Evaluation of Sperm Parameters

In IVF, the selection of even a single sperm placed inside the egg is very important. Problems in the genetic structure of the sperm and various problems that negatively affect the fertilization function of the sperm can negatively affect egg fertilization. It may cause the eggs not to be fertilized, a small number of eggs to be fertilized, genetically problematic fertilization or the formation of poor quality embryos, and pregnancy rates may decrease. Aim; It is primarily the production of quality sperm and then the selection of the sperm with the highest pregnancy potential using various advanced technological methods.

Detailed Sperm Analysis

It is the evaluation of sperm in terms of number, motility and shape. The data obtained as a result of these studies primarily provide valuable information regarding the delay in spontaneous pregnancy. It is necessary to investigate in detail the increase in sperm shape and anomalies, especially according to the Kruger classification.

DNA Damage Analysis

It is the evaluation of a sperm cell's most valuable asset, its genetic material, in terms of DNA damage. Obesity, age, smoking and alcohol use, stress, genetically modified foods and genetic factors can cause individual-specific deteriorations. This may lead to a diagnosis of infertility of unknown cause. DNA Damage Analysis; Even if sperm parameters are very good, it is a parameter that should be investigated in case of early pregnancy losses and recurrent IVF failures. Using sperm that has no damage or breakage during treatment is the first stop on the road to success.

ROS Test (sORP Test)

Semen analysis is only indicative about the visual parameters (mobility, number, morphology) of sperm cells. But now, with the advancement of science, we have more information about cell biology. According to recent developments, the antioxidant capacity of semen is important for infertility treatments. Increased reactive oxygen species (ROS) in semen cause damage to sperm DNA. In addition, it causes severe damage to the sperm cell membrane. As a result of these damages, the egg fertilization capacity of the sperm (fertilization rates) and the obtaining of healthy embryos are damaged.

As can be understood from the Balancing Concept, these ROS molecules must also be in balance. Therefore, the ROS balance in semen should be measured and the correct treatment should be applied to bring the balance to the right place or unnecessary treatment should not be applied.

Sperm Function Tests

A group of tests called PFT are performed in the form of a panel in Gürgan Clinic Embryology Laboratory. With these tests, the negative effects that may occur during the treatment are determined in advance, and by applying the sperm selection technique according to the test results, we can give the couple the full chance of a healthy pregnancy and birth with healthier embryos.

Azoospermia, which means no sperm in the semen, is one of the important causes of male infertility. Azoospermia is seen in 1% of all men and in 10-15% of men with infertility problems. In these cases, sperm cells can be obtained from the reproductive ducts or testicular tissue and microinjection can be performed.

First of all, the cause of azoospermia is investigated, and according to the diagnosis, necessary interventions are made to maximize the sperm recovery rate (hormone therapy, empirical treatments). Here, obtaining sperm through surgical intervention (MESA, PESA, TESA, TESE, Micro TESE) is always used as a last resort. Our first goal is to ensure that sperm comes out in the semen. If there is no sperm in the semen; The surgical intervention method that is most suitable for the patient and has the highest sperm recovery rate is determined and applied. In case of obtaining sperm from the testicle by surgical method, mature sperm must be identified and selected very carefully.

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.

In cases where there are no mature sperm that can fertilize the egg during micro-testing, even with the fibering technique, precursor sperm cells called round spermatids are found and used in egg fertilization; It is an important ray of hope for men who are azoospermic and have not had successful fertilization before.

Sperm Detox

It is a practice based on the early detection of sperm problems that may occur in men due to genetic predisposition, smoking and alcohol use, stress, overweight, advanced age or various diseases, and eliminating these negative factors as much as possible. Problematic points are identified and repaired by performing special tests that determine the rates of disorders in sperm functions. In order to establish hormonal balance, injections and drug treatments should be administered to replace missing hormones. Better quality and healthier sperm can be obtained with supportive medication, vitamins and antioxidant treatments.

Methods used for this purpose

• Diet, obesity, insulin resistance control
• Lifestyle changes, psychological support
• Workout planner
• Quit smoking and alcohol
• Acupuncture
• hormonal treatments
• Antioxidant treatments
• vitamin treatments
• Microbiota regulation

In in vitro fertilization treatment, the sperm to be put into the egg must be selected from those who are mature and in good genetic condition. To this end "Personal" Various techniques should be applied by experienced personnel. According to the data obtained in our center, the following approaches are selected and offered to patient service. The use of special diagnostic and treatment approaches increases the success of treatment in men who have problems with sperm count, motility and abnormal development, or who have no sperm at all.

Microfluidic Chip Technique

Microfluidic chip method; It is used to select sperm that are in better physiological and genetic condition by eliminating the damage that classical methods such as mixing with a pipette and centrifuging may cause to healthy sperm cells. This technique, which is prepared by creating a similar natural environment in the female reproductive system, allows the sperm that can pass through micro channels to be selected as if they are closest to nature, as if it were a filter.

It can contribute to increasing success as a promising treatment with additional methods, especially in male-related problems. When necessary, it has been observed that sperm quality is better as a result of sperms selected with the existing chip and having higher genetic quality being selected again with a new chip. For this reason, in advanced male factor cases, the sperm selection technique we call DOUBLE CHIP is important in obtaining high quality sperm.

Polarized Microscope (Beam Decomposition Technique)

It is the technique of selecting the right sperm by using the double refraction feature of light with a polarized microscope. In this technique, a special light is sent onto the sperm samples. The difference in the light reflection sent by sperm with DNA breaks or fertilization problems ensures that problematic sperm are separated and not used. Embryo development is healthier by selecting good sperm for fertilization.

High magnification Microinjection

It is a microinjection process performed with high-resolution advanced microscopes. It is the technique of identifying sperm anomalies that we cannot detect with normal (approximately 400x) magnification, using special high-magnification microscope objectives and lenses, with 6600x magnification, and selecting the sperm that are likely to fertilize the best eggs. Being able to apply this extremely complex and advanced technology technique; It requires knowledge and experience of sperm physiology. Some studies have reported that it positively affects fertilization and embryonic development.

Hyaluronan Binding Assay (Physiological Microinjection / Membrane Binding Technique)

While sperm are being prepared for the microinjection (ICSI) process, which is the process of fertilizing eggs, the most mobile and most well-shaped sperm are selected using special techniques. In this method, sperm is selected in special solutions for microinjection. These solutions distinguish sperm with healthy DNA according to their binding capacity to specially developed membranes, and the differentiated sperm are collected and microinjected. Scientific studies show that physiological ICSI reduces miscarriage rates while increasing the fertilization rate and embryo quality.