You have undergone all the tests for becoming a parent and you have decided to go with in-vitro fertilization per your doctor’s recommendation. Currently there are new methods to increase your chances of becoming pregnant with this treatment plan.
The factors that impact chances of pregnancy in the in-vitro fertilization method are indicated to be the woman’s age, her egg reserves and quality and the number and quality of the man’s sperm. The main objective of in-vitro fertilization, taking into account these factors can be summarized as “transferring the best embryo, which is achieved by uniting the best quality egg and sperm, into the mother’s womb at the best time”. The microinjection that is applied to achieve this objective, selecting the best embryo from the embryos that are extracted in this process and transferring it to the patient all require a good team and excellent teamwork. There are also other factors that increase the success of in-vitro fertilization in modern day medicine. Acibadem Kadıköy Hospital, In-Vitro Fertilization Center Director and Obstetrician, Prof. Dr. Tayfun Bağış provided information on such techniques from the special devices developed to select quality embryos from genetic diagnosis methods.
This method is used in in-vitro fertilization treatments, particularly in cases where several unsuccessful attempts have occurred (especially in cases where the failure is due to the embryo being unable to latch onto the uterine wall). In this method the membrane surrounding the embryo is cut or made thinner in order to increase the probability of it latching onto the uterine wall.
Embryo biopsy (PGT – pre-implantation genetic testing)
The advances in genetic diagnosis provide a vital service, especially to families who have decided to have in-vitro fertilization, but a genetic disease exists in their family history. With the guidance of a specialist, nearly 20 genetic disorders like Mediterranean anemia, sickle cell anemia, hemophilia A and B and phenylketonuria can be genetically diagnosed from an embryo. In cases where genetic testing is recommended, the process is performed on three-day-old embryos to assist in selecting the best quality embryos that do not carry this genetic coding. Also, in situations where parents wish to choose a sex for their baby and carry out histocompatibility of a sibling (like for transferring tissue in the case of leukemia, etc.) pre-implantation genetic testing can be carried out.
(Intracytoplasmic Morphologically Selected Sperm Injection)
Microscopes are critical in the selection of healthy sperm. In the old methods, microscopes that could enlarge up to 400 times were used but the ‘IMSI’ magnifies sperm 8000 times to make the process easier for specialists.
Metabolomix selects the best embryo
The process to select the best embryo, from among the embryos that have been extracted by the microinjection method and grown in a setting similar to a uterus (incubator) had been done by observation until recently. The newly developed metabolomics method selects the embryo itself based on nearly 25 thousand items of data to increase the chance of pregnancy.
(Cleaning out of residual particles)
Defragmentation is done when the embryo is three days old. In situations where there are excessive amounts of cell matter within the embryo, a pipette is used to clean some of these out and extract them to help the cell develop.
Co-culture is another method that is used in cases where several unsuccessful consecutive attempts have occurred. Prior to starting the in-vitro fertilization treatment, cells are extracted from the woman’s uterus and reproduced in a laboratory over a period of one month. The harvested embryos are developed in this prepared setting to increase the chance of the embryo attaching itself.
New regulations have placed some serious restrictions on embryos that are to be transferred to patients. (According to the regulation, only a single embryo can be transferred during in-vitro fertilization to women under 35 years of age.) This method freezes the other good quality embryos of the patient so that they can be transferred within 5 years if they wish. Also if the first embryo transfer is unsuccessful a previously frozen embryo can be transferred to the uterus a few months later without having to go through the whole extraction procedure again.
“In-vitro fertilization is a process that requires expertise and teamwork”
Prof. Dr. Tayfun Bağış: “In-vitro fertilization is a process completely reliant on teamwork and expertise. In this team, the doctor determines the treatment protocol, monitors the patient and harvests the patient’s eggs. After these stages the embryologist takes over to carry out the process of uniting the sperm and the egg. Critical issues like performing the microinjection procedure, the process of keeping the embryos alive and deciding when they are to be given are the answers to why working with an embryologist is so important. Storing, monitoring, checking, carrying out the necessary laboratory procedures, selection and deciding when to transfer the embryo are all processes that fall into the field of an embryologist and are just as important as fertilization.”..