PGD (Pre-implantation Genetic Diagnostic)
PREIMPLANTATION GENETIC DIAGNOSIS
In recent years, developments in genetics allow genetic analysis to be carried out on embryos developed in vitro by in vitro fertilization ethods and the placement of selected healthy embryos in the uterus of the mother before pregnancy occurs. This method is called pre- regnancy genetic diagnosis (Preimplantation Genetic Diagnosis-PGD).
One of the most important application areas of the PGT technique embryos that do not have a genetic disease but may not have a genetic disorder in their chromosomes.
These disorders are more common in women of advanced age (35 years and older). This situation may result in infertility as it both reduces the chance of attachment of the embryo (implantation) and may cause unwanted abortions. As a matter of fact, 40 out of every 100 pregnancies in women aged 39 and over have problems that occur due to a numerical chromosomal disorder
The aim of PGD is to increase implantation rates, reduce spontaneous abortions and increase healthy baby birth rates by selecting hromosomally normal embryos. Indeed, the miscarriage rate, which can reach up to 23 percent in normal pregnancy due to chromosomal disorders, may decrease to 9 percent after PGD.
Pre-pregnancy genetic diagnosis is performed by taking 1 or 2 cells from embryos developed as a result of fertilization of egg and sperm cells obtained from mother and father candidates in laboratory environment. Special methods called Fluorescence In Situ Hybridization (FISH), Microarray-based comparative genomic hybridization (aCGH) or Polymerase Chain Reaction (PCR) are used for genetic diagnosis. Diagnosis of numerical chromosomal disorders such as monosomy or trisomy (Down syndrome and other trisomies) and single gene diseases (such as hemophilia, Mediterranean anemia, cystic fibrosis, muscular dystrophies) in the baby to be born is possible with PGD. Thus, healthy babies are born by transferring disease-free, healthy embryos to the expectant mother.
DIAGNOSIS BEFORE PREGNANCY
- In couples with a genetic or hereditary disease carrier,
- In couples who have a child or children with a previous genetic disease,
- For the purpose of HLA genotyping (tissue typing),
- In the identification of diseases showing genetic predisposition (tendency)
- Women in the advanced age group (37 years and over) who have been accepted for assisted reproductive techniques,
- In couples with recurrent early pregnancy miscarriages,
- In couples who could not achieve pregnancy with assisted reproductive techniques despite multiple applications or who lost their pregnancy due to miscarriage,
- It is applied in cases of chromosomal disorders or genetic diseases associated with severe male infertility.
HOW IS THE PGT TEST DONE?
- Whether the patient is suitable for PGD is evaluated by the reproductive health specialist, genetic counselor and the doctor of the related disease.
- The couple is prepared for the IVF procedure.
- The egg taken from the mother is fertilized in the laboratory with the sperm taken from the father.
- 1-2 blastomere cells are removed from the obtained embryo by biopsy by embryologists
- Cells obtained by biopsy are prepared and tested according to the method to be applied.
- Embryos with genetic diseases or chromosomal disorders are selected and discarded and healthy embryos are transferred to the mothers womb.
Asisted Hatching
It is a technique developed to increase the rate of attachment of embryos to the uterus. In this technique, puncture the sheath (zona pellucida) surrounding the embryo by laser, acid or mechanical methods opens. This process can also be used prior to the transfer of cryopreserved embryos.
Microchip
In patients with low sperm viability, quantity, number and structural quality, microfluidic technology, also known as the "chip baby method", ensures that the best quality sperm cells are selected by competing with each other in a way similar to the natural environment in the uterus, and ICSI is defined in in vitro fertilization treatment. With the application, it is left into the egg cell by microinjection method.
In this method, sperm cells with the best structural form, genetics and physiology are selected without causing cell damage, since techniques such as centrifugation (settling), vortex (mixing with high vibration) or mixing with a pipette are not applied to the sperm cells, which can physically damage the sperm cells. In classical preparation methods, sperm cells are prepared in a shorter time without being subjected to manipulation by skipping processes such as washing, flotation, gradient (grading), centrifugation (precipitation at high speeds). Thus, the sperm cells with the best DNA quality and physiologically are selected by themselves, and the sperm cells that pass this pre-screening are again screened under the microscope and the sperm cells of excellent quality are used for microinjection.
The above-mentioned classical preparation methods cause sperm cells to undergo respiratory stress, known as oxidative stress, and it has been scientifically proven that this can also cause DNA damage in healthy sperm cells. Better quality embryos are tried to be obtained with sperm cells that have been proven to be of the best quality by scientific data, and thus embryos with the highest potential for implantation (attachment) and development are obtained. The average total mobility in suckling samples taken from male individuals with microchip technology increased by 1.7 times.
The sperm cells obtained by this method were found 3 times faster than the classical preparation methods, and the forward motile sperm cells increased 3.8 times.
WHAT IS MINI IVF? WHO IS APPLIED? WHAT ARE THE MEDICINES USED IN MINI IVF TREATMENT?
Recently, it has been revealed that egg quality obtained from patients with low reserve is lower and genetic problems in the embryo are higher. In this direction, it is aimed to create fewer but better quality embryos by obtaining higher quality eggs with less drugs. Mini IVF appears as a simplified in vitro fertilization practice, unlike the known in vitro fertilization practices performed with daily injections and high-dose drug use. Especially in patients with a low number of eggs or in advanced age, the success rates are higher than conventional treatments. What is mini IVF, who is it applied to and what are the drugs used in its treatment? You can continue reading our article for questions and all the details.
What is mini IVF?
Mini IVF is an in vitro fertilization application that enables the development of fewer but higher quality eggs by using lower doses of drugs. Eggs developed with this method are taken and fertilization is performed by applying the microinjection technique. Embryos formed after fertilization are transferred to the patient, assuming that the probability of attachment is higher.
In addition to the advantages such as less drug use, less cost and less time spent with mini IVF treatment, high success rates can be obtained in patients with a low number of eggs and advancing age.
Who is mini IVF applied to?
In cases where pregnancy does not occur naturally;
Those who want to use hormone drugs less,
At risk of developing OHSS (overstimulation of the ovaries),
Concerned about the daily injection process in IVF treatment,
Those who have problems in the fallopian tubes and are younger than 35 years old,
Having low egg reserve that cannot be increased with treatment,
Looking for a more economical solution than conventional treatment,
People who have tried many times in vitro fertilization but have not achieved a result, and
Mini IVF treatment can be applied to women who want to reduce the possibility of multiple pregnancy.
However, a treatment plan should be made by a specialist by listening to the patient's history of the disease, analyzing their expectations and performing health checks in detail.
What are the drugs used in mini IVF treatment?
Mini IVF treatment is a type of in vitro fertilization that uses little or no medication to increase and develop the number of eggs. In standard IVF treatments, hormone injections are made for 8-10 days to reproduce eggs, while these drugs are not used in the Mini IVF method. Oral tablets and very low dose hormone injections are used instead. With Mini IVF, which is a natural in vitro fertilization method, it is ensured that the highest quality eggs are produced by using the least amount of medication.
Mini IVF method is aimed to obtain better quality eggs with the use of low doses of drugs. At this point, it is possible to determine your treatment plan by consulting your doctor. You can visit our website for more information.
You may be interested in:
