Successful Applications in IVF Treatment

1.Preimplantation Genetic Diagnosis

Preimplantation Genetic Diagnosis (PGD) is the process of genetically analyzing embryos created from eggs and sperm obtained from the mother and father in in vitro fertilization treatment, and selecting healthy embryos before they are transferred to the mother. With PGT, it is determined whether a known genetic disease in the mother or father is transmitted to the embryo, or the chromosome counts of embryos from genetically normal parents are examined.

How is Preimplantation Genetic Diagnosis (PGD) Performed?

Couples whose genetic analysis is completed before PGD can begin IVF treatment. Embryos created from eggs and sperm obtained from the parents are cultured for 3 days. During their development, they reach the 6-8 blastomere stage. One or two blastomeres are removed and transferred to tubes for genetic analysis. The embryo is at the uterine stage.

Who Can Benefit from Preimplantation Genetic Diagnosis (PGD)?

Who Can Benefit from Preimplantation Genetic Diagnosis (PGD)? Couples experiencing recurrent pregnancy loss and recurrent IVF failure 2. Men with infertility issues Couples with a family history of an X-linked genetic disorder Couples carrying an autosomal recessive disorder Couples carrying an autosomal dominant disorder Couples carrying structural chromosome abnormalities HLA-compatible sibling Older mothers

CCS (Expanded Chromosome Screening)

A new technique in IVF that increases the chances of pregnancy for older women. Embryos obtained through IVF treatment are first tested for major chromosomal abnormalities using the CCS (Comprehensive Chromosome Screening) method. For this purpose, samples are taken from embryos at the blastocyst stage when they consist of approximately 100 cells. CCS tests whether each embryo contains the normal number of 46 chromosomes, 23 from the mother and 23 from the father. Genetically normal embryos are frozen and stored for 1-2 months before being transferred to the mother's uterus, to be thawed later. This storage period allows the woman's hormonal balance, which has been disrupted by in vitro fertilization treatment, to return to normal.

2. Assisted Hatching (Assisted Hatching)

In more than half of couples who apply to IVF centers, pregnancy does not occur despite embryo development. The source of pregnancy failure despite fertilization is likely during the embryo's implantation phase in the uterus. Following the implantation of the embryo into the uterus, various events occur; the embryo continues to divide and grow. When it reaches a certain size, it ruptures the membrane surrounding it (zona pellucida) and embeds itself deeper into the tissue lining the uterus, known as the endometrium, and continues to grow. The most important reason for pregnancy failure is that the embryo cannot break through this membrane and emerge, thus failing to implant in the uterine wall.To solve this problem, a small hole is created in this membrane surrounding the embryo using chemical or mechanical methods before the embryo transfer procedure. This allows the embryo to rupture the membrane and implant itself into the uterine wall.

3. Blastocyst Transfer

The use of recently developed medium systems has further extended embryo viability in the laboratory environment, and accordingly, in contemporary IVF centers, higher pregnancy rates are achieved with 5th or 6th Day transfer procedures have begun to become more common. This is called blastocyst transfer. The final stage the embryo reaches before attaching to the uterine wall is called the blastocyst stage.

We can list the advantages of blastocyst transfer as follows:

• Ability to select embryos with better developmental potential Reduction of the likelihood of multiple pregnancies by transferring a smaller number of embryos with higher viability Better observation of embryo development The ability to rotate embryos during the period of highest developmental potential, namely at the blastocyst stage.

4. Embryo Freezing

To minimize the risk of multiple pregnancies in IVF treatments, the general approach is to transfer a maximum of two embryos. Freezing the excess embryos obtained in this way provides both an economic and psychological advantage to the patient. Additionally, when frozen embryos are to be transferred, the patient does not require any treatment. The success rate has increased with the vitrification (rapid freezing) method, which has been used in embryo freezing procedures in recent years. Embryos frozen upon obtaining consent from the couples are stored and can be used whenever the couples wish.

5. In vitro fertilization treatment in patients with hydrosalpinx (fluid in the tubes)

hydrosalpinx (fluid in the tubes) If fluid is observed in the tubes (hydrosalpinx) in a patient undergoing in vitro fertilization treatment, this issue must be resolved before starting treatment.

What is Hydrosalpinx?

Hydrosalpinx is the accumulation of fluid in a woman's fallopian tubes resulting from a previous infection.

How does hydrosalpinx affect IVF success?

The presence of fluid in the tubes reduces the chances of pregnancy, implantation (embryo attachment), and live birth by half compared to other causes of infertility originating from the tubes. This condition also doubles the risk of miscarriage. How is hydrosalpinx treated? Although the mechanism preventing pregnancy cannot be fully explained, research has shown that this fluid must be drained before starting in vitro fertilization treatment. There are several treatment methods available for this:

Practices That Increase Success in Male InfertilityHealthy Sperm Selection in Male Infertility

When looking at couples who cannot have children despite wanting to, it is possible to say that 40% of the problems stem from men, 40% from women, and 20% from both partners. While more research is conducted on women, the evaluation of men is reduced solely to sperm analysis. The primary factors affecting male infertility (sterility) include: Congenital urogenital abnormalities (the most common being undescended testis), Malignancies (cancer), Urogenital infections, Varicocele (enlargement of the testicular veins), Hormonal disorders, Genetic anomalies can also be considered.

In 30-40% of cases, the cause of the problem is unknown. This group is medically referred to as "idiopathic male infertility". When the problem is in the male partner in couples, the man must definitely be examined by a urology specialist. This is important for diagnosing anatomical disorders, detecting common hormonal disorders associated with infertility such as low testosterone, or for early diagnosis and treatment of diseases like testicular tumors. Evaluating a man solely based on sperm analysis and directly referring him to IVF treatments leads to repeated treatment failures and financial and emotional losses. DNA FRAGMENTATION TESTS FOR HEALTHY SPERM SELECTION "Handsome sperm isn't enough!" Three indicators are examined in sperm analyses.

Sperm count (must be at least 20 million). Motility (at least 50% must be motile forward). Morphology, that is, shape, appearance. However, this data is not sufficient. The DNA of the sperm is also an important determinant. Because a defect in the DNA can lead both to egg fertilization failure and miscarriage. In conventional IVF procedures, sperm are typically selected using the spinning or floating method.However, these processes may partially damage the sperm. The "microchip" (also known as a sperm chip or microfluidic chip), developed based on the idea of selecting sperm in a manner similar to their natural environment, in other words, using microfluidic liquid technology, is a convenience.It must be acknowledged that there has been a very significant development, particularly in finding the highest quality and healthiest sperm. Is There a Solution Even If There Are No Sperm in the Semen?

In cases of azoospermia, where there is no sperm in the semen, two main types of causes can generally be identified: Sperm production in the testis has decreased. Although sperm production is present, the ducts are either congenitally absent or blocked. In this case, the patient's examination and hormone tests lead to the diagnosis. Today, sperm can be retrieved surgically from testicular tissue using the micro-TESE procedure performed under a microscope. However, in cases of azoospermia, the diagnosis must be made accurately.