iakentro advanced medical center
DESCRIPTION
IAKENTRO ADVANCED MEDICAL CENTER. NIKOS PRAPAS ASSOCIATE PROFESSOR ARISTOTELES UNIVERSITY OF THESSALONIKI. IAKENTRO ADVANCED MEDICAL CENTER. OUR TEAM. 4 gynecologists 5 embryologists, 4 laboratory technicians, 1 geneticist, 1 molecular biologist - PowerPoint PPT PresentationTRANSCRIPT
IAKENTRO ADVANCED MEDICAL CENTER
NIKOS PRAPASASSOCIATE PROFESSOR
ARISTOTELES UNIVERSITY OF THESSALONIKI
IAKENTROADVANCED MEDICAL CENTER
OUR TEAM
IVF
MOLECULAR AND GENETICS LABORATORY
MATERNAL - FETAL MEDICINE
REPRODUCTIVE SYSTEM SURGERY - HYSTEROSCOPY/LAPAROSCOPY
DEPARTMENTS
Intra Uterine InseminationSperm Diagram - Sperm Enrichment
In Vitro Fertilization IVF-ICSIMale Infertility Treatment FNA-TESE
In Vitro Maturation IVM
Oocyte DonationSperm DonationEmbryo 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 – VitrificationOocyte 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 lossIn 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 miscarriagesWhen the candidate mother is over 36 yearsWhere there is a history of multiple IVF failuresWhen the couple demonstrate chromosomal abnormalities When there is already one child with a genetic syndrome, which can be diagnosed in laboratoryWhen there is family history of cerebral damage or abnormal development.
PREIMPLANTATION GENETIC SCREENING - DIAGNOSIS
High Security Vitrification
ASEPTIC COOLINGASEPTIC COOLING
1750°C/min1750°C/min
EMBRYOSEMBRYOS
LOADINGLOADING
THERMOSEALINGTHERMOSEALING
High Security Vitrification
85% SURVIVAL RATE AFTER WARMING
65% PREGNANCY RATE (BLASTOCYSTS)
Why consider IVM, when we have the establish IVF
Safe for the patientRisk of OHSS is eliminated
CheapFor 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 weekIVM 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 12 144
US US OPU IVF/ ICSI
ET
17-estradiol 6 mg17-estradiol 6 mg
progesterone 600 mgprogesterone 600 mg
WhenFSH 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 criteriaAge 18-35
Normal ovulatory cycles (26 – 35 days)
BMI between 18-30 kg/m2, kg x kg/height
No endocrine abnormalities
Maximum 3 previously failed IVF cycles
Cause of infertilityPCO & PCOS
Male
Tubal
Unexplained
IAKENTRO Advanced Medical Center
Agiou Vasiliou 4, Thessaloniki 54250, GreeceTel : +30 2310 325525
Fax : +30 2310 325765 [email protected]
www.iakentro.gr