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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
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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 2 coordinators of the gametes donations program
DEPARTMENTS IVFMOLECULAR AND GENETICS LABORATORYMATERNAL - FETAL MEDICINEREPRODUCTIVE SYSTEM SURGERY - HYSTEROSCOPY/LAPAROSCOPY
IVF • Intra Uterine Insemination • Sperm Diagram - Sperm Enrichment • In Vitro Fertilization IVF-ICSI • Male Infertility Treatment FNA-TESE • In Vitro Maturation IVM • Oocyte Donation • Sperm Donation • Embryo Donation • Surrogacy
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 – Vitrification Oocyte 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 loss • In cases of unexplained infertility
Preimplantation Genetic Screening - Diagnosis • 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 miscarriages • When the candidate mother is over 36 years • Where there is a history of multiple IVF failures • When the couple demonstrate chromosomal abnormalities • When there is already one child with a genetic syndrome, which can be diagnosed in laboratory • When there is family history of cerebral damage or abnormal development.
High Security Vitrification EMBRYOS LOADING ASEPTIC COOLING 1750°C/min THERMOSEALING
High Security Vitrification • 85% SURVIVAL RATE AFTER WARMING • 65% PREGNANCY RATE (BLASTOCYSTS)
IVM....Why? Why consider IVM, when we have the establish IVF • Safe for the patient • Risk of OHSS is eliminated • Cheap • For 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 week • IVM 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 • 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
17-estradiol 6 mg progesterone 600 mg CD 1 3 4 6 8 9 10 12 14 IVF/ ICSI US US OPU ET
WhenFSH priming Day - 1 Day 2 or day 3 Day 0 Day 1 Oestradiol, 6mg Progesterone, 600mg Cycle day 3 US Start on FSH FSH for 3 days Blood sample Cycle day 6 US Cycle day 7 US Cycle day 8 or 9 US Oocyte pick-up
Recommended Criteria IVM • Inclusion criteria Age 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 infertility PCO & PCOS Male Tubal Unexplained
IAKENTRO Advanced Medical Center Agiou Vasiliou 4, Thessaloniki 54250, Greece Tel : +30 2310 325525 Fax : +30 2310 325765 info@iakentro.gr www.iakentro.gr