What is In Vitro Fertilisation?

In Vitro Fertilisation (IVF) was developed in the 1970s as a treatment for infertility due to the tubal factor, but it has proven an efficient treatment for patients suffering from endometriosis, ovulatory disfunction, infertility caused by poor sperm quality, genetic conditions and infertility of unknown origin.

In-Vitro Fertilization (IVF) is a technology that introduces the female egg (oocyte) and male sperm together in a specialized culture medium (outside of female body hence the term in vitro) where the chances of successful fertilization are greatly enhanced. The embryos are observed and grown in our IVF laboratory, where they are graded for quality and reintroduced to the recipient’s uterus at a multicell embryo stage or later at the blastocyst embryo stage. All procedures required during an IVF cycle, including ovarian stimulation and monitoring, egg retrieval, and embryo transfer, are performed on-site in our state-of-the-art facilities.

Classical IVF and Intra-Cytoplasmic Sperm Injection …

Fertilisation of the egg by the sperm involves a complex sequence of events, initially controlled by the sperm.

Classical IVF and intra-cytoplasmic sperm injection (ICSI) are the two most popular assisted reproductive technologies used for successful fertilisation. The only difference between the two is the way the egg is fertilised. IVF allows the sperm to penetrate the egg of its own accord whereas ICSI directly inserts the sperm into the egg

ICSI (Intracytoplasmic Sperm Injection) bypasses the work the sperm otherwise has to do during fertilisation. The eggs are placed in a shallow dish in microdroplets of culture medium under oil, arranged around a central drop containing sperm. The embryologist captures sperm one at a time using fine glass needles attached to manipulators mounted on a microscope. The embryologist then moves to a drop containing an egg, holds the egg with another fine pipette, and injects the sperm deep into the egg.

As part of the ICSI procedure, the embryologist breaks the egg’s membrane to trick the egg into thinking it has been fertilised in the normal way. The embryologist also breaks the sperm’s tail before injection to allow chemicals to escape from the sperm into the egg, and so signal that the sperm is present and ready to be ‘unpackaged’.

ICSI can work because in most men the genetic make-up of sperm is normal even though the sperm might be abnormally shaped, unable to move very well, or unable to undertake the steps of normal fertilisation.

The stages of IVF

Starting IVF can be a very exciting time – it is another step closer to becoming parents. Naturally, you will feel hopeful about a successful outcome but you also need to prepare yourself for around two months of medications, numerous procedures and testing. Please also bear in mind that the success rate of modern fertility treatments is high, but for some of couples, multiple treatment cycles may be necessary. The whole process up to the embryo transfer stage will usually take two to three weeks. IVF & ICSI involve 6 stages:

• Stage 1: Ovarian stimulation and monitoring
• Stage 2: Egg (oocyte) retrieval [Oocyte Pick Up – OPU]
• Stage 3: Fertilisation
• Stage 4: Embryo development
• Stage 5: Embryo transfer
• Stage 6: Luteal phase support

IVF in Albania – is it worth the hassle?

In Vitro Fertilization (IVF) is the most widely used form of treatment for infertility. The number of patient who decide to undergo IVF treatment abroad is increased year by year. Out of numerous clinics in a number of european countries, for example Spain, the Czech Republic, Greece or Turkey, one of the main destinantions for IVF is Albania.

Location of Albania in Europe

Location of Albania in Balkans

But the mediterranean climate and the increasing touristic attractions aren’t the only factors drawing them to Albania – so what does Albania have to offer that the other countries doesn’t?

IVF in Albania – general overview

One of the main factors drawing infertile couples from their countries to Albania is egg donation. Many people are encouraged by the affordable prices and the fact that in Alania there are virtually no waiting lists for this procedure. The reason behind that is a large number of egg donors, who are ensured total anonymity. Of course, all donors are tested for any diseases, both physical and psychological.

In Albania, the leader in IVF services is American Hospital Tirana. Its IVF department offer every medical procedures related with infertility, for instance IVF, IUI, ICSI (Intracytoplasmatic Sperm Injection), AH (assisted hatching), surgical sperm retrieval, blatocyst transfer, time – lapse technique (Embryoscope), frozen embryo transfer, Egg freezing and egg banking, pre-implantation genetic diagnosis (PGD) and others..

