TREATMENT

Intrauterine insemination (IUI)
Intrauterine Insemination (IUI) is a fertility technique which is normally applied for a couple that has a sperm amount lower than a standard proposed by World Health Organization (WHO) or a couple that has an ejaculation dysfunction or unexplained fertility problems.
This treatment selects most active and effective sperms and insert sperms directly into the uterus during ovulation period. This is to reduce the selected sperms traveling distance and help increasing pregnancy opportunity.
Patient Instructions before IntrauterineInsemination
- Husband must not have sexual intercourse or any ejaculation for 3-5 days before IUI appointment date.
- On IUI appointment date, a husband will have to provide semen sample by masturbation at a clinic sperm collection room one hour and a half before IUI process.
- Please get enough rest and sleep. Relax and avoid stresses.
- Please avoid drinking any alcohol or smoking prior to IUI.
- Please avoid using any fragrance, perfume, spray and cosmetic products including powder on the day of IUI.
Patient Instructions after Intrauterine Insemination (IUI)
- You may eat regular food after the procedure.
- You can have regular work and normal exercise.
- You can have sexual intercourse as usual.
- Please avoid the use of medications that may affect pregnancy such as an acne treatment or medicines, antibiotics and etc. In case you need to use certain medications or have any question, please consult with your doctor first.
- You may experience a mild to moderate lower abdominal cramping discomfort for 2-3 days, which is similar to abdominal pain during menstruation but possibly more severe. This is normal and has no negative effect towards pregnancy rate. You may take one or two regular strength Paracetamol tablets for discomfort and rest.
- Driving a car, riding a motorcycle, riding a boat, and flying in an airplane, are considered safe after IUI.
- In case you receive medication(s) after IUI, you shall continue taking medication(s) as instructed. Do not stop taking medication(s) unless instructed otherwise by your doctor. And please come for your further appointment as scheduled.
- If you do not have menstruation more than 14 days after IUI, or more than you expected, you shall contact your doctor to have a pregnancy test.
- If you have abnormal symptoms, such as vaginal spotting or bleeding, or drug allergy. Please contact your doctor for advice immediately.
- After a positive pregnancy test, you should come for an ultrasound follow-up in order to confirm a normal pregnancy, a number of gestation sac(s) or embryo(s), and a confirmation of fetus heartbeat.
By Assoc.Prof. Matchuporn Sukprasert

PRP therapy
What is PRP
The known components of blood are red blood cells, white blood cells, platelets, and plasma. This will cause the blood to separate and settle. Makes it possible to separate only the platelets.
PRP (Platelet Rich Plasma) is a blood plasma filled with concentrated platelets. extracted from the patient's blood and injected back into the patient's own body, thus making PRP therapy a highly safe treatment and has been widely accepted.
The protagonist in platelets is α granule that can enter the site of cell injury and release various substances in the granules. The substances released by α granule have the following abilities:
- Repair damaged cells.
- Restore damaged cells.
- Improves cell division.
- Rehabilitation of blood vessels to feed the cells better.
In addition, each substance released by the α granule has a pregnancy-related potency.
- Promotes implantation of the embryo.
- Helps prevent recurring miscarriages.
- Helps the endometrium change to be ready for pregnancy.
- Helps the embryo to implant in the uterus better.
- Helps the placenta to attach to the uterine lining better.
- Provides better blood supply to the uterine cavity.
In addition to being able to repair and regenerate cells The substances released by the α granule also have fertility benefits. It can therefore be used as an aid to increase the chances of getting pregnant. For infertility treated by IVF process.
PRP for the ovary to restore ovarian function
Who is it suitable for?
- Women with premature ovarian Insufficiency.
- Women who are Perimenopause.
- Menopausal women
- Women with Poor Ovarian Response.
- Women with low levels of AMH and/or high levels of FSH.
PRP for endometrium to increase the thickness of the endometrium before embryo transfer.
Who is it suitable for?
- Thin uterine walls (< 7 mm) for unknown reasons.
- Thin uterine walls (< 7 mm) due to fibrosis in the uterus.
- Have had an embryo transferred but were unsuccessful due to a thin uterus.
