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The methods and applications of IVF treatment are developing day by day with the technology that continues to develop. The accepted technique, which is one of the new methods for now, is the dynamic tracking of embryos.
The age of the woman is a very important factor in IVF treatment. If the CV and family history of the couple, whose age is younger than 35, does not have any risk regarding this issue, if pregnancy cannot be achieved even after 1 year of unprotected and regular sexual intercourse, a doctor should be consulted without delay. Under the same conditions, if the woman is older than 35, 6 months, if she is older than 38 and has had chemotherapy or any surgery related to the ovaries that may adversely affect her ovaries, and if the man has a history of chemotherapy or surgery that will adversely affect sperm values, couples should seek medical advice as soon as possible. must go.
Infertility research is carried out simultaneously with the couples. The basic tests applied in the first step are;
For infertility, some patients require reproductive aid, such as ovulation stimulation or vaccination , prior to vaccination. If only these methods fail in this group of patients, the step of in vitro fertilization treatment is started. But in a certain group of patients, the success rate of different treatment methods is negligible or nonexistent. In this patient group, IVF treatment is mostly performed as the first choice.
The methods and applications of IVF treatment are developing day by day with the technology that continues to develop. The accepted technique, which is one of the new methods for now, is the dynamic tracking of embryos. (Embryoscope) After that, the embryos are examined not with the images in a limited time period as long as they are followed, but with the videos that come out with the combination of the images taken from 7 different regions every 15 minutes to 20 minutes. The quality of the embryos is determined within the scope of these data. This means that from now on we have much more information about the development of embryos. We have been able to collect so much data on the development of the embryo for the first time since the first in vitro fertilization practices, and this information we have is very valuable.
How much does the chance of success increase with innovations? In order to get a clear answer to this question, it is necessary to wait a little longer. It should be noted that the dynamic monitoring method offered for embryo selection really increases the success rate.
Embryos, which increase the amount of cells by developing for days, divide into two different cell types after 5 days and store a kind of fluid among themselves. These embryos are called ' Blastocysts '. However, not every embryo can continue its development until it reaches this step. In a shorter time than this period, its development stops. Only if the sperm that creates that embryo is not of very low egg quality, the embryo continues to develop.
Observed studies have shown that even embryos that have reached the blastocyst stage contain too few high-quality cells in some of them to allow pregnancy to occur or to continue the pregnancy. However, this rate is much less than those that stop their development in the early period. As a result of this situation; Transferring a blastocyst to a patient means increasing the likelihood of pregnancy. The fewer embryos transferred to the patient, the greater the chance of pregnancy by transferring a blastocyst. For this reason, the application of blastocyst transfer has a successful effect in cases where the amount of transfer is reduced. For example, the regulation that started to be implemented in Turkey 2 years ago has limited the number of embryos transplanted. As a result of this practice, multiple pregnancies resulting from IVF have significantly decreased. This new situation has led some clinics to increase the number of blastocyst transplants.
If the required number and quality of blastocyst is obtained from the patient, it will be more beneficial to turn to reasons other than the embryo as the reason for the failure of the applied treatments.
The real quality of the sperm, as we have just stated, is related to its hereditary structure and to what extent this structure is affected by environmental factors. It doesn't just mean its shape, structure and mobility. Now, when sperm analysis is done, it is tried to understand the real quality of the embryo that will affect its development. At this point, the most important issue is to select the sperms whose hereditary characteristics are damaged to the least level, and if possible not damaged at all, and to be able to combine them with the egg cell.
Sperm cell selection at high magnification (IMSI), selection of the head region to bind or not to certain molecules (PICSI or MACS-like methods) are used for this purpose. Unfortunately, the validity of these selection methods has not been proven fully and with the most accurate scientific methods for now. For this reason, more time is needed. However, there are many centers that use such innovations to increase the likelihood of patients becoming pregnant.
The first of the moments when genetic studies are clearly needed are the situations in which the responsible chromosome or gene region is known, inherited in the family, which can be transmitted to the baby to be born. This region or chromosomes are examined on the embryos, and embryos that are not diseased are transferred. Another situation is repeated pregnancy losses. This means successive miscarriages or failures to conceive. In both cases mentioned, at times, genetically defective embryos may be the root of the problem. For this reason, just before the couples start in vitro fertilization treatment, detailed analyzes should be made and other reasons that may cause the same problem should be excluded, apart from the genetic problems of the embryos.
This rate is around 30%. The main value that concerns patients should also be the latter.
As a result of not achieving the desired success in 3 trials, unfortunately, the probability of catching pregnancy for families does not increase much. Before embryo transfer, combined applications such as genetic research, creation of artificial womb under laboratory conditions, changes in sperm selection methods are performed. However, as a result of these techniques, there is currently no sufficient proof that the success has increased significantly.
Currently, 2 different freezing methods are used. These are slow and fast freezing techniques. While the use of the slow freezing method was more popular until 5 years ago, the fast freezing method is more preferred today. The reason for this is that with this technique, the chance of maintaining the vitality of all embryos, that is, all cells, without any damage, is higher than with the other method. In this case, it directly affects the success rates.
The impressions taken from the couples who applied for the freezing technique are related to their approach to the freezing and thawing processes a little shyly. However, the future of IVF is hidden in these freezing and thawing processes. Apart from this, another advantage of freezing treatments is that the drugs used in treatments that stimulate the ovaries in some cases enlarge the eggs and damage the embryo accepting mechanism in the uterine tissue. However, in freezing treatments, while the uterine tissue is not damaged, the mechanism that accepts the embryo remains undamaged.
In short, freezing techniques have an important place in the overall success rates of the centers.
The IVF trial varies according to the couples and their situations. There is no exact amount of the number of trials. In other words, it cannot be done after 3 or 5 attempts, there is no rule saying that pregnancy cannot be achieved even if it is done. However, on average, it should be tried at most 3 times. Statistically, 95% of mother and father candidates who apply for IVF treatment should repeat the treatment 3 times. For the remaining 5%, no limit is required. A couple who conceived by applying to an IVF center had between 15 and 18 trials outside before getting pregnant. This aforementioned couple is located between the 5% segment we just mentioned. However, scientific publications show that 95% of couples who apply IVF significantly lose the possibility of getting pregnant after the first 3 attempts.
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