Heterologous fertilisation - Prof. Antonio La Marca
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Prof. La Marca receives by appointment at the Policlinico di Modena.

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Prof. Antonio La Marca

Heterologous fertilisation

Insight into performance

Heterologous fertilisation

In some cases, for certain clinical conditions, couples desiring offspring must resort to gametes (oocytes and/or sperm) from voluntary and disinterested donors in order to fulfil their reproductive desire. We speak in this case of heterologous fertilisation, which may be female (by ovodonation) when the use of donated oocytes that are fertilised by the sperm of the recipient couple is envisaged, or male when the use of donated sperm is envisaged. Egg donation is indicated in women who do not respond to hormonal stimulation preparatory to a homologous fertilisation cycle, women of advanced reproductive age, women with reduced ovarian reserve, women affected by or carrying a significant genetic defect, women with poor quality oocytes and/or embryos, or repeated failed attempts at conception through homologous PMA techniques. Donor sperm is used in the case of men with an absence of spermatozoa, carriers of a genetic disorder or sexually transmitted disease, and sperm chromosome abnormalities.
The biggest problem we face today is the procurement of both male (spermatozoa) and female (oocytes) gametes. In Italy, there are very few donors of reproductive cells. To date, therefore, the gametes used for heterologous assisted fertilisation techniques mainly come from banks in other European countries. All donors are carefully screened as they should meet very specific requirements in order to be able to donate, including young age, no family history of genetically transmitted diseases and normal genetic medical history, negative test results for sexually transmitted diseases, normal reproductive system, good physical and mental health.Personal data are protected and safeguarded by confidentiality, keeping the donor's identity anonymous. This is because any gamete donation must be anonymous and voluntary, meaning that the identity of donors and recipients may not be revealed at any time, either during or after the heterologous fertilisation process. Frozen gamete donation is currently the most common technique in Italy.
Authorised centres can import gametes from authorised centres in countries where there is a more established donor presence, e.g. Spain. A recently introduced technique is vitrification, ultra-fast freezing, which allows oocytes to be instantly frozen while keeping the cells unaltered for an indefinite period of time, until they are used. Ongoing medical-scientific and professional collaborations with leading foreign centres, aimed at performing and applying the most advanced medical techniques for the diagnosis and treatment of infertility, make the couple's journey more straightforward and provide the care and attention needed to achieve their goals. It is precisely this close cooperation that has enabled the creation of extremely effective egg donation paths involving the insemination of fresh oocytes in the foreign centre, obtaining the embryos and transporting them to the Italian centre for transfer. We have called this method 'Transnational fresh Oocyte Donation - TOD'.
This strategy is currently recognised as the most effective in remote egg donation programmes.

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Performances

Myolysis or thermoablation of uterine fibroids

Myolysis or Thermoablation is a technique currently only performed in a few centres. Prof La Marca personally handles the method and receives patients from all over the country to perform this innovative therapy.

Radiofrequency and microwaves for gynaecological pathology

Radiofrequency and microwaves have been introduced into our clinical practice with excellent results. Prof La Marca is considered among the pioneers for the use of this procedure in gynaecology and receives patients from all over the country for the ultra minimally invasive treatment of uterine fibroids and adenomyosis.

In vitro fertilisation

In vitro fertilisation is a therapeutic strategy that is far from standardised. Like all medical and surgical practices, it is greatly affected by the technical skills and cultural updating of the practitioners involved. The results are therefore by far operator-dependent. This aspect is very little known, both by clinicians and patients.

Gynaecological endocrinology

The ovarian and menstrual function of women is extremely delicate and responds to a complex interaction between the centres (hypothalamus-pituitary) and the periphery (ovary-uterus).

Transfer to the blastocyst stage

In in vitro fertilisation, fertilised oocytes (zygotes) are kept in the laboratory, in incubators, under controlled temperature conditions (37°C) and an atmosphere with 5% oxygen and 6% carbon dioxide.

Infertility

It is well known that a considerable percentage of couples experience difficulties in conceiving. It is estimated that 10-15% of the population can be classified as infertile.

Recurrent abortion

Miscarriage is defined as a termination of pregnancy that occurs spontaneously within 24 weeks of gestation.

Diagnostic and operative hysteroscopy

Diagnostic Hysteroscopy is an endoscopic technique that can be performed in an outpatient setting using a hysteroscope.

Heterologous fertilisation

For certain clinical conditions, couples desiring offspring must resort to gametes (oocytes and/or spermatozoa) from voluntary and disinterested donors in order to fulfil their reproductive desire.

Fertility preservation

Over the past three decades, a phenomenon has taken hold in the Western world that is likely to have major implications for birth rates: the scheduling of births at a significantly older age than in the past.

Gynaecology and obstetrics

Gynaecology and Obstetrics is the medical discipline par excellence in the care of women. The aim of this clinical speciality has always been to care for the patient in all phases of her life.

Diagnosis and treatment of adenomyosis

At our clinic, the diagnosis and therapy of adenomyosis is performed to the most up-to-date standards. Prof La Marca is among the clinicians with the most experience in treating adenomyosis with thermoablation, an innovative therapeutic strategy for this disease.

Diagnostic examinations

Diagnostic examinations in gynaecology and obstetrics are nowadays very accurate and their correct execution and interpretation are the basis for the right clinical picture of the patient and the most appropriate therapeutic strategy.

Fibroids therapy

Uterine leiomyomas, more commonly called fibroids, are benign solid neoformations and represent the most frequent gynaecological neoplasm in women of childbearing age.

Uterine anomalies

An arrest of the organogenic stages can cause uterine and vaginal abnormalities of varying degrees.

Endometriosis

Endometriosis is a chronic, oestrogen-dependent inflammatory disease characterised by the presence of functional endometrial tissue (glands and stroma) in extrauterine sites.

Menstrual cycle disorders

It represents the most obvious and measurable clinical sign of pubertal maturation and in most women it occurs about two to three years after the onset of telarche with an average age of around 12½ years.

Intrauterine insemination

A Level I medically assisted procreation procedure based on the deposition of spermatozoa directly inside the uterine cavity. This procedure is carried out after ovulation induction.

Outpatient ultrasound aspiration of ovarian cysts

At our clinic, Prof La Marca personally handles the method. Ultrasound-guided aspiration of ovarian cysts is an ultra-mini-invasive method that is only available in very few centres nationwide. If there are the right indications, the method allows a rapid and non-invasive solution for the pathology in question

Tubal recanalisation

At our clinic, Prof La Marca personally handles the method. Endoscopic tubal recanalisation, where indicated, is today performed in only a few centres throughout Europe. The expertise is therefore concentrated in a limited number of experts capable of performing it correctly.

Assisted laser hatching

Laser-assisted hatching (LAH) is a laboratory technique that consists of cutting a small section of the zona pellucida (ZP).

IMSI, intracytoplasmic sperm injection

This is a level II technique used in the field of in vitro fertilisation. It takes the form of a variant of traditional ICSI, both of which consist of the direct injection of a spermatozoon into the cytoplasm of the oocyte.