What is the genetically applied in vitro fertilization method? How is it different from the classical IVF method?
The IVF method is not only applied to have children. It is also done in order to obtain a healthy child in those who have recurrent miscarriages, those who have given birth to an unhealthy baby before, and those who have a disease carried by the mother or father. For example, children born with familial Mediterranean anemia are subjected to many methods such as blood transfusions and surgical removal of the spleen since they are born. It is a very common disease especially in the Southern Region of Turkey. In cases where the mother or father living in this region is a carrier, the probability of giving birth to a sick child is 25 percent. If nothing is done, one in four children will become ill. The family can give birth to another child for exchange transfusion and bone marrow transplant to that unhealthy baby, both healthy and firstborn. Another example is that the BRCA gene in women increases the risk of developing breast cancer in the future. The transmission of the BRCA gene to the child can be prevented by in vitro fertilization so that the child to be born does not have breast cancer in the future. Therefore, in the carrier of any disease, geneticists examine the genes that they carry, depending on which genes they carry, and the transmission of these genes to the baby can be prevented. Because giving birth to a healthy baby is paramount. Therefore, in vitro fertilization is a form of treatment that both prevents the transmission of genetic diseases and is used for treatment. In the future, in vitro fertilization will be possible to ensure that even those with a high family history of cancer, heart disease or diabetes do not have these diseases in their children.
How is the genetically applied in vitro fertilization method applied?
Preimplantation genetic diagnosis (genetic applied in vitro fertilization method) applied?
In people who come knowing the name of the disease they have and have undergone genetic examination, normal in vitro fertilization is performed to prevent the transmission of that disease to the baby. Embryos are created in laboratories, the egg and sperm unite, the embryos are followed, and when the stage of transfer to the mother comes, the embryos are biopsied on the 3rd or 5th day, depending on the disease carried. A cell or several cells are taken from the embryo; If the cells have a disease or genetic problems, chromosomal problems carried from the mother or father, it is checked whether they carry them. It is not possible to repair the embryo at this time. After the embryo that does not carry the disease is found, it is transferred to the uterus. When the family becomes pregnant, it gives birth to a healthier baby who does not carry that disease. Thus, the continuation of this disease in future generations is somehow prevented. This is very important for our country. Because, as a Mediterranean country, such diseases are very common. We are also a country with consanguineous marriages. In consanguineous marriages, especially diseases carried in the family cause the emergence of sick children. Often the status of the genes is unknown and the child is lost shortly after birth. However, if a test is done and it is learned due to which genetic problem that child was lost, its recurrence in the future will be prevented. In such cases, there are disease screenings that geneticists do as a package. By applying that test to a woman or a man, it is scanned whether 3-4 thousand diseases are present in that mother-to-be. If a disease occurs, the male is also screened. If the same problem occurs in men, they are told not to get pregnant on their own in the next try. Before we put the baby in the womb, we check whether it carries the disease.
Are Chromosomal Problems !
Apart from diseases, there are also those who have chromosomal problems. Our chromosomes are 46, female's 46 + XX, male 46+XY. But we are not always born like this. There are cases where the chromosomes break off and stick somewhere. There may be breaks in the chromosomes. When they have children, they come up with recurrent miscarriages when the irregular chromosome structures are transmitted to the baby. Because when the baby is unhealthy, the body does not accept it and throws it away somehow. Pregnancy loss occurs in the first months. Here, before putting the baby in the uterus, we check whether the chromosome structure and number are normal, and we find a solution for those who have recurrent miscarriages, since we put the healthy baby in the uterus.
What Causes Baby Loss?
To what extent does the chance of success in pregnancy increase in women with recurrent miscarriages thanks to preimplantation genetic diagnosis?
There are 2 reasons for the loss of a baby. If we accept the womb as soil; a seed has not grown in a soil. Then either there is a problem in the soil, that is, in the womb that feeds the baby, it could not feed the baby; Or there is a problem with the seed itself. The cause should be thoroughly investigated.
In case of pregnancy loss, we always recommend that in cases where a 6-7-8-week-old baby does not grow in the womb, it should be taken for future periods and examined genetically, not pathologically. If genetics is sent and it is determined that the baby has a chromosomal problem, it is understood that the miscarriage is not related to the uterus. But if there is no chromosomal problem, if it is healthy but has not grown, it is necessary to find the problem that prevents the baby from growing in the womb. Broken tubes, large fibroids that affect the inside of the uterus, or large polyps can somehow prevent the baby from growing.
Uterine deformities can also cause miscarriage. Therefore, regardless of the cause, if there is a problem in the uterus, the uterus is repaired; If a problem is found in the baby, then it is checked whether the baby is healthy before putting it into the womb, and in this way the occurrence of miscarriages is prevented.'
Is genetic screening done to ensure that pregnancies of older women also result in a healthy baby?
This is a much discussed topic. Because genetic testing also has disadvantages. If genetic testing is to be done, it is necessary to wait for the baby from the 3rd day to the 5th day and take the biopsy on the 5th day. But while we wait from the 3rd to the 5th day, we can lose a lot of babies that could conceive when we put them in the womb, just because they don't come from the 3rd day to the 5th day in the laboratory. Genetic testing is done by taking one or a few cells from the embryos; may not reflect the entire embryo.
One study was done, from embryo biopsied on day 3. On the 5th day, another biopsy was taken from the same embryo, and on the 3rd day, some of the embryos that we call these unhealthy embryos were found to be healthy on the 5th day, and this rate is 25 percent. In other words, 1 out of 4 embryos can correct themselves when they pass from the 3rd day to the 5th day. How do we know that if we do a biopsy on the 5th day, it will not correct itself on the 7th day? Therefore, it can be useful in very selected cases. But we usually prefer to put the babies formed in the uterus, even if the age is advanced, to see if the baby is healthy after conception. At 12-13 weeks, we can clearly see whether the baby is healthy with today's technology.
Turkey Very Successful in IVF Treatment
From which countries do patients mostly come to Turkey for IVF treatment? Which factors are among the reasons why Turkey is preferred in IVF treatment?
Turkey is a country that is proudly successful in in vitro fertilization and is not lacking anywhere else in the world in terms of technology. First of all, we love both children and reproduction as a structure. Therefore, from all Turkic Republics; There is a serious preference for Turkey from Middle Eastern countries such as Iraq, Syria, Iran, Saudi Arabia, and even North African countries. Most of the Europeans come from Germany and mostly from countries such as Austria, Netherlands, Belgium and Kosovo where Turks live.'