Tirana is an easily accessible location, both by plane and by car.

Why American Hospital Tirana?

The IVF department of American Hospital Tirana has been specializing in the diagnosis and infertility treatment for over 10 years and provides access to most up-to-date methods of treatment, all at a very reasonable price.

Apart from being the biggest IVF destination in Albania in matter of treated patients and with the highest success rates, American Hospital Tirana held the Albanian record of IVF: in 2013 N. K a 56 years old lady is the oldest woman in Albania to give birth using IVF with donated eggs. In 2016 we reported the 1st live birth after In Vitro Maturation and in 2017 the 1st live birth after frozen eggs in Albania.

For our patients from abroad, we offer a complete service in different languages (english, italian, french, spanish and german) which promotes clear communication and understanding.

At American Hospital Tirana we are committed to being at the forefront of assisted human reproduction research, constantly assessing and using innovation and technology to ensure our patients receive the best possible treatment. This commitment also allows us to achieve positive outcomes in often complex cases such as:

• Patients with implantation failure.
• Repeated miscarriages.
• Anonymous egg donation,
• Anonymous sperm donation,
• Embryodonation
• Pre-implantation genetic diagnosis (PGD)

Figure 3. List of IVF services offered by American Hospital Tirana

Our aim

We truly believe that transparency and individualisation are key to offer our patients the best options to journey towards their dream of forming a family. That is why we pay special attention to the aspects that exert the greatest influence on the fulfillment of that dream, designing the most specific and personalised strategies in each case; because to us each patient is different and unique.

Our main goal as experts in fertility is for our patients to trust the quality of our treatments and also to make them feel safe during the process and confident about its success.

American Hospital records in In Vitro Fertilisation:

– 2018 – Oldest woman in Albania to be pregnant after a succesfuel IVF ate the age of 62 years. This was made possible by the team of dr. Elton Peci and embryolog Besfort Ferhati. It was a case of an Italian patient who gave birth to a healthy baby girl in December 2018.

– 2018 – 1st succesfuel case in Albania of a live birth after using Time – Lapse embryo imaging of embryos. This case was made possible by Dr. Elton Peci and embryolog Besfort Ferhati.

– 2016 – 1st woman in Albania to gave birth to twins after a succesfuel In Vitro Fertilisation of frozen oocytes. This case was made possible by Dr. Elton Peci and embryolog Besfort Ferhati.

– 2016 – 1st delivery of a healthy baby after In Vitro Maturation in Albania. This case was made possible by the team of Prof. Dr. Hakan Satiroglu and embryolog Besfort Ferhati.

– 2013 – Oldest woman in Albania to gave birth after a succesfuel IVF ate the age of 56 years. This was made possible by the team of dr. Elton Peci and embryolog Tugce Isidan.

– 2013 – Oldest woman in Albania to gave birth to twins after a succesfuel IVF at the age of 52 years. This was made possible by the team of dr. Elton Peci and embryolog Tugce Isidan.

Thoracic Surgery

• Lung cancer surgery (lobectomy, pneumectomy)
• Benign muscle and thoracic cancers surgery (wedge resection, lobectomy, pneumonectomy)
• Lung infections surgery
• Pleura infection surgery (empyema), decortication of the lungs
• VATS (video assisted thoracic surgery) for pneumothorax, lung biopsy, pleural fluid treatment
• Mediastinoscopy biopsy of lymph glands
• Mediastinoscopy
• Thoracic surgery (pectus, excavatum, pectus carinatum)
• Lung Transplantation

CARDIAC SURGERY PROCEDURES

• Coronary bypass (with or without extracorporeal circulation)
• Repair or replacement of the aortic valve
• Mitral valve repair or replacement
• Multi-valve surgery
• Repairing of congenital diseases in children
• Repairing of congenital disease in adults
• Repairing of the aortic aneurism
• Emergency surgery in aortic aneurysms
• Other surgery interventions in patients with advanced cardiac insufficiency

VASCULAR SURGERY

• Peripheral artery diseases (aortobifemoral, aortofemoral, femoropoliteal, extra-anatomic bypasses etc.)
• Carotid artery surgery
• Surgery in varicose veins

Since 8 years the American Hospital is the only and undisputable leader in heart surgery in Albania. Over 3,800 patients trusted their hearts to the cardiac surgery team. All the cardiologic pathologies, ranging from the aortic surgery in the valve surgery, from the congenital heart defects to the multiple bypasses, find solution in one single address.

