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Iakentroivf Iakentroivf Presentation Transcript

  • IAKENTRO ADVANCED MEDICAL CENTER NIKOS PRAPAS ASSOCIATE PROFESSOR ARISTOTELES UNIVERSITY OF THESSALONIKI
  • IAKENTRO ADVANCED MEDICAL CENTER
  • OUR TEAM
  • IVF MOLECULAR AND GENETICS LABORATORY MATERNAL - FETAL MEDICINE REPRODUCTIVE SYSTEM SURGERY - HYSTEROSCOPY/LAPAROSCOPY DEPARTMENTS
    • Intra Uterine Insemination
    • Sperm Diagram - Sperm Enrichment
    • In Vitro Fertilization IVF-ICSI
    • Male Infertility Treatment FNA-TESE
    • In Vitro Maturation IVM
    • Oocyte Donation
    • Sperm Donation
    • Embryo Donation
    • Surrogacy
    IVF
  •  
    • SPECIALISED EMBRYOLOGICAL LABORATORY TECHNIQUES
    • Assisted Hatching
    • Blastocyst Embryo Transfer
    • Biochemical Embryo Assessment (sHLA-g)
    • Single Embryo Transfer (SET)
    • Sperm Cryopreservation - Sperm Bank
    • Ovarian Tissue Cryopreservation
  • Sperm DNA Analysis (DNA Fragmentation – FISH) Preimplantation Genetic Diagnosis (PGS-PGD) Embryo Cryopreservation – Vitrification Oocyte Cryopreservation- Vitrification (Fertility Preservation) In Vitro Maturation
  • SPERM DNA FRAGMENTATION
    • Examination for the existence of damage to the sperm genetic material (DNA fragmentation) is recommended:
    • For couples with more than 3 successive IVF failures
    • In cases of IVF where interruption of embryo development is observed in the first days after fertilization
    • In cases of recurrent pregnancy loss
    • In cases of unexplained infertility
    • Pre implantation genetic diagnosis is a relatively new technique that detects genetic and chromosomal abnormalities in IVF embryos before embryo transfer.
    • PGD is recommended:
    • In case of multiple first trimester miscarriages
    • When the candidate mother is over 36 years
    • Where there is a history of multiple IVF failures
    • When the couple demonstrate chromosomal abnormalities
    • When there is already one child with a genetic syndrome, which can be diagnosed in laboratory
    • When there is family history of cerebral damage or abnormal development.
    P REIMPLANTATION G ENETIC S CREENING - D IAGNOSIS
  • H igh S ecurity V itrification ASEPTIC COOLING 1750°C/min EMBRYOS LOADING THERMOSEALING
  • H igh S ecurity V itrification
    • 85% SURVIVAL RATE AFTER WARMING
    • 65% PREGNANCY RATE (BLASTOCYSTS)
    • Why consider IVM, when we have the establish IVF
      • Safe for the patient
        • Risk of OHSS is eliminated
      • Cheap
        • For the patient (minus hormone)
        • For the IVF clinic (visit frequency)
        • For the society (hospitalization, twins)
      • First line therapy (before IVF treatment)
      • Short cycle
        • IVF 7-8 week
        • IVM 3½ week
      • Ethical point of view
        • If male factor, IVM treat “her” fairly
    IVM....Why?
  • Traditional IVF Down regulation Daily hormone injection hCG injection Emotional stress Long treatment, 4-8 weeks Potential side effects, OHSS IVM....Why?
    • IVM
    • No down regulation
    • No hormone injections or only
    • for 3 days
    • No hCG injection
    • Reduced interference with daily
    • life
    • Reduced treatment time, 2 weeks
    • Not reported any side effects
  • CD 1 3 6 8 9 10 12 14 4 US US OPU IVF/ ICSI ET 17-estradiol 6 mg progesterone 600 mg
  • When FSH priming Cycle day 3 US Start on FSH FSH for 3 days Blood sample Cycle day 6 US Cycle day 8 or 9 US Oocyte pick-up Oestradiol, 6mg Progesterone, 600mg Day - 1 Day 0 Day 1 Day 2 or day 3 Cycle day 7 US
  • Recommended Criteria IVM
    • Inclusion criteria
      • Age 18-35
      • Normal ovulatory cycles (26 – 35 days)
      • BMI between 18-30 kg/m 2 , kg x kg/height
      • No endocrine abnormalities
      • Maximum 3 previously failed IVF cycles
      • Cause of infertility
        • PCO & PCOS
        • Male
        • Tubal
        • Unexplained
  • IAKENTRO Advanced Medical Center Agiou Vasiliou 4, Thessaloniki 54250, Greece Tel  : +30 2310 325525 Fax : +30 2310 325765 info@iakentro.gr www.iakentro.gr