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Dr Lyndon Hale delivered this presentation at the 2014 Medical Tourism Summit. The Summit examines the implications of recent changes within the medical tourism industry and the impact on the Australian market. Find out more at http://bit.ly/1zgqUTX
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Medical Tourism
Dr LYNDON HALE
MBBS, FRANZCOG, CREI
Presentation Content
• IVF/ART Terminology
what are we talking about
• Australian/Virtus : IVF clinics
features of Australian IVF
clinics
• Who might want to access treatment
in Australia
IVF/ART Terminology
• Gametes
• IVF
• IVF/ICSI
• PGD, PGS
• Embryo transfer • Cleavage stage
• Blastocyst stage
Human oocyte (egg) in cumulus
Human Sperm
Morphology
Sperm washed, smeared
on glass slide, fixed,
stained (Shorr stain) and
examined under oil
immersion (1000x).
Note many abnormally
shaped sperm (arrows)
Catching sperm for ICSI
IntraCytoplasmic Sperm Injection
Micromanipulation (ICSI)
equipment
Human embryo development (
day 2 )
Extended culture of human embryos
Day 3 Day 4/5 Day 5 Day 5/6
Morula Early blastocyst Blastocyst 8 cells
Storage of frozen embryos
Time lapse imaging of human
embryo development in vitro
PGD: Pre-implantation genetic diagnosis
• Aneuploidy screening
• Monogenic screening
• Sex selection
Embryo biopsy
Embryo biopsy (video)
Preimplantation Genetic Diagnosis
(PGD)
NORMAL 13, 16, 18, 21, 22 - 22
FISH
CGH Microarray 46XX (Template 46XY)
Who do we treat?
• Couples Heterosexual Same sex
• Single Patients
• 3rd Party reproduction
3rd or more party reproduction
• Donor
– Sperm
– Egg
– Embryo
• Surrogacy
3rd party remuneration
• Altruistic: expense reimbursement
• Commercial arrangement
Australian/Virtus IVF
• Longevity
• Scale
• Scientific excellence
• Accreditation
• Success rates
• Range of treatment options
• Legal framework
Australia’s 1st IVF Baby: I980
Longevity
• Were at the beginning
• MIVF 3rd birth in the world
• Very few units disappeared
• No multi-clinician units closed
Scale
• Virtus ~ 12,000 cycles per year (40% of
Australian market)
– Melbourne IVF
– IVF Australia: Sydney
– QFG: Queensland Fertility Group
• Monash IVF Group
• City Fertility
• Genea
Scientific excellence
• Many IVF initiatives originated in
Australia
• Early adoption of new techniques
• Preferred research partners for large
pharma groups
Research & Development
Our research department is the largest and most productive of any Australian IVF program
• Egg freezing & tissue transplantation • Chronic viral illness group • Molecular biology • Follicle health physiology • Psycho-social & epidemiology • Implantation failure study group • Male infertility • Endocrine & Metabolic disorders • Clinical trials
World firsts
World firsts
Melbourne IVF & The Royal Women’s
Hospital Fertility Preservation Service
achieved world’s first pregnancy and
births from ovarian tissue grafted in the
anterior abdominal wall of a Victorian
woman
Accreditation/Legislation
• RTAC
• ISO
• State-based health law
• NHMRC Guidelines
Success Rates
• All pregnancies reported to ANZARD
• National yearly report
• Victoria yearly report
– Transparency of outcome
Who may want to access treatment?
• Expatriate Australians
• Reputational/scientific excellence
• Legislative assurance
• Anonymity
• Privacy
What is not allowed
• Commercial gamete donation
• Commercial surrogacy arrangements
• Embryo sex selection for family
balancing
Emerging trends
• Social egg freezing
• Genetic screening; increasing use for
screening for disease? Role for
desireable traits
• Uterine transplantation, 1st birth
reported
Thank you
Thank You