We were among the first in Lithuania to provide diagnostic and treatment services to couples facing infertility. The Baltic American Clinic Fertility Centre utilises the most modern, globally-renowned methods for diagnosing and treating fertility problems.
When should you be investigated for infertility?
Investigations for an infertile couple are initiated if:
- the woman has not conceived for one year or more;
- the woman has not conceived for 6 months or more and is aged 35 or older;
- there is a known clear cause of the couple’s infertility, such as an irregular menstrual cycle, previous pelvic inflammatory disease (PID), uterine and ovarian endometriosis, fallopian tube pathology, consequences of gynaecological surgery, or abnormalities in male sperm count and motility.
Investigations for an infertile couple are recommended to be carried out in specialised clinics staffed by experienced gynaecologists or, in cases of male infertility, urologist-andrologists. Both partners are investigated.
Consultations and investigations performed at the Fertility Centre
Infertility consultations
During this, the clinician assesses the medical histories of both partners and the potential causes of infertility, and arranges the necessary investigations. It is recommended that both partners attend the consultation. Understanding the sensitivity of this matter, we focus not only on its medical aspects but also on the emotional and psychological well-being of the couple.
Fallopian tube patency tests
The condition of the fallopian tubes is one of the most crucial factors determining natural conception. Patency tests, performed using ultrasound or X-ray equipment, identify potential fallopian tube blockages and damage and, if necessary, help select the most optimal treatment pathway – ranging from medical or surgical therapy to assisted conception.
Comprehensive and detailed male semen analysis (semen analysis)
Semen analysis allows the assessment of key male fertility indicators – sperm count, motility, morphology (shape), and the overall condition of the semen. If required, advanced tests such as sperm DNA fragmentation or the MAR test can also be performed. The results help determine whether natural conception is achievable or if assisted conception procedures are necessary. The test is quick and painless, yet highly significant in the diagnostic process.
Hormone tests for endocrine disorders
Female infertility is often influenced by hormonal imbalances – such as a lack of ovulation, polycystic ovary syndrome (PCOS), or thyroid disease. Blood tests are performed to assess hormone levels and identify potential endocrine disorders. Treatment may involve medication, ovulation induction, or lifestyle changes. Properly diagnosing a hormonal imbalance increases the likelihood of conception.
Procedures performed at the Fertility Centre
Intrauterine insemination (IUI)
An assisted conception procedure in which specially prepared sperm is introduced directly into the womb. It is most commonly used in cases where, for one reason or another, the couple are unable to have penetrative intercourse, or where there are abnormalities in sperm quality or the cervix. The procedure is quick, does not require anaesthesia, and is typically performed on an outpatient basis. Although it is a simpler method than in vitro fertilisation (IVF), it can be highly effective in certain cases.
In vitro fertilisation (IVF)
One of the most advanced assisted conception procedures, where eggs are fertilised in a laboratory, and the resulting embryos are transferred to the woman’s womb. IVF is most commonly performed when natural conception is unsuccessful due to blocked fallopian tubes, ovulation disorders, endometriosis, or unexplained infertility. The procedure is carried out in several stages – first, the ovaries are stimulated, followed by egg retrieval (follicular puncture), fertilisation, and embryo transfer. This method is used worldwide and is highly effective.
Intracytoplasmic sperm injection (ICSI)
A procedure where a single selected sperm is injected directly into each egg under a microscope. It is performed when there are severe abnormalities in sperm quality – such as low sperm concentration and motility, abnormal shape, or when sperm is retrieved surgically (TESA). ICSI increases the likelihood of fertilisation in cases where conventional fertilisation has failed. The procedure is complex and requires high levels of laboratory expertise.
Physiological intracytoplasmic sperm injection (PICSI)
PICSI is a variation of the ICSI procedure where sperm are selected based on their ability to bind to hyaluronic acid, which surrounds the egg. This allows the selection of more mature, genetically higher-quality sperm. This procedure is most commonly recommended when, during previous ICSI attempts, embryos either failed to form or were of poor quality. By choosing physiologically more suitable sperm, the likelihood of successful embryo development is increased.
Testicular sperm aspiration (TESA)
When there are no sperm in the man’s ejaculate (azoospermia), they can be retrieved directly from the testicles. The procedure is performed under general anaesthesia – a fine needle is passed through the skin to collect testicular tissue, from which viable sperm are isolated. TESA is most commonly used in conjunction with ICSI or PICSI.
Embryo freezing
The Baltic American Clinic was the first in Lithuania to introduce vitrification – an ultra-rapid method for freezing embryos and eggs. Special protective substances (cryoprotectants) are used during this process, meaning that ice crystals do not form inside the embryo during freezing, the internal cellular environment is not “scratched”, and internal cell structures are not damaged. This ensures higher embryo survival and quality after thawing.
During ovarian stimulation and egg retrieval, more eggs are usually obtained, and following assisted conception procedures, more embryos are created than are transferred in a single cycle. Surplus embryos of suitable quality are frozen and can be used later, should an additional attempt be required or if the couple wishes to have another child.
There is no scientific evidence that the freeze-thaw procedure harms the future baby. In liquid nitrogen at a low temperature of -196°C, all biological processes are effectively paused in time. In 2008, following vitrification and the transfer of thawed embryos performed at the clinic, the first “vitrified” baby in Lithuania was born.
Egg freezing
Egg freezing (vitrification) offers a woman the opportunity to preserve her fertility for the future. The procedure is often performed prior to cancer treatment, in cases of genetic conditions, or if a woman decides to delay motherhood for personal or professional reasons. Frozen eggs are stored at -196°C, ensuring their quality remains high despite the passage of time.
Frozen embryo transfer (FET)
A procedure during which thawed embryo(s) are transferred into the woman’s womb. At the appropriate time in the woman’s cycle, the embryo is gently introduced into the womb via a thin catheter. The likelihood of success is the same as when transferring fresh (unfrozen) embryos, allowing the couple to choose the most suitable time to plan their pregnancy.
Blastocyst culture and transfer
Some embryos are monitored and cultured in the laboratory for up to 5-6 days – this developmental stage is called a blastocyst. Since only a portion of embryos reach this stage, it is advisable to select the strongest ones to achieve the best results. Transferring blastocysts into the womb is often associated with a higher likelihood of conception. This method is particularly suitable in cases where several high-quality embryos develop and the goal is to reduce the number of embryo transfers.
Every couple is unique, as is their journey to parenthood
Infertility treatment is a sensitive and responsible process that begins with an open conversation and mutual trust. We work with each couple individually, gaining a deep understanding of their situation, experience, and expectations. Our goal is not only to apply the most advanced treatment methods but also to support you throughout the entire process. We create a personalised treatment plan for each couple that best meets their needs, helping them get closer to their primary goal – the birth of a child.
