Exclusive Combination Of Medication Therapy
The first step of IVF treatment is to collect healthy and mature egg cells. The higher number of egg cells collected during egg retrieval in the first IVF cycle may increase the success rate, but it doesn’t exactly show that more egg cells mean more success. The quality of the egg cells that are stimulated during IVF treatment will affect the fertilization and ofcourse the quality of embryos. In ovarian stimulation process; stimulation protocol and
medication dosages, decision of combining different medications and adjusting their dosages, planning the length of stimulation and overall treatment will be unique for every patient.
To this end, experienced personnel should apply various personalized techniques. In other words, adjusting the medication dosage for stimulating eggs, observing the development, and checking all these procedures require knowledge and experience on fertility treatments. Experienced personnel will figure out the real problem before applying the procedures. This approach prevents unnecessary medication usage and helps the couple financially as the cost of IVF medications is high.
Total Freeze (Freeze All)
In recent years, scientific studies show that the medications that are used to stimulate egg cells during IVF cycle may decrease the embedment ability of intrauterine.
In some patient groups our first goal is to start stimulation by medications and get healthy and high-quality embryos. Embryos will be frozen and will not be transferred following the fertilization. Embryo transfer will be scheduled later, when the uterus is fully recovered after medication therapy.
In Vitro Maturation (IVF without medication)
In ovarian stimulation stage, number of egg cells can be increased by adjusting medication dosage. This may affect patients financially in a negative way or even can cause over hyperstimulation syndrome (OHSS) in patients with polycystic ovary syndrome.
In vitro maturation (IVM) is not only for patients with OHSS or Polycystic Ovary Syndrome. It is also suggested to patients who have cancer derived from estrogen sensitivity and have no time to start hormonal medication therapy for preserving fertility. In this treatment, immature egg cells will be retrieved without any stimulation. Maturation
and fertilization will be observed in laboratory conditions. With this method expected pregnancy success rate is between 33% and 40%. Our center is one of the leading IVF Centers in Turkey and has the first successful pregnancy from IVM method in Turkey. In Vitro Maturation (IVM) procedure is especially suitable for polycystic ovary syndrome (PCO) cases. For this reason, this method should be applied in experienced and scientific centers with competent doctors.
Laser ICSI
“Zona Pellucida” is a glycoprotein that surrounds egg cells membrane. Zona pellucida thickness may decrease fertilization rates by causing fertilization abnormalities and implantation failures. During micro injection, this thickness may cause zona hardening and difficult in hatching. In order to prevent this micro injection is assisted
with laser and it’s called as Laser-assisted intra cytoplasmic sperm injection (Laser ICSI).
In this procedure, the thick membrane is thinned with the help of laser, and then the sperm is injected inside egg cell. It is known that this method prevents egg cell damage, and contributes high success rates by increasing the quality of the egg cells and fertilization. This method is suggested in repeated IVF failures, advanced age, low ovarian reserve and issues that cause zona pellucida thickness.
The Egg Activation
In cases where sperm cannot fertilize the egg cell, sperm and egg should be evaluated together in order to find out the real reason. Low level or lack of sperm enzymes that activate egg cells and disorders in egg cells can be a reason
for the unsuccessful fertilization. As a result, getting low quality embryos can decrease IVF success rates. Using Calcium ionophore and Piezoelectric for egg activation may increase the success rates.
Ongoing Studies
In Vitro Activation (IVA)
In patients with premature ovarian insufficiency (POI), in vitro activation is performed with laparoscopic surgery. In this surgery, ovarian cortex is removed and cut into strips. These ovarian tissue strips are cultured for 2 days in
laboratory conditions. After 2 days waiting, these tissues will be transplanted laparoscopically into ovaries back.
It is expected that after this procedure women who cannot produce egg or with premature ovarian insufficiency will produce egg cells in the ovaries again.
(HSD) Hippo Signalling Disruption – Surgical Activation of Ovaries
This procedure is performed to the patients with premature ovarian insufficiency. In contrary to in vitro activation, ovarian tissue strips doesn’t have to be cultured for 2 days. The transplantation will be done during the operation in the same day. Gürgan Clinic team follows latest developments and scientific approaches that contribute to treatment process.
