We all know that ovarian function and the level of fertility decline with age and we might just need that extra help to conceive as we age. While standard IVF/ICSI treatments can be a solution for some, some other patients may need to explore added benefits of technology and innovation as well as "outside the box" treatments to achieve pregnancy.
At North Cyprus IVF Clinic, we have been offering "outside the box" treatment options for our patients when offering assisted reproductive treatments. Our new treatment option "Cytoplasmic Tandem IVF" is one such treatment option for patients with lowered ovarian reserves and poor egg quality. Cytoplasmic Tandem IVF combines the benefits of a "Tandem IVF Cycle" with "Cytoplasmic IVF Transfer" to give you the best of two worlds!
A Tandem IVF cycle means using your own eggs as well as donor eggs in a single IVF treatment cycle. This allows women to have a chance of pregnancy using their own eggs by also having donor eggs as their back-up plan should their own eggs do not provide good quality embryos, sufficient for an embryo transfer.
A Cytoplasmic IVF transfer also uses an egg donor and own eggs in a single cycle. But with cytoplasmic IVF, it is not the eggs of the egg donor that we are interested in but rather the cytoplasmic content of the eggs. We retrieve the cytoplasmic content of the egg donor's eggs and inject it into the eggs of the patient, thus, providing our patient's eggs with a better host environment for cellular growth and development and giving them a higher chance of success with their own eggs.
By combining the two treatments, we not only improve your chances of IVF success using your own eggs, but we also allow you to fertilize the rest of the donor eggs (the ones that are not used for their cytoplasm) with your partner's sperm sample. The embryos created by donor eggs can be frozen and preserved for a future date in case your treatment cycle fails and you decide to use donor eggs in the future. This way, you can have an IVF treatment where your personal success likelihood is maximized using your own eggs and where you are also given a back-up plan with donor eggs in a future IVF cycle should things don't work out as planned - All for a single cost of treatment!
Please contact us for more information!
One of the main problems facing IVF patients over 40 years of age is the decline in ovarian reserves. Every woman is born with a finite number of ovarian follicles and while a very small number of these follicles succeed in becoming a mature egg, majority of the rest of the follicles never reach ovulation and are disposed with every menstrual cycle. Around the age of 37, the decline in ovarian reserves becomes very sharp.
As a woman gets older, declining ovarian reserves is not the only problem faced in fertility. As age gets older, so do the follicles in the ovaries. Therefore, another problem called "oocyte aging" becomes more pronounced. This is in fact one of the main reasons why women above the age of 40 are more likely to experience a miscarriage- An aging oocyte will be associated with a number of genetic problems, causing the baby to have genetic mutations, thus leading to a miscarriage.
At North Cyprus IVF Center, we offer a comprehensive treatment approach for 40+ patients, which combines a number of important considerations in terms of ovarian reserves and oocyte aging. Patients who still ovulate, and who still have a minimal level of ovarian activity are ideal candidates for our 40+ treatment program. It is important that the female patient still has at least 1/2 pre-antral follicles to be recruited via controlled ovarian hyperstimulation so that we can offer a chance of success with own eggs. For patients with no ovarian function, then using an Egg Donor becomes the only option.
#1- Cytoplasmic IVF Treatment: Patients who still have a few oocytes, but cannot get pregnancy with those oocytes due to oocyte aging can possibly benefit from our cytoplasmic IVF treatment. The principle here is, we use the genetic material from the patient, but we provide the non-genetic parts of the egg from an egg donor so that the patient's own eggs have a friendlier host for optimal growth. It is a known fact that the mitochondria found in the cell's cytoplasm is responsible for cellular energy production and cell growth. By providing the patient's eggs with donor mitochondria, we allow the eggs to grow more optimally and become more viable.
#2- PGS for Genetic Screening: While Cytoplasmic IVF Treatment will allow your eggs to be more viable with higher fertilization potential, it will not be able to eliminate potential genetic risks associated with the age of the patient. Therefore, pre-implantation genetic screening is a good idea to make sure only the genetically correct embryos are transferred into the uterus. Keep in mind that we are not aiming for just any pregnancy. We are aiming for a healthy and viable pregnancy.
#3- Embryo Batching: Given that IVF treatment after a certain age will only allow us to have just a few eggs, any method that will allow us to get more eggs will increase our chances of success. Therefore, while we will be providing your eggs with a better host for optimal growth via cytoplasmic transfer, we still need a certain number of eggs so that we can make sure in the end we have at least one well-grown, genetically correct embryo to transfer. Embryo batching is the key component of success in this age bracket. Combining two rounds of IVF cycles into one allows us to get double the number of eggs- Essentially, what we do is, we prepare you for one round of IVF cycle where we collect the eggs, infuse them with donor cytoplasm, fertilize into embryos and freeze. Once you are ready for the second round, we collect another set of eggs, repeat the same procedures and make a new batch of embryos. With the two sets of embryos at hand, we proceed with pre-implantation genetic screening (PGS) and select a chromosomally normal embryo for transfer, thus giving you the maximum chance of success possible using your own eggs.
We give your eggs the maximum chance of survival through cytoplasmic transfer - we collect two rounds of eggs to increase your likelihood of success by creating multiple embryos - We make sure the embryos to be transferred are chromosomally euploid through PGS testing. This is how we are able to offer you the maximum chance of success possible with your own eggs.
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Some clinics have cut-off age for accepting patients into their IVF program. While the age may vary from one IVF program to the other, most European clinics will have an age limit between 43 and 47. There are two main reasons for having a cut-off age.
1- Each woman is born with a certain set of ovarian reserves and starting with puberty, hundreds of potential oocytes are lost during a menstrual cycle. The reserves keep declining as the age of the woman advances and eventually the reserve finishes once the woman reaches menopause. The ovarian function tends to fall below 20-25% of its starting numbers at the age of 35, and beyond the age of 40, chances of pregnancy with own eggs become very slim. Having a cut-off age for IVF treatment where the patient uses her own eggs avoids a very high risk of a negative treatment outcome and disappointment.
2- Having a cut-off age means not admitting patients who are not likely to succeed, which means the fertility clinic can keep its success rates high.
Whether we agree with this or not is not the main point. The main point is, should there be a cut-off age for trying with your own eggs? The answer is not so simple. Patients may not be willing to give up on their eggs just yet regardless of what the statistics might be saying. If there is a 1% chance, it means 1 in every 100 women will achieve success with treatment. While unfortunately 99 others won't be so lucky.
When it comes to using your own eggs, our clinic does not subscribe into age limitations. However, we make sure that you are well-informed about likely outcomes so that you can make your decision accordingly. For maximizing success wheh using your own eggs beyond a certain age, we have additional methods such as "Cytoplasmic IVF Treatment" that can potentially add a few percentages to your success statistics.
While we do not have an advertised age limit, we do not recommend IVF treatment using own eggs after the age of 47, which is the age of the oldest reported IVF pregnancy worldwide.
For more information on our recommendations for patients over 50 years of age, using donor eggs, please see our "IVF over 50" section.
Improvements in IVF technologies enable us to incorporate the use of additional techniques and procedures into our daily IVF practice. One such innovation in fertility treatments is Cytoplasmic IVF Treatment, sometimes referred to as the "Three parent Family". While the "Three parent family" has an interesting ring to it, it is more of a catchy phrase rather than being a fully correct statement.
Cytoplasmic IVF Treatment at North Cyprus IVF Centre has been offered since 2012. While it has been almost three years since we have brought this concept into practice, it is important to mention that this treatment is still in its infancy years and the number of cases performed are still far from creating accurate and statistically significant numbers. However, data so far suggests that cytoplasmic transfer is able to increase success rates by 4 to 5 percent compared to standard IVF/ICSI treatments.
What is Cytoplasmic IVF Treatment?
Cytoplasmic IVF Treatment is the treatment option suited for two types of patients:
- Patients with known mitochondria defects
- Patients in older age brackets with likely mitochondria defects due to oocyte aging.
As women age, so do their eggs. Just like any cell, the egg cells is consisted of a nucleus, which contains the genetic material as well as a cytoplasm, which surrounds the nucleus. Within the cytoplasm, there are many other organelles. One of the most important organelles in the the cell is mitochondrion (plural, mitochondria). Mitochondria are responsible for providing the cell with its energy, which facilitates cellular growth and development. As the oocyte (egg cell) ages, so do the mitochondria found within the egg cell. As the mitochondria age, they fail to provide sufficient amount of energy for growth and development, therefore, the egg cells start to lose their viability. This is precisely where cytoplasmic IVF treatment gets in the picture.
With cytoplasmic IVF treatment, a young, healthy and pregnancy proven egg donor is used, very much like an egg donation program. However, it is not the eggs, or the genetic material inside her eggs that we are interested in. Rather, we are interested in the cyoplasm of the donor's eggs. In cytoplasmic IVF treatment, we extract the cytoplasm of the donor's eggs and inject it into the eggs of the recipient. That way, we can provide a healthier cytoplasm (therefore mitochondria) for the growth and development of the recipient's eggs. In a way, we make the recipient's eggs' host environment more friendly for growth. This provides us with a higher chance of IVF success when the own eggs of a patient is used in more advanced age brackets.
However, it should be known that this treatment also has its limits. This is a treatment option which provides a healthier host for the growth and development of your own genetic material. This is not a method that can correct and genetic problems with your eggs that may come with age. If the main reason why you are not able to fall pregnant or experience miscarriages is due to genetic problems associated with oocyte aging, then cytoplasmic IVF treatment is not likely to generate desired results and in such cases, IVF with egg donation should be considered.
IVF with cytoplasmic transfer is mostly recommended for patients with known mitochondrial DNA defects, or patients in more advanced age brackets who still have some ovarian activity, but standard IVF treatments fail to succeed even though the patient has viable oocytes during treatment.
Please check out our "Cytoplasmic IVF Treatment" page for more information.
Dr. Savas Ozyigit
Egg donation in Cyprus, Gender selection in Cyprus and IVF treatments in North Cyprus in general: you will find information on new advances in IVF technology and latest IVF practices. All the blogs are personally written by Dr. Savas Ozyigit and his expert medical team.