• Cardiac check-up
• Electrocardiogram (ECG)
• Transthoracic echocardiogram
• Transesophageal echocardiogram
• Stress echo test
• Heart rate HOLTER
• Arterial pressure HOLTER
• (Scheduled or emergency) Coronary angiography
• Stent implant
• Pacemaker implant
• Electrophysiological study
• Ablation
• Heart catheterization

The first cornerstone of the American Hospital and, at the same time, the greatest pride of our work of these years, which was founded at a time where the cardiac patients had to leave the country for diagnosis and treatment of heart problems abroad, the cardiology department at the American Hospital gave birth to a new era in the Albanian modern medicine.

A team of talented cardiologists has treated thousands of patients with different cardiologic problems in years, including the most severe cases of the acute myocardial infarctions.

With a great team which is trained in the respective disciplines and is equipped with the most up-to-date devices, the cardiology department provides a 24/7 service that covers all the demands from the polyclinics and cardiologic emergencies, ensuring medical treatment by coronary angiography, stents, where required, electrophysiological study, ablation, etc.

In addition to the medical treatment and application of invasive methods, the Cardiology Department has dedicated special attention to the patient education on the prevention and treatment in due time of cardiologic diseases, as well as on the up-to-date heart imagery examination methods, such as the angiographic scanning or Calcium score; measurement of sclera plaques of the blood vessels

SURGERY OF ESOPHAGUS SURGICAL PATHOLOGIES

• Esophageal polyps
• Esophageal cancer
• Esophageal strictures
• Achalasia

GASTRIC SURGERY (OF THE STOMACH)

• Surgical treatment of complications from peptic ulcer
• Treatment of neoformations such as the gastric cancer
• Correction of the pathologies of the stomach operated previously

INTESTINAL SURGERY (LARGE INTENSTINE)

• Intestinal and mesentery tumours
• Various occlusions

OLORECTAL SURGERY

• Treatment of the colon Dexter cancer
• Treatment of the transverse colon
• Treatment of the sinister colon and rectosigmoidien

SURGERY OF BILIARY TRACTS AND HEPARIN(LIVER)

• Colecistis calculosa (Gallbladder)
• Calculosa of biliary tracts
• Benign and malign icterus mechanical
• Heparins Echinococcus
• Heparin abscesses

PANCREATIC SURGERY

• Treatment of pancreatic pseudocysts
• Treatment of pancreatic tumours

SOFT TISSUE CARCINOMA

• Treatment of lipoma
• Treatment of soft cutaneous and subcutaneous formations

SURGERY OF ABDOMINAL PARIETES

• Inguinal hernia
• Umbilical hernia
• Incisional Hernia (laparocele)

ENDOCRINE SURGERY

• Thyroid glands
• Treatment of lumps
• Toxic adenomas
• Morbus Basedow

SURGERY OF PARATHYROID GLANDS SURENAL SURGERY

• Surenal cortical tumours

SURGICAL EMERGENCY 24 HOURS

• Acute abdomen
• Acute appendicitis
• Acute colecist
• Peritonite
• Occlusions
• Incarcerated hernia
• Drainage of different abscesses

The general surgery has been one of the most advanced areas of medicine in centuries and it still keeps preserving its important place while it advances its methodology day by day.

Currently, the American Hospital, with its selected team of Albanian and foreign surgeons, marks the widest range of surgical interventions that have been carried out in the country.

A particular place in the work of the surgical team occupies the oncologic surgery, which plays a key role in the adequate treatment of the patients diagnosed with cancers.

The General Surgery is a department that collaborates closely with many other departments, such as; Gastroenterology, the Advanced and Invasive Imagery, ORL, Urology, Gynaecology, Pathology, Oncology, Orthopedics-Traumatology, Endocrinology, etc.