- Difficult to prepare the endometrial wall Tried all methods of preparation with no success.
Limitations of treatment with PRP.
The following conditions may have limitations in terms of the effectiveness of PRP injection therapy.
- People with body mass index (BMI) less than 18.5 or more than 30 (overweight or underweight) as this may result in less PRP extraction and may prevent treatment success.
- Autoimmune disease.
- Sexually transmitted disease.
- Infectious disease.
- Chronic inflammatory disease, such as pelvic inflammatory disease.
- Anemia.
- Thrombophilic disorders.
- Current cancer diagnosis.
Side effects of PRP injections
PRP is a concentrated platelet that is extracted from the blood of a person who will receive the injection. Therefore, the platelet of the patient to be injected into the patient himself, so it does not cause any side effects and in the PRP injection, blood will be drawn on the day of injection Then take the blood to extract PRP and immediately inject it within 1 hour. This method is highly secure. It does not cause any allergic reactions or infections.
By Assoc.Prof Matchuporn Sukprasert

IVF / ICSI
IVF procedure
- The female patient visits the physician within the first 1–3 days of menstrual cycle for an ultrasound and hormonal evaluation. Based on the results, the physician will prescribe ovarian stimulation medications tailored to the individual.
- The female patient visits the physician within the first 1–3 days of menstrual cycle for an ultrasound and hormonal evaluation. Based on the results, the physician will prescribe ovarian stimulation medications tailored to the individual.
- On the day of egg retrieval, the male partner should accompany the female partner to provide a semen sample. The egg retrieval procedure will be performed under intravenous sedation.
- Fertilization is usually performed using Intracytoplasmic Sperm Injection (ICSI), in which a single sperm is injected directly into an egg. The resulting embryos are cultured until they reach the blastocyst stage.
- In the case of a fresh transfer, the embryo is transferred to the uterus 3–5 days after egg retrieval. If the physician recommends freezing the embryos for a later cycle, the female patient will be asked to return on days 1–2 of next menstrual cycle for ultrasound and medication to prepare the uterine lining.
- Pregnancy Testing: A blood test for pregnancy hormones (β-hCG) will be conducted 7–10 days after embryo transfer.
Egg Retrieval Procedure
Egg retrieval is one of the critical steps in the IVF process and is performed approximately 34–36 hours after the ovulation trigger injection. The eggs are collected transvaginal using a fine needle attached to an ultrasound probe, allowing for both identification and aspiration of the follicles. The procedure is performed under intravenous sedation and typically takes less than 30 minutes. The aspirated follicular fluid is then examined by an embryologist to assess egg quality and select suitable ones for ICSI.
Pre-Egg Retrieval Instructions
- Confirm and adhere strictly to the date and time for the ovulation trigger injection as advised by the physician.
- Refrain from eating or drinking for at least 8 hours prior to the scheduled egg retrieval time.
- Arrive at N.I.C IVF Clinic at least 1 hour before the procedure for preparation.
- Cleanse body and genital area before the procedure.
- The male partner should be prepared to provide a semen sample around the same time as egg retrieval.
- Abstain from sexual intercourse, as it may damage the ovaries.
- Avoid scented products, including perfume, sprays, cosmetics, or powder on the day of egg retrieval.
- Remove any nail polish before the procedure.
- Do not wear jewelry or bring valuables to the clinic.
- Do not wear jewelry or bring valuables to the clinic.
Post-Egg Retrieval Care Instructions
- Upon waking from sedation, mild nausea, abdominal pain, or light vaginal bleeding may occur.
- Rest in the recovery room for approximately 1–2 hours before going home.
- Pain relief medication can be taken as prescribed if discomfort arises.
- Strictly follow the doctor’s instructions regarding all medications (injections, oral, or suppositories).
- Prioritize rest and maintain a positive emotional state.
- Do not drive yourself home it is essential to be accompanied by a relative or companion.
- Seek immediate medical attention if you experience severe bloating, abdominal discomfort, difficulty breathing, significant abdominal enlargement, or abnormal vaginal bleeding.
