterward.

Day Three Embryo Transfer (68-72 hours post-insemination)
In Diamond’s transfer room, selected embryos are transferred to the female partner via a specialized catheter. Recognize couples’ individuality – clinical history, including previous IVF failure, and current factors as well as personal choices (possible selective reduction) – our physicians and embryologist consult with them regarding the number of embryos to be transferred. Most couples aim to achieve a singleton pregnancy and to minimize the chance of having high orders (> 2) of multiple pregnancies. We look for embryos at the most advanced development (6-8 cells on day 3) and with the best morphology.

Blastocyst Culture and Transfer
In vivo, the human embryo enters the uterus at either the morula stage or the blastocyst stage, day 4-5 post-fertilization. Our advanced laboratory technology enables us to grow embryos to blastocyst stage for many of our patients. This makes day 5 transfers a successful approach in IVF cycles, producing high implantation and pregnancy rates. Choosing the best quality embryos at this stage can reduce the number of embryo transfers and lower the risk of multiple pregnancies.

Preimplantation Genetic Diagnosis (PGD)
To give each couple a better potential outcome of producing a healthy baby, Diamond Institute employs preimplantation genetic diagnosis (PGD) along with in vitro fertilization. PGD screens early stage embryos for specific genetic diseases and/or chromosomal abnormalities. The process involves extracting and analyzing single cells from embryos, testing them for these issues, and then implanting embryos in the uterus when the results are clear. Click here to see video