We provide professional support in Embryology.
In Vitro Fertilization (IVF) treatment is a form of
assisted reproductive technology (UYTE). During IVF treatment, a woman’s
eggs are combined with her husband’s sperm outside the body in a sterile
laboratory environment, and after the embryo is formed, it is transferred into
the uterus. IVF / ICSI treatment is the combination of the best quality
sperm with the best quality eggs, according to the laboratory procedures after
the egg collection process, taken from the female patient. This method is
used when women and their partners have difficulty conceiving naturally and
usually
after other methods have been tried.
The natural cycle is a treatment similar to conventional
or induced IVF, but without the use of drugs to stimulate the ovaries to produce
multiple eggs. Sometimes a small amount of medication is used to prevent
ovulation. To monitor the growth of the dominant follicle, patients are
monitored in a natural cycle with transvaginal ultrasounds and blood work,
especially Estradiol (E2). Egg retrieval is performed when the dominant
follicle is found to be of an appropriate size, approximately 18 mm. The
retrieved egg is then fertilized in the laboratory by ICSI, in the same way as
conventional IVF. If an embryo is produced and continues to develop, it is
transferred back to the uterus in the same way as traditional IVF.
In the process of egg collection, it is the collection of
oocytes (egg cells) in the follicle fluids that are aspirated vaginally (the
follicle is inserted and pulled with a needle) from the patient under mild
anesthesia under the microscope in a sterile working cabinet. The oocytes
coming to the laboratory are collected in a way that they remain at body
temperature and taken into the culture fluids and kept for 4 hours until the
denudation process, which will allow the cells around them to be
separated. Egg cells may not emerge from all of the follicles whose eggs
have been collected and whose growth has been observed with ultrasound until
that day. The differences between the number of follicles specified to the
patient during follow-up and the number of eggs collected in the laboratory are
due to this.
Eggs collected in the OPU process are surrounded by
thousands of cumulus cells, defined as COC, that support the development and
vitality of the egg during the development phase and the process until
fertilization. If microinjection (ICSI) is planned, the cumulus cells are
separated from the egg by a process called denudation in order to identify
mature eggs and egg qualities. In the microscopic evaluation, mature and
immature eggs are detected, taken into culture fluids where they will be kept
until microinjection process and removed to incubators that provide the necessary
environmental conditions. Only cells that have matured (Metaphase 2 – M2)
are processed from the collected eggs. For this reason, every collected
egg cell cannot be treated.
Sperm preparation methods are of great importance for the
rapid and effective removal of sperm cells in the ejaculate from seminal
plasma. The separation of the spermatozoa from the seminal plasma is a
prerequisite for the acrosomal reaction required for capacitation and
fertilization. Prolonged exposure of spermatozoon to seminal plasma
adversely affects mobility and viability and significantly increases the amount
of DNA fragmentation. For this reason, purification of sperm cells from
seminal plasma as soon as possible is important in the success of IVF
treatment. Sperm washing method should basically provide the following
principles;
– Motile sperm should be isolated as much as possible,
– Damages that would disrupt the physiology of sperm cells should not be done,
–
Remove dead cells, inactive sperm cells, bacteria and leukocytes from the
environment, – Remove toxic and bioactive substances such as
decapacitation factors or ROS from the environment,
Sperm preparation techniques
It should always be taken into account that the most important prerequisite of
the Swim-up Method is number and mobility. In this application, it is
ensured that the spermatozoa with progressive motility are separated from the
washed pellet and float into fresh culture medium. As the total
progressive (forward motile) sperm count increases in the sample, the
incubation time decreases.
Density gradient method is a method that makes separation
depending on the density and motility of the sperm. Although it can be
applied to all ejaculate samples, it can be applied successfully and
effectively especially in the samples of TESE, low motility and SHOAT (severe
oligoastenoteratozoospermia) cases. Thanks to this method, spermatozoa,
which are mobile and morphologically normal, can easily pass through the
particles forming the gradient after centrifugation and are collected at the
bottom of the tube as pellets.
The microchip is a unique device used to select sperm
with good quality genetics to fertilize an egg in IVF. Microchip
technology is one of the currently accepted sperm selection methods in in vitro
fertilization treatments. Compared to other sperm selection methods,
microchip is a more natural method because it mimics normal
physiology. Micro canals in a special solution are an environment close to
nature, suitable for selecting the best quality sperm to fertilize the
egg. With the microchip method, it is ensured that the healthiest and best
quality sperm are distinguished from weak sperm. Microchips consist of
micro canals. Micro channels also
help select good quality sperm. With this method, unhealthy
sperms with damaged DNA are collected in one section.
In the other section, good quality and undamaged healthy sperm
are collected by passing through micro channels, passing through many
obstacles as if competing to reach the egg in a natural
environment . Therefore, higher pregnancy results are
obtained with embryos created from healthy sperm .
It is predicted that the success rate is high in studies
conducted with the microchip method. In this method, the highest quality
sperm with the healthiest DNA is selected among the sperms thanks to
micro-fluid chips. Even if there is a small damage in the DNA, the sperms
are separated as poor quality and quality sperm is not allowed to pass into the
canal where they are collected. In this way, the
probability of choosing the most suitable sperm for
fertilization increases.
Ota Medical Center and Jinemed Hospital, two reputable health institutions of Beşiktaş, joined their forces under the name of “OTA & Jinemed Hospital”. The hospital experience of Fulya Jinemed, where customer satisfaction and quality standards are prioritized, are combined with OTA’s wide polyclinic network and the advantage of serving patients with SGK assurance. In our hospital, which has an agreement with SGK and all private health insurances, the number of branches that provide polyclinic service has increased with this merger, and many new specialist doctors have joined our staff.
OTA & Jinemed Hospital, which has developed pioneering practices in its sector by adopting the philosophy of “Evidence-Based Medicine” as a principle with its preventive medicine practices and comfortable hospital, aims to bring patients from all segments of the society together with high quality health services. In our center, we work with a service philosophy that cares about your health as much as you, with our specialist doctors, professional team and modern diagnostic methods.
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