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IVF EXPERIENCE IN GREECE

Explore the bioethical challenges faced in Greece during the early stages of IVF and how legislation has evolved. Learn about the IVF experience in Thessaloniki and Athens, including success rates and available techniques.

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IVF EXPERIENCE IN GREECE

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  1. IVF EXPERIENCE IN GREECE Thessaloniki Athens Nikos Prapas Associate Professor Ob/Gyn Aristotle University of Thessaloniki

  2. BIOETHICAL PROBLEMS From1987, when the first IVF child was born, until 2002 the Greek legislation regarding bioethics, didn’t exist. Therefore all IVF centers decided by themselves as far as bioethics was concerned.

  3. The law determines the following: • The child’s sex selection is permitted only in hereditary diseases’ cases. • IVF procedure is allowed for non-married woman who lives with her partner. The consent of the two parts is not valid in case one of the two parts dies before the transfer. • The uterus donation is allowed only in case the two women live in Greece. • The embryo freezing is permited for a duration of 5 years maximum. After this time, the embryos can be donated or discarded. • In case a third person participate in IVF procedure, any access on his personal file is forbidden with an exception in hereditary deseases’ cases. • Assisted reproduction is allowed in women until the age of 50 • Reproductive cloning is forbidden.

  4. Thessaloniki Athens Today in Greece approx 12.000 IVF cycles per year take place in 52 assisted reproduction centres, that are mainly located in Athens and Thessaloniki. Regarding the insurance system the medication is covered approx. by 75 %, The medical IVF procedure is covered approx. by 20%.

  5. Gynecologists Nikos Prapas YannisPrapas MichalisBiliounis Biologists YannisPanagiotidis LiaKasapi Genetist-Microbiologist Stella Prapa Coordinator TriadaBouloukoudis

  6. The evolution of our group followed the international growing of assisted reproduction. Therefore from the 126 IVF cycles in 1987 we reached 1300 this year.

  7. Results’ evolution

  8. Results 2006

  9. Laboratory techniques • Hatching • Coculture • Vitrification • PGD

  10. Embryo Transfer • Measurements of the uterus cavity • 2-3 embryos • Full bladder • The transfer is done under ultrasonography control

  11. Since 1989 we started an oocyte donation program. In the last 6 years couples from other countries (Turkey, France, etc...), where the legislation prohibits or distructs the oocyte donation, participate in this program.

  12. Neccessary exams for the donors • Blood groups – Rhésus • Caryotype • Hépatites B&C, HIV • Electrophoresis of hemoglobin • Mycoplasma, Chlamydia, CMV, Toxoplasma, Listeria, • VDRL • Cystic fibrosis

  13. Necessary exams for IVF • Blood group - Rhésus • General blood and urine test • HIV • Hepatitis B&C • Immune control (Test for the presense of antibodies for CMV, mycoplasma, toxoplasma and listeria ) • Hysterosalpingography • Hysteroscopy

  14. Causes of failure The administration of progesterone independently from the day of pick-up. Lack of hysterosalpingography Endometrium < 8mm Cervical stenosis Women with polyps or endometrium symphyses which have not been treated with hysteroscopy.

  15. The evolution of assisted reproduction in Greece follows the international trend. We are certainly very priviledged that the legislation regarding bioethics is very liberal, and we can use all the proposed techniques in order to increase the success of assisted reproduction.

  16. The research in biology and endocrinology resulted in the evolution of culture and freezing media which contributed to the increase of pregnancy rates and the decrease of the number of embryos transferred per cycle.

  17. Thank You

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