Iakentroivf

596 views

Published on

Published in: Health & Medicine
  • Be the first to comment

  • Be the first to like this

Iakentroivf

  1. 1. IAKENTRO ADVANCED MEDICAL CENTER NIKOS PRAPAS ASSOCIATE PROFESSOR ARISTOTELES UNIVERSITY OF THESSALONIKI
  2. 2. IAKENTRO ADVANCED MEDICAL CENTER
  3. 3. OUR TEAM
  4. 4. IVF MOLECULAR AND GENETICS LABORATORY MATERNAL - FETAL MEDICINE REPRODUCTIVE SYSTEM SURGERY - HYSTEROSCOPY/LAPAROSCOPY DEPARTMENTS
  5. 5. <ul><li>Intra Uterine Insemination </li></ul><ul><li>Sperm Diagram - Sperm Enrichment </li></ul><ul><li>In Vitro Fertilization IVF-ICSI </li></ul><ul><li>Male Infertility Treatment FNA-TESE </li></ul><ul><li>In Vitro Maturation IVM </li></ul><ul><li>Oocyte Donation </li></ul><ul><li>Sperm Donation </li></ul><ul><li>Embryo Donation </li></ul><ul><li>Surrogacy </li></ul>IVF
  6. 7. <ul><li>SPECIALISED EMBRYOLOGICAL LABORATORY TECHNIQUES </li></ul><ul><li>Assisted Hatching </li></ul><ul><li>Blastocyst Embryo Transfer </li></ul><ul><li>Biochemical Embryo Assessment (sHLA-g) </li></ul><ul><li>Single Embryo Transfer (SET) </li></ul><ul><li>Sperm Cryopreservation - Sperm Bank </li></ul><ul><li>Ovarian Tissue Cryopreservation </li></ul>
  7. 8. Sperm DNA Analysis (DNA Fragmentation – FISH) Preimplantation Genetic Diagnosis (PGS-PGD) Embryo Cryopreservation – Vitrification Oocyte Cryopreservation- Vitrification (Fertility Preservation) In Vitro Maturation
  8. 9. SPERM DNA FRAGMENTATION <ul><li>Examination for the existence of damage to the sperm genetic material (DNA fragmentation) is recommended: </li></ul><ul><li>For couples with more than 3 successive IVF failures </li></ul><ul><li>In cases of IVF where interruption of embryo development is observed in the first days after fertilization </li></ul><ul><li>In cases of recurrent pregnancy loss </li></ul><ul><li>In cases of unexplained infertility </li></ul>
  9. 10. <ul><li>Pre implantation genetic diagnosis is a relatively new technique that detects genetic and chromosomal abnormalities in IVF embryos before embryo transfer. </li></ul><ul><li>PGD is recommended: </li></ul><ul><li>In case of multiple first trimester miscarriages </li></ul><ul><li>When the candidate mother is over 36 years </li></ul><ul><li>Where there is a history of multiple IVF failures </li></ul><ul><li>When the couple demonstrate chromosomal abnormalities </li></ul><ul><li>When there is already one child with a genetic syndrome, which can be diagnosed in laboratory </li></ul><ul><li>When there is family history of cerebral damage or abnormal development. </li></ul>P REIMPLANTATION G ENETIC S CREENING - D IAGNOSIS
  10. 11. H igh S ecurity V itrification ASEPTIC COOLING 1750°C/min EMBRYOS LOADING THERMOSEALING
  11. 12. H igh S ecurity V itrification <ul><li>85% SURVIVAL RATE AFTER WARMING </li></ul><ul><li>65% PREGNANCY RATE (BLASTOCYSTS) </li></ul>
  12. 13. <ul><li>Why consider IVM, when we have the establish IVF </li></ul><ul><ul><li>Safe for the patient </li></ul></ul><ul><ul><ul><li>Risk of OHSS is eliminated </li></ul></ul></ul><ul><ul><li>Cheap </li></ul></ul><ul><ul><ul><li>For the patient (minus hormone) </li></ul></ul></ul><ul><ul><ul><li>For the IVF clinic (visit frequency) </li></ul></ul></ul><ul><ul><ul><li>For the society (hospitalization, twins) </li></ul></ul></ul><ul><ul><li>First line therapy (before IVF treatment) </li></ul></ul><ul><ul><li>Short cycle </li></ul></ul><ul><ul><ul><li>IVF 7-8 week </li></ul></ul></ul><ul><ul><ul><li>IVM 3½ week </li></ul></ul></ul><ul><ul><li>Ethical point of view </li></ul></ul><ul><ul><ul><li>If male factor, IVM treat “her” fairly </li></ul></ul></ul>IVM....Why?
  13. 14. Traditional IVF Down regulation Daily hormone injection hCG injection Emotional stress Long treatment, 4-8 weeks Potential side effects, OHSS IVM....Why? <ul><li>IVM </li></ul><ul><li>No down regulation </li></ul><ul><li>No hormone injections or only </li></ul><ul><li>for 3 days </li></ul><ul><li>No hCG injection </li></ul><ul><li>Reduced interference with daily </li></ul><ul><li>life </li></ul><ul><li>Reduced treatment time, 2 weeks </li></ul><ul><li>Not reported any side effects </li></ul>
  14. 15. CD 1 3 6 8 9 10 12 14 4 US US OPU IVF/ ICSI ET 17-estradiol 6 mg progesterone 600 mg
  15. 16. 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
  16. 17. Recommended Criteria IVM <ul><li>Inclusion criteria </li></ul><ul><ul><li>Age 18-35 </li></ul></ul><ul><ul><li>Normal ovulatory cycles (26 – 35 days) </li></ul></ul><ul><ul><li>BMI between 18-30 kg/m 2 , kg x kg/height </li></ul></ul><ul><ul><li>No endocrine abnormalities </li></ul></ul><ul><ul><li>Maximum 3 previously failed IVF cycles </li></ul></ul><ul><ul><li>Cause of infertility </li></ul></ul><ul><ul><ul><li>PCO & PCOS </li></ul></ul></ul><ul><ul><ul><li>Male </li></ul></ul></ul><ul><ul><ul><li>Tubal </li></ul></ul></ul><ul><ul><ul><li>Unexplained </li></ul></ul></ul>
  17. 18. IAKENTRO Advanced Medical Center Agiou Vasiliou 4, Thessaloniki 54250, Greece Tel  : +30 2310 325525 Fax : +30 2310 325765 info@iakentro.gr www.iakentro.gr

×