Drug-free IVF (in-vitro maturation)

Today, in order to increase the chance of success in in vitro fertilization, a large number of oocytes (eggs) are obtained, and it is tried to develop a large number of eggs with drugs that increase ovulation, which we call gonadotropin for controlled ovarian hyperstimulation (KOH) performed for this purpose. This increases the risk of ovarian hyperstimulation syndrome (OHSS). Especially in cases with polycystic ovary syndrome, the risk of developing a potentially life-threatening (OHSS) development with excessive response to gonadotropin drugs is very high. The feared risk of developing OHSS was eliminated with the IVM method, which was first used in these PCOS cases and gave the opportunity to perform in vitro fertilization treatment without the use of drugs. The IVM method, which was first introduced in the late 1990s; immature eggs that are developed and collected without using any drugs or after a short-term drug use, (in-vitro)after ripening (maturation) It is based on transferring by fertilization. Because; in public Drug-Free IVF Treatment-Maturation of Eggs in a Laboratory Environment”is referred to as.

Since drugs are not used in IVM applications, undesirable side effects such as weight gain, irritability, nausea, bloating, tightness in the breasts, and vomiting are not observed due to these drugs. Not using drugs also reduces the cost of treatment. The IVM method, which has these advantages, also has disadvantages. Embryos obtained in routine IVF applications are healthier than embryos obtained from lab-ripened eggs in IVM applications. There are many reasons for this. To summarize, different protocols are applied in the IVM procedure than in routine IVF applications. The mediums used are specific to the IVM method, prepared in the center that performs the procedure, are not standardized and have potential problems. Again, although the egg collection (OPU) process in in vitro fertilization applications is standardized, the egg collection process in IVM applications requires more specialized equipment, protocol and experience since the eggs are not matured yet. For these reasons, pregnancy rates in IVM applications that cannot be standardized and are in search of continuous improvement are lower than the pregnancy rates in routine IVF treatment with drugs. The fact that the IVM method has not become widespread is probably due to these reasons. It is hoped that this disadvantage will be overcome with the development of new mediums.

IVM process; It is still early for its routine application in this patient group, as there is not enough scientific information to make the final decision about its use in cases with failed IVF or insufficient ovarian reserve. Since the ovarian-ovarian tissue of the person may be damaged due to therapeutic radiotherapy and chemotherapy applications in cancer cases, the IVM method can also be used to freeze and store early stage egg cells, which we call primordial follicles, to be taken from the ovarian tissue before these treatments. The tissue samples taken are stored by freezing and after the necessary treatments are applied to the patient, the frozen material can be thawed and fertilized after maturation with the IVM process. Since the desired egg quality has not been reached after the thawing process, these applications have not entered into the routine. Therefore, the IVM method nowadays; it is routinely used in the clinic only in the PCOS patient group.

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