By Assoc.Prof. Matchuporn Sukprasert

PGT-A / NGS
The technology of preimplantation genetic testing has advanced significantly in recent years. Originally developed in 1980, this testing was based on the use of PCR (Polymerase Chain Reaction) to amplify genetic material, primarily focusing on sex-linked chromosomal disorders. Due to technical limitations at the time, the testing could only determine the sex of the embryo and not identify specific gene or chromosomal abnormalities. As a result, embryos were selected based on sex to avoid severe genetic diseases, potentially discarding embryos of the opposite sex that may have been healthy or only mild carriers, without knowing their actual genetic condition. This limitation underscored the need to develop more specific techniques capable of identifying both the sex and the presence of genetic or chromosomal abnormalities. Over time, advancements have been made in both genetic amplification and diagnostic accuracy. Techniques such as Comparative Genomic Hybridization (CGH), Next Generation Sequencing (NGS), real-time PCR, and Karyomapping have emerged. Currently, the most widely used technology for preimplantation genetic testing prior to embryo transfer into the uterus is Next Generation Sequencing (NGS).
Next Generation Sequencing (NGS) is a modern base sequencing technology that enables rapid and comprehensive sequencing. It allows for the analysis of all 24 chromosomes of an embryo in a single test, as illustrated in Figures 1 and 2. This method offers a high accuracy rate of up to 99%. Since current testing is performed at the blastocyst stage, where a higher number of cells is available for analysis, the precision of the test is significantly improved. In addition to detecting full chromosomal aneuploidy (gain or loss of entire chromosomes), NGS can also identify segmental aneuploidy, which refers to partial chromosomal abnormalities. Older techniques such as FISH or CGH are not capable of detecting these segmental changes. Moreover, NGS has been shown to increase pregnancy success rates and reduce miscarriage rates by up to 50%, making it a crucial advancement in the field of reproductive genetics.
Picture 1 demonstrates female embryo with normal chromosomes using NGS method: 46 XX.
Picture 2 demonstrates male embryo with normal chromosome using NGS method: 46 XY.
By Assoc.Prof. Matchuporn Sukprasert

EGG FREEZING
Nowadays, people in Thai society tend to get married at older ages. According to the figure in picture 1, we can see that age plays as an important role in the quality of eggs. The best time for reproductive systems is between 25 – 29 years old and then will continue to decrease especially when women are more than 35 years old. This is why there is a recommendation for women to do egg freezing before turning 35 years old in order to stop egg aging.
Picture 1 demonstrates the relationship between ages and reproductive percentile.
Additionally, the eggs in women who are more than 35 years old tend to have embryos with abnormal chromosomes when fertilize with sperm. This fact is shown in Picture 2.
Picture 2 demonstrates the relationship between the age of women and the percentile
of having Down syndrome babies.
Due to egg production stops since being in the mother’s womb and has the most amount during the 7 months of pregnancy. Then the amount will gradually decrease that is why women should consider egg freezing when they are still young according to Picture 3.

The process of egg freezing begins by stimulating the ovaries in order to produce multiple eggs as same as doing IVF / ICSI procedure. It is to make sure that we have enough eggs. After eggs are in an appropriate size, they will be retrieved and stored separately from sperm by the method of egg freezing which is the same as the embryo. The only differences are the chemicals being used. However, after being frozen, the endurance of eggs is less than embryos. After eggs are dissolved to prepare for fertility, the remaining eggs are only 80% overall.
Egg Freezing Indications
- Egg freezing is done to fertilize with sperm that belongs to a legal husband in the future.
- Egg freezing is done after being diagnosed with certain cancer which is the plan of treatment: for example, chemotherapy can affect egg production. In addition, treatments for other diseases can cause lower quality in egg production as well.
By Assoc.Prof. Matchuporn Sukprasert

PESA / TESE
A surgical procedure to extract sperm from epididymis can be done when men have the following abnormalities:
- Sperm cannot be found in the fluid due to blockages in the vas deferens, or there is no vas deferens since birth.
- Not being able to store sperm with natural methods.
- Not being able to ejaculate sperm normally, or having a problem doing so because of other health problems. All the sperm that come out are not alive.
- Those who have been done a vasectomy and do not want to have a reversal.
In the past, men who had been diagnosed with infertility were unable to have children unless they received donated sperm. However, with advanced technology, now doctors can perform a procedure that retrieves healthy sperm directly from the source which is the epididymis or testis. The doctor will examine an appropriate method of surgery according to the condition of each patient.
These are the steps of the procedure:
PESA (Percutaneous Epididymal Sperm Aspiration)
PESA is a surgical procedure that requires a small needle with a radius of 2 millimeters to extract sperm from the epididymis. The epididymis is on the top part of the testicles which is where sperm is. After retrieving the fluid, the doctor will examine, look for sperm, evaluate the quality, and use it for ICSI procedures. PESA usually takes about 10 – 20 minutes, and the patient will be given local anesthesia before the procedure. The patient should rest for an hour after the procedure is done then he can go home.
TESE (Testicular Sperm Extraction)
This method is used after trying to retrieve sperm but cannot find sperm in the epididymis. The doctor will use a small blade to trim the skin that covers the testicles. The cut is not more than 1 – 2 millimeters. The doctor will bring the tissue that produces sperm in order to examine for sperm. Local anesthesia will be given, and it will be a bit painful. Therefore, painkiller medicine might be given, and all the pain will be gone within 3 days.
Guidelines before the procedure
The doctor will require a blood test to evaluate overall health and to prepare for the surgery. The patient must refrain from eating and drinking 6 – 8 hours before the procedure.
Guidelines after the procedure
- Keep the wound dry and avoid swimming or being in a bathtub until the wound is completely dry and healed.
- After using the toilet, make sure to wipe the wound dry and always keep it clean and dry.
- Take painkiller medication and antibiotics according to the doctor’s prescription to reduce swollen and avoid inflammation.
- Avoid doing exercises for 2 weeks to avoid pain and inflammation.
- Refrain from having sexual intercourse until the wound is completely dry and healed.
Risks and side effects of the procedure
We only found less than 2% that has an infection, blood clot in the testicles, and pain after the surgery. However, these can be treated and go back to normal.
The Success of this treatment
TESE procedure is very successful, especially in patients with blockage in vas deferens. However, the success rate also depends on the causes of each individual.
Is PESA/TESE safe procedures?
In general, they are very safe procedures, and they offer better options for patients with infertility. From a current study, the rates of having abnormalities and disabilities in babies from doing the procedures are not different from normal cases.
By Assoc.Prof. Matchuporn Sukprasert

Hysteroscopy
Hysteroscopic Surgery in Uterine Cavity for Infertility Patients
When some patients did not have successful treatments even though their embryo chromosomes have been examined to be normal, or there were no obvious problems after an evaluation, we can assume that this group of patients may have embryo implantation problems. Usually, the patients will be recommended to be examined for possible causes in the uterine cavity whether they have any symptoms or not. In general, the symptoms that can cause pathology of the uterine cavity are abnormal heavy menstrual bleeding, irregular menstrual cycle, or menstrual pain.
Nowadays, the well-known examination for the pathology of the uterine cavity is Hysteroscopy, which can be used for diagnosis and also for treatments.
Generally, there are two types of the method.
1. Diagnostic Hysteroscopy
It is a minor surgery that can be done in the outpatient department. A small hysteroscope with a size of around 2.9 – 4 millimeters will be inserted inside the uterine cavity to perform a pathology examination. These are the types of uterine cavities that usually can be found:
Normal endometrium is a normal uterine cavity with no fibroid or polyps that might be an obstacle to embryo implantation. The surface is smooth with the size shown in Picture 1.
Picture 1 demonstrates a normal uterine cavity from performing diagnostic hysteroscopy.
Endometrial polyp is a uterine polyp that is commonly found in an abnormal uterine cavity and might have no symptoms. With the small size, the polyp could come out with menstrual bleeding, and it is noncancerous. After treatment, it could occur again. However, endometrial polyp surgery needs to be done because it can interfere with embryo implantation as shown in Picture 2.
Picture 2 demonstrates endometrial polyp inside the uterine cavity.
Submucous myoma is a fibroid that usually can be found in reproductive-age women. The one that develops in the uterine cavity can interfere with pregnancy. As shown in Picture 3, this can create no symptoms at all or can cause excessive heavy menstrual bleeding, and it will lead to anemia. This kind of fibroid mostly will not be cancerous but need to be removed before pregnancy.
Picture 3 demonstrates fibroid that grows inside the uterine cavity.
Septate uterus is a deformity that happens before birth. The inner portion of the uterine cavity was divided by a wall of tissue, and the embryo cannot be implanted, or there is a high risk of having a miscarriage later. This could be treated with surgery to remove the wall of tissue inside the uterine cavity as shown in Picture 4.
Picture 4 demonstrates the surgery to remove a wall of tissue inside the uterine cavity.
Uterine synechiae is a condition that usually happens after dilatation and curettage or after having a severe infection in the uterine cavity that can cause adhesion. Therefore, surgery needs to be done to remove the adhesion before pregnancy.
Picture 5 demonstrates adhesion band inside the uterine cavity.
2. Hysteroscopic surgery
The procedure is done in the surgery room. Usually, the size of the hysteroscope will be bigger than the one used during diagnosis, and the cervix needs to be enlarged before inserting the camera. These are additional tools such as electric loops, small scissors, and morcellator to help remove polyps, fibroids, adhesions, or a wall of tissue inside the uterine cavity. So, the patient may be given medication to help her relax and to block the pain during the surgery.
The appropriate time to schedule for diagnostic hysteroscopy and surgery is after the menstrual period until before ovulation. During this time, the uterine cavity is not thick and not swollen from ovulation’s discharge, so we can clearly see the pathology.
Preparation for uterine cavity hysteroscopy
1. Diagnostic Hysteroscopy
This procedure can be done an outpatient department (OPD), and anesthesia is not required. So, the patient does not have to prepare many things in particular. However, the procedure should not be performed right after having a meal to avoid vomiting during the hysteroscopy. So, the patient should avoid having food 2 – 3 hours before the procedure. Make sure to use the toilet and may also take some painkiller medicines an hour before the procedure.
Hysteroscopic surgery
- Refrain from eating and drinking 6-8 hours before the surgery.
- Medicine will be inserted into the vagina 6-8 hours before the surgery. This is necessary because it will open the cervix and help the process to be smoother. However, there might be some side effects such as having a low-grade fever, stomach pain, or having blood show from the vagina due to the medicine that causes contraction. These symptoms will be gone after the surgery.
Post-surgery Instructions
- Complete the course of antibiotics.
- Avoid having sexual intercourse, swimming, and heavy exercise for the first 2 weeks after the surgery.
- Eat healthy meals. There is no specific restriction.
- There might be some blood from the vagina within the first week after the surgery but it should not have any smell. Stomach cramps that are similar to menstrual cramps might occur, but they are not harmful. Should there be any serious symptoms, please contact your doctor.
By Doctor Warawun Lupthalug

Special technology
These techniques are as of followings.
1. Next Generation Sequencing (NGS)
This is a testing technique that screens all 24 chromosomes or whole-genome human sequencing in the least amount of time. This particular method, when applied to the pre-implantation process, allows a doctor or scientist to select only embryos with a normal chromosome profile to transfer. This could yield a higher chance of an effective pregnancy rate compared to Fluorescence in situ hybridization (FISH) technique which is able to screen only 5 pairs of chromosomes.
2. Macs® Art Annexin V system
This is a technology that optimizes sperm separation in assisted reproduction. It helps separate sperm with activated apoptosis signaling (dead cell) before entering the fertilization process. This results in an enhanced clinical pregnancy rate compared to an old technique that cannot distinguish the sperm.
3. Halosperm® G2
This technique allows the visualization of sperm that contains highly degraded DNA compared to other sperm. It is a fast, simple, and cost-effective method that provides an IVF doctor
to examine sperm DNA fragmentation easily. Therefore good quality sperm selection could be obtained for a fertilization process. This could increase the fertilization rate and embryo implantation rate accordingly.
4. Endometrial Receptivity Test (ERA® Test)
ERA is a genetic test that evaluates the state of endometrial receptivity, which is the optimal time for embryo transfer. It diagnoses the time that a uterus is ready to receive the embryo. Since the implantation period for each woman is different. The ERA test enables us to personalize embryo transferring time for each couple accurately. This greatly increases the chance of a successful embryo transfer rate and pregnancy rate.
5. Oosight® Spindle view
This computerized high-power microscope technology enables a doctor or an embryologist to see spindles of retrieved eggs when performing Intracytoplasmic sperm injection (ICSI). This is to avoid corrupting the egg spindles when injecting sperm cell into the egg. Therefore, a successful chance of fertilization becomes higher compared to one without the Oosight technique which the doctor or embryologist can perform the ICSI procedure merely from an educated guess.
6. Preimplantation Genetic Testing for Monogenic Disease (PGT-M)
The PGT-M are created uniquely for each family or each fertile couple who has a risk of transmitting a genetic disorder to their offspring. The genetic disorder includes, for example, Thalassemia, Huntington's disease, Duchenne Muscular Dystrophy, Hemophilia and etc. This exceptional technique must be solely performed by a doctor who is a specialist and graduated in Reproductive Genetic. One of our clinic team, Assistant Professor Dr. Matchuporn Sukprasert is the first doctor in Thailand who graduated in this particular field. She was a fellow from Weill Cornell Medical College, Cornell University, New York, United States. She and our scientists are ready to consult willingly with any couple who is possibly related to monogenetic diseases.

Embryo Transfer (ET)
Embryo Transfer (ET)
Embryo transfer into the uterine cavity is the final step in assisted reproductive technology. Although this process is often the most anxiety inducing for patients, in reality, it is similar to a routine gynecological pelvic exam that women undergo annually only even more gentle. The procedure is painless in order to avoid stimulating uterine muscle contractions, thus sedation or pain relief medication is generally unnecessary.
The embryo transfer involves inserting a small, soft plastic catheter into the uterine cavity at the appropriate location, followed by the placement of the embryo through the catheter. This process is typically guided by abdominal ultrasound to determine the optimal position for embryo placement, maximizing the chances of pregnancy.
Patient Instructions before Embryo Transfer (ET)
- Please arrive at the N.I.C IVF Clinic 1 hour prior to your scheduled time for preparation
- Shower and maintain personal hygiene.
- Fasting is not required; you may eat and drink as usual.
- Avoid using scented products such as perfumes, sprays, cosmetics, or body powders on the day of embryo transfer.
- Please do not wear any jewelry or accessory or bring valuables on the embryo transfer date.
Note :
***If your embryo transfer appointment is BEFORE 12.00 PM, DO NOT NEED TO INSERT VAGINAL MEDICATION that morning.
***If your embryo transfer appointment is AFTER 12.00 PM, PLEASE INSERT VAGINAL MEDICATION as usual.
Patient Instructions after Embryo Transfer (ET)
- Remain lying down for at least 30 minutes immediately after the procedure.
- You may resume eating normally, preferably light, easily digestible, and hygienic food.
- You may go home after resting for at least one hour post-procedure.
- Strictly follow the doctor's prescription for any injectable, vaginal, or oral medications.
- After embryo transfer
- Avoid sexual intercourse for approximately 14 days or until the scheduled blood test.
- Do not douche the vaginal area.
- Do not lift heavy objects. You may use stairs only when necessary.
- Refrain from intense physical activities such as heavy workouts, hot yoga, or sauna.
- Avoid strenuous work or highly stressful tasks during this period.
- Prevent constipation or diarrhea by managing your diet carefully.
- Avoid crowded places to reduce the risk of infection (e.g., colds, rubella) from others.
- Avoid swimming in shared pools to prevent potential infections.
- Get adequate rest. You may lie on your back or side (left or right). It is not necessary to stay in bed all day, but avoid sudden or vigorous movements.
- Do not drive yourself to avoid sudden jolts or impacts.
- Return for a blood test to check for pregnancy approximately 7–14 days after embryo transfer.
- If you experience any abnormal symptoms such as bleeding, lower abdominal pain, or unusual vaginal discharge, contact your doctor immediately.
By Assoc.Prof. Matchuporn Sukprasert