COSMETIC PROCEDURES

• Abdominoplasty (tummy tuck)
• Arm Lift
• Body Contouring
• Body lift
• Botox
• Breast augmentation
• Breast lift
• Breast Reconstruction
• Breast Reduction
• Brow lift
• Chemical peel
• Chin surgery
• Dermabrasion
• Ear surgery
• Eyelid surgery
• Facelift
• Facial Implants
• Hair replacement
• Filler injections
• Liposuction
• Microdermabrasion

RECONSTRUCTIVE PROCEDURES

• Cleft Lip & Palate
• Hand Surgery
• Orthognathic Surgery (correction of jaw deformities)
• Scar Revision
• Skin Cancer surgery
• Tissue replacement

Since 2008, hundreds of patients have trusted the American Hospital with their choice to have a greater body, a more perfect look or to revise a previous damage. The plastic surgery at the American Hospital, with a rate of over 40 interventions on a monthly basis, not only has satisfied the demands of all those who are in search of a more sophisticated look, but has, at the same time, broken the taboo that plastic surgery can be done only out of the country.

• Routine tests
• Biochemical tests
• Hematologic tests
• Hormonal tests
• Immunological tests
• Viral tests
• Microbiological tests
• Allergy tests
• Drug dosage
• Electrophoresis
• Coagulation tests
• Urine tests
• Toxicological testing
• Specific tests of various pathologies
• Metabolic panel and electrolytes
• Specific biochemical tests
• Specific proteins
• Lipoproteins and phospholipids
• Detailed coagulation tests
• Laboratory haematology
• Laboratory tests in urine
• Laboratory tests in the feces
• Laboratory tests of the cerebrospinal fluid
• Laboratory tests of the articular fluid
• Tumoral markers
• Immunopathology laboratory tests
• Electrophoresis and immunoelectrophoresis
• Dosage of hepatitis antigens and antibodies
• Tests of viral pathologies and other infectious agents
• Laboratory tests according to the pathologies and medical procedures
• Specific IgE and food intolerance
• Check up by age and sex
• Pathological tests
• Prenatal genetics and molecular biology

The Department of the clinical-biochemical, microbiological and pathologic Laboratory undertakes to successfully provide outpatient lab support for the prevention and diagnosis of various pathologies and for the application of pre-coronarography protocols for cardiac patients, prechemotherapy for oncologic patients, pre and post-operative tracking of cardiac surgery patients, patients of general surgery, orthopaedic surgery and all types of surgery.

Being a centre of reference for many important surgery procedures, the American Hospital has dedicated particular focus to the immunohistopathology laboratory, which has been trusted to a selected staff. In this way, the accurate diagnostics and therapy are strongly sustained not only by the conventional biopsy, but also by the most advanced frozen method, which allow us to apply conservative surgery at best.

The American Hospital Laboratory undertakes with success detailed genetic, clinical and biochemical examinations of pre-transplant patients and the frequent laboratory monitoring of immunosuppressants among these patients in the post-transplant stage.

Is a specialty of medicine and pediatrics that concerns itself with the kidneys:

• The study of normal kidney function and kidney disease
• The preservation of kidney health
• The treatment of kidney disease, from diet and medication to renal replacement therapy (dialysis and kidney transplantation).
• Nephrology also studies systemic conditions that affect the kidneys, such as diabetes and autoimmune disease and systemic diseases that occur as a result of kidney disease, such as renal osteodystrophy and hypertension.

One of the frontrunner departments which, together with the general surgery, have given the American Hospital the name of the only centre of transplants in the country.

Counting 200 successful transplants and 80 haemodialysis beds that are on a 24-hour service in three of our hospitals, this department has reached the most advanced stage of the treatments that are currently provided in the area of nephrology in the world.

Specialties

• Diagnostics of kidney diseases or disorders
• Disorders of the urinary tract and urine composition
• Disorders caused by high blood pressure
• Acute or chronic renal insufficiency
• Application of haemodialysis in acute cases
• Kidney biopsy
• Peritoneal haemodialysis and dialysis
• Kidneys transplant

TREATED DISEASES

• Vascular and Endovascular neurosurgery
• Stereotactic, Functional and Epilepsy neurosurgery
• Oncological neurosurgery
• Spine neurosurgery
• Peripheral nerve surgery
• Pediatric neurosurgery

OTHER CONDITIONS TREATED BY NEUROSURGEONS INCLUDE:

• Meningitis and other central nervous system infections including abscesses
• Spinal disc herniation
• Cervical spinal stenosis and Lumbar spinal stenosis
• Hydrocephalus
• Head trauma (brain hemorrhages, skull fractures, etc.)
• Spinal cord trauma
• Traumatic injuries of peripheral nerves
• Tumors of the spine, spinal cord and peripheral nerves
• Intracerebral hemorrhage, such as subarachnoid hemorrhage, interdepartmental, and intracellular hemorrhages
• Some forms of drug-resistant epilepsy

Through the best and advanced technology, patient-focused care; innovative clinical and laboratory research; and specialized academic training, the Department of Neurosurgery at the American Hospital provides complete neurosurgical expertise to patients with cranial and spinal diseases and disorders.

Neurosurgery (or neurological surgery) is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of disorders which affect any portion of the nervous system including the brain, spinal cord, peripheral nerves, and extracranial cerebrovascular system. Dedicated to advancing the field of neurosurgery, providing leadingedge, compassionate care and conducting unparalleled research, Neurosurgery Department offers the best treatment options for patients.

Is a branch of medicine dealing with disorders of the nervous system. The Department of Neurology in the American Hospital deals with the diagnosis and treatment of all categories of conditions and disease involving the central and peripheral nervous systems (and their subdivisions, the autonomic and somatic nervous systems), including their coverings, blood vessels, and all effector tissue, such as muscle.

Our diagnostics and treatment of the entire range of neurological diseases are based on the most sophisticated imaging examinations, specialized radiology staff deals with their interpretation (MRI, MRA CT, Angio-CT, ECHO Doppler, X-rays) and a specialized laboratory diagnose neurological problems.

The Neuroelectrophysiology Laboratory performs EEG, Video EEG, and Polymerography.

Electroencephalogram (EEG)

With electrodes applied to your scalp, an EEG measures electrical activity in the brain.

To make a diagnosis, our neurologists uses imaging tests such as:

• computed tomography, or CT scan
• magnetic resonance imaging, or MRI scan
• positron emission tomography, or PET scan

Other diagnostic procedures include angiography (Angio-CT) which determines blockages in the blood vessels going to the brain.

Treated diseases

• Cerebral vascular diseases (cerebral vascular accidents) – Ischemia and cerebral haemorrhage; Diagnosis of malformations of cerebral veins (Aneurysms, AV, cavernoma, etc.)
• Diagnosis and treatment of carotid pathology (medical and surgical)
• Neurodegenerative diseases
• Parkinson Disease; Dementia Syndromes; spinocerebellar ataxia; Lateral amyotrophic sclerosis; Huntington Disease etc.
• Epilepsy (epileptic syndrome)
• Headaches
• Spinal pathologies and peripheral neuropathy (medullar spinal damages, discal hernia, neuropathies of different etiology)
• Muscular pathologies

SERVICES

• Gynaecologic exam
• Check-up during pregnancy
• Postnatal gynaecological care
• Gynaecological oncology
• Ultrasonography
• Pregnancy tracking with ultrasonography
• Doppler ultrasonography screening during the pregnancy
• Bi test, triple test and amniocentesis during the pregnancy
• Delivery
• PAP test
• Colposcopy and biopsy
• Laparoscopy
• Hysteroscopy
• Hysterosalpingography (HSG)
• Placement of intrauterine protective devices
• Routine tests of gynaecological check-up
• Day surgery/outpatient surgery

TREATMENTS OF:

• Menstrual cycle disorders
• Menopause disorders
• Tumours in genital organs
• Disorders of vaginal dischargers
• Sexually Transmitted Diseases
• Birth control and application of contraceptive methods

The American Hospital Women Health Care Centre is one of the most advanced clinics of the whole structure. With a full range of services, surgical procedures and infertility treatments, this centre is unique in its kind and the quality it offers.

Since the establishment of the American Hospital 2, the Women Healthcare and Natal department treats all gynaecological disorders; the tumours of female reproductive organs, menopause disorders, it provides normal care during pregnancies, tracks high-risk pregnancies etc. A particular focus of the team led by Prof. Dr. Hakan Șatıroglu is given to infertility treatment for those couples who not only have tried in years to become parents but have also sought the long-awaited pregnancy out of Albania. Equipped with an embryology laboratory, which is unique throughout the Balkans, the team of infertility experts has enabled pregnancy among many couples with various problems who have come to this centre not only from Albania, but also from neighbouring countries