Personalized combination drug treatments
The first step in in vitro fertilization treatment is to obtain healthy and mature eggs. It is generally accepted that obtaining more eggs increases success in couples starting treatment for the first time; In fact, the fact that fewer eggs are obtained from other women during treatment upsets the couple. But more eggs does not mean more success! The quality of the eggs developed during treatment ensures that they can later be fertilized well and develop an embryo that can lead to pregnancy.
Personal stimulation of the ovaries and maturation of the eggs inside them; Personal selection of the drugs used to develop eggs, adjusting the dose, deciding to use them with other drugs and adjusting the treatment duration well depend on the knowledge, experience and selection of drug protocols according to the characteristics of the woman.
In other words, adjusting the use of medication to increase and develop eggs is a medical art that requires knowledge, experience and care to be applied in accordance with the person and the month of treatment. It requires knowledge, experience, time and detailed research of your characteristics. This approach also prevents unnecessary medication use and does not cause high drug costs to burden couples. Because couples pay a large amount for drugs in addition to the money they pay for IVF.
Total Freezing / Storage
In recent years, scientific data has been obtained showing that the drugs given to promote egg development during IVF treatments can reduce the uterine lining. For this reason, good quality embryos formed during treatment in some patient groups; It is kept frozen and stored within the month of drug treatment without being transferred. It is transferred in the following months after the problem that drug treatment may cause in the uterus is eliminated.
In vitro maturation (IVM) method | Drug-Free In Vitro Fertilization Method
During the egg development process, the number of eggs obtained is increased. However, egg development is a costly and distressing process for the patient and can lead to hyperstimulation syndrome (OHSS) in patients with polycystic ovaries. In Vitro Maturation (IVM) has begun to gain importance for such cases. It is recommended for use in women with polycystic ovaries or PCO-like ovaries who are at risk of OHSS, women with estrogen-sensitive cancer types, and patients who do not have time for hormone therapy to preserve fertility.
In this treatment, immature eggs obtained without medication are matured, fertilized and embryo developed in special solutions under laboratory conditions, and by placing these embryos into the uterus, a pregnancy rate of 33% to 40% can be achieved. Our center achieved the first IVM pregnancy in our country and this pregnancy resulted in birth. It is a method that should be preferred especially in PCOS cases and should be applied in experienced centers.
Laser ICSI
Thickening of the membrane called 'zona pellucida' around the eggs may have a negative impact on fertilization failure or embryo attachment. In the process of putting sperm into eggs with microinjection needles, difficulty in passing through the membrane may occur and the structure of the egg may be damaged. To prevent the problem, micro injection is applied with the Laser ICSI method. In this process, the thickened membrane of the egg is first thinned with the help of a laser, and then the needle that will carry the sperm into the egg is inserted into the egg through the thinned hole. This process prevents the egg from being damaged; It is known to increase pregnancy rates by increasing fertilization and the quality of the developing egg. It is an auxiliary technique used in cases of repeated IVF failures, in women with advanced age and reduced egg reserve, and in cases where microinjection is difficult and in problems that cause hardening of the zona pellucida.
With the method we call LIFLATING; Under the microscope, the pieces taken from the testicle are separated into fibers mechanically and enzymatically. Afterwards, each testicular sample is examined for the presence of sperm by more than one embryologist for approximately four hours. After the presence of sperm is confirmed, the most mature sperm are selected with polarized light under special microscopes. Eggs are fertilized with the microinjection process.
In this way, the percentage of sperm retrieval is increased to the highest level and the quality of the embryos that will be formed using these sperms will be higher. The sum of all these transactions; It is positively reflected in pregnancy rates and live birth rates. With surgical sperm retrieval methods, sperm is found in 100% of azoospermia cases with duct obstruction and in 65% of azoospermia cases without obstruction.
Egg Activation
In cases where the sperm cannot fertilize the egg, causes related to the sperm or egg must be investigated. The lack or absence of enzymes and substances that activate the egg in the sperm may be a factor, as well as problems of the egg itself. As a result, reduced fertilization rate, no fertilization or low quality embryos occur, which reduces the success of IVF. In these cases, in order to ensure higher quality and higher egg fertilization; The egg is activated using calcium ionophore or Piezo electricity.
Ongoing Studies
(IVA) In Vitro Activation
In women with ovarian failure at an early age, the outer shell of the ovary is removed laparoscopically, mechanically cut into small pieces with incisions, and left in a special activating liquid for 2 days in the laboratory environment to be processed enzymatically. After this two-day enzymatic process, these ovarian shell particles are placed back into the patient's ovaries laparoscopically. As a result of this treatment, patients who were previously unable to produce eggs and experienced ovarian failure can start producing eggs again after a certain period of time.
(HSD) Hippo Signaling Distruption
Surgical Ovarian Activation: The same treatment method is performed in the same patient groups, in a single step and in a single session, with a special operation technique, without any enzymatic treatment with activation fluid. Gürgan Clinic closely follows scientific developments and research and continues scientific studies on both methods and will make positive contributions to the treatment process in the light of the data obtained.
Delicate balances play a role in a couple having a child. When there is a disturbance in any of these balances, there may be delays in the couple's ability to become pregnant spontaneously or with the help of assisted reproductive techniques, or pregnancy may not occur at all.