1. Core indications and treatment challenges for male infertility
Thailand's IVF technology provides precise solutions to the following male infertility problems
1. Severe oligospermia: The sperm concentration in semen is less than 5×10/ml or the forward moving sperm is less than 32%, and the natural pregnancy probability approaches zero.
2. Non-obstructive azoospermia (Noa): testicular spermatogenesis failure requires the acquisition of trace sperm through testicular microspermography (Tese).
3. Retrograde ejaculation: The semen flows back into the bladder, and in vitro fertilization needs to be achieved through urine separation sperm technology.
4. Hereditary infertility: such as microdeletion of the Y chromosome (deletion of the AZF region), mutation of the cystic fibrosis gene, etc., should be combined with preimplantation genetic diagnosis (PGD) to block disease transmission.
1. Intracytoplasmic injection of single sperm (ICSI 2.0)
·Technology upgrade: Using microfluidic chips to screen high-vitality sperm, combined with polarized light microscopy to identify DNA integrity, increasing the fertilization rate to 75%(traditional ICSI is 50%-60%).
· Technological upgrades: Microfluidic chips are used to screen highly active sperm, and polarized light microscopes are used to identify DNA integrity, increasing the fertilization rate to 75% (compared to 50% -60% for traditional ICSI).
· Adaptation scenario: patients with severe hypozoospermia (sperm concentration < 1 × 10 φ/ml), acrosomal reaction deficiency.
Combined with testicular sperm activation technology (such as calcium ionophore), the fertilization rate can reach 55%.
Combined with testicular sperm activation technology (such as calcium ionophore), the fertilization rate can reach 55%.
3. Preimplantation genetic testing of embryos (PGT-M/PGT-SR)
·Technical advantages
NGS sequencing platform: The detection accuracy reaches 99.9%, and it can identify 24 chromosome microdeletions/duplications and single gene diseases (such as thalassemia).
☞NGS sequencing platform: detection accuracy of 99.9%, can identify 24 chromosome microdeletion/duplication and monogenic diseases (such as thalassemia).
☞Mitochondrial DNA screening: screening of healthy mitochondrial DNA embryos for blocked embryonic development due to deficiencies in sperm energy metabolism.
·Hyaluronic acid screening method: Simulate the zona pellucida environment of the egg to screen out highly penetrating sperm and reduce the risk of chromosomal abnormalities in embryos (studies have shown a 22% reduction in abortion rates).
· Hyaluronic acid screening method: Simulate the environment of the ovum clear zone to screen highly mature sperm with strong penetration and reduce the risk of embryonic chromosomal abnormalities (studies show a 22% reduction in miscarriage rate).
· Hypotonic swelling test (Hos): Evaluates sperm tail integrity, preferably sperm with normal motor ability.
1. Full chain technology closed loop
From sperm harvesting (TESE), optimization processing (microfluidic sorting) to embryonic genetic screening (PGT), a standardized diagnosis and treatment path has been formed.
From sperm acquisition (TESE), optimization (microfluidic sorting) to embryo genetic screening (PGT), a standardized pathway for diagnosis and treatment is established.
· Typical case: BangkokJetanin HospitalSuccessfully delivered healthy male babies with a customized “Tese + PGT-M” regimen for AZF-deficient patients.
·Time-lapse embryo monitoring: Record the division timing of embryos for 5 consecutive days and screen out embryos with high development potential (30% increase in identification accuracy of high-quality embryos).
· Time-lapse embryo monitoring: Embryo division timing was recorded for 5 consecutive days, and high developmental potential embryos were screened (30% improvement in the accuracy of high-quality embryo recognition).
3. Personalized treatment plan
·Low gonadotropin therapy: For patients with low testicular function, GnRH pulse therapy combined with FSH/HMG to promote excretion is used to increase sperm concentration.
· Hypogonadotropic therapy: GnRH pulse therapy combined with FSH/HMG stimulation increases sperm concentration in patients with testicular hypofunction.
· Sperm DNA fragment management: The DNA fragment index (DFI) was reduced from 45% to 25% by optimizing the timing of oral antioxidants (such as coenzyme Q10) in combination with testicular spermatography.
5. Future technology outlook
Microfluidic chip embryo culture: Simulate the flow of fluid in the fallopian tube and improve the synchronization of embryo development (expected to be used in clinical practice in 2026).
Microfluidic chip embryo culture: simulates the fluid flow inside the fallopian tubes to improve the synchrony of embryo development (expected clinical application in 2026).
Epigenetic regulation technology: improving sperm epigenetic status through DNA methylation modification, reducing the risk of metabolic diseases in offspring.
Bioengineered sperm: using induced pluripotent stem cells (iPSC) to differentiate functional sperm, providing new possibilities for complete azoospermia.