Meet Dr Rami Wakim

A fertility health check is a combination of private consultations, blood tests and transvaginal ultrasound scans aimed at the assessment of an overall reproductive health of a patient. Some of the tests that form part of the health check process include Anti-Mullerian Hormone (AMH) for ovarian reserve, undertaken in conjunction with Luteinising Hormone (LH), Follicle Stimulating Hormone (FSH) and thyroid function tests, the results of which will then be discussed with a fertility specialist.

Ovulation induction is a fertility treatment for women who have not yet reached menopause but fail to ovulate, usually presenting an irregular or even completely absent menstrual cycle. Some of the most common causes for this condition include stress, weight fluctuations and a condition known Polycystic Ovary Syndrome (PCOS). There is a relatively low cost associated with this treatment, which is offered to patients after their initial assessment, if there is no significant factor affecting fertility has been identified.

Intrauterine insemination (IUI) or artificial insemination is a relatively straightforward fertility treatment, which involves the placement of specially prepared sperm from the male partner (or donor) into the woman’s uterus, close to the time of ovulation. This is performed using a simple, minimally invasive procedure (similar to a cervical smear test) using a speculum and a fine catheter.

In Vitro Fertilization (IVF) is an Assisted Reproductive Technology (ART) procedure, whereby one or more mature eggs from the follicles developing inside the woman’s ovaries are removed via the egg collection procedure and fertilised with sperm in a specialised laboratory. Once fertilised, embryos are allowed to grow in a protected environment for some days before being transferred into the woman’s uterus for the subsequent development, thereby increasing the chance that a pregnancy will occur. Depending on patient’s conditions and/or preferences, a low dose or minimal stimulation IVF (commonly known as mini or mild IVF) may be offered, which involves a similar procedure to that of a standard IVF cycle, albeit with less medication.

Intracytoplasmic Sperm Injection (ICSI) is a refinement of the traditional In Vitro Fertilization (IVF) procedure, which involves injecting a single best quality sperm directly into an egg to fertilise it. As with the standard IVF cycle, the fertilised egg (embryo) is then transferred into the woman’s uterus a few days later to continue growing as in normal pregnancy. Commonly, ICSI procedure can be used to overcome male infertility.

A follicle tracking is a diagnostic technique that involves a series of transvaginal ultrasound observations of ovaries (number and size of pre-ovulatory follicles) and endometrial lining. These scans are performed using a sterile probe and are relatively painless. Follicle tracking is a vital component of In Vitro Fertilization (IVF) assessment and is often used before and during ovarian stimulation.

Reproductive immunology is a relatively new and highly specialised service committed to the management of fertility problems associated with a disrupted or defective immune response. It involves a range of tests, performed to investigate the possible cause of recurrent miscarriage or previously unexplained infertility, and their detailed interpretation to offer a more targeted fertility treatment.

Fertility preservation options for women include egg and embryo freezing, which are considered if a patient’s fertility is at risk due to medical conditions (including menopausal symptoms and cancer) or to give a better chance of conceiving at an older age at which fertility naturally declines. During the advanced fast freeze technology procedure called vitrification, egg cells and embryos are immersed in a series of solutions, resulting in high survival rate after thawing. Vitrification technology allows specimens to be stored for an indefinite period of time.

Egg Donation or In Vitro Fertilization (IVF) with donated eggs is a solution for women who are unable to conceive using their own eggs, either due to a medical condition or failed attempts to conceive naturally at an older age. During this process, donor eggs are fertilised in the laboratory with sperm from either the recipient’s partner or sperm bank. The resulting embryos are transferred into the recipient’s uterine cavity for their subsequent development.

Surrogacy is a process of aided reproduction where future parents actively work with a gestational surrogate who carries the pregnancy until birth. Couples use surrogacy to begin or expand their families when they cannot do it independently due to medical or physical reasons. The intended parent(s) become the legal parent(s) of a child born through surrogacy.

Recurring miscarriage diagnosis via C4M2 test detects a genetic mutation in a specific gene carried on chromosome 4 that predisposes patients to the risk of miscarriage in the first stage of pregnancy. Identified with the saliva swab-based sample, the gene mutation is subsequently treated